Risk Factors of Oral Leukoplakia in Iraqi Patients: A Case Control Study

Abstract

Background: Oral leukoplakia is a precancerous condition that causes white and grey patches inside the mouth. The patches are hyperplastic lesions of oral squamous epithelium, with some cases tending to malignancy. The WHO Collaboration Centre for oral cancer identified 11 oral disorders as potentially malignant disorders, and oral leukoplakia was the most frequent finding in clinical practice. There are several risk factors for the development of oral leukoplakia. These factors will be evaluated and assessed in this study in Iraqi patients.

Aim: To determine the risk factors for oral leukoplakia in Iraqi patients.

Methods: A case-control study was conducted in Osol Al-elm University College’s clinics from the 3rd of March 2021 to 17th August 2024. The study included 331 patients divided into two groups: a case group included 131 patients with oral leukoplakia (n=131) and a control group included 200 patients (n=200) who attended the outpatient clinics. Any patient with oral leukoplakia visiting dental clinics in Osol Al-elm University College is included in the study and regarded as a case group. In contrast, the control group is selected haphazardly from patients visiting dental clinics for one reason or another. Criteria for selecting the control group include: age of more than 20 years for both sexes (males and females).

Results: In this study, the age of the patient was evaluated as a risk factor for oral leukoplakia. The mean age for the case group was 55.46 with SD±8.5, while for the control group, 44.9 with SD±13.5. Regarding the age, patients aged more than 50 years are associated with increased risk for oral leukoplakia (P value = 0.01), especially the age group 50-59 years old as shown in fig. 1.

Regarding the gender: sex difference was not significantly associated with leukoplakia (P value= 0.4), as 73 patients out of 131 with oral leukoplakia are males while 58 out of 131 are females comparing with control group as male patients are 112 out of 200, while females are 88 out of 200, showing no significant difference between the two groups. Considering smoking as a risk factor, heavy smoking patients are associated with increased risk for oral leukoplakia (P value 0.04).

Conclusion: The current study identifies 2 risk factors for the development of oral leukoplakia in Iraqi patients. These risk factors were age and cigarette smoking, while excluding gender and denture use as risk factors for the development of oral leukoplakia.