Prevalence and determinants of oral premalignant and malignant lesions in Rural Konkan, India: A retrospective cross-sectional study from a preventive oncology outpatient department

Background: Preventive oncology outpatient departments (OPDs) have emerged as a pragmatic approach to improving early cancer detection in underserved rural India. However, data from the Konkan region remain limited. Objectives: This study estimated the prevalence of oral abnormalities and associated risk factors using methods for rare outcomes, including Firth’s penalized logistic regression and FDR correction.Methods: We conducted a retrospective cross-sectional analysis of ۷,۴۳۵ individuals screened at a preventive oncology OPD in rural Konkan between January ۲۰۲۴ and June ۲۰۲۵. Descriptive statistics summarized participant characteristics. Group comparisons used chi-square tests with FDR-adjusted p-values. The primary outcome was premalignant or malignant oral lesions (n = ۴۱); benign lesions were descriptive only. Firth’s penalized logistic regression addressed small-event bias. Model performance used calibration metrics and bootstrap validation (۱,۰۰۰ iterations). Sensitivity analyses were exploratory and hypothesis-generating.Results: The prevalence of any abnormal oral finding was ۰.۷۳% (۹۵% CI: ۰.۵۵–۰.۹۵). Premalignant lesions were identified in ۰.۳۶% (۲۷/۷,۴۳۵) and malignant lesions in ۰.۱۹% (۱۴/۷,۴۳۵), yielding a combined prevalence of ۰.۵۵% (۴۱/۷,۴۳۵). Smokeless tobacco use was reported by ۱۷.۳%, with gutka most common (۵۰%). Gutka users had higher lesion prevalence than other forms (۳.۱% vs. ۱.۷%), with an unadjusted OR of ~۱.۹. In penalized models, smokeless tobacco use (aOR ۳.۴۵), poor oral hygiene (aOR ۲.۸۹), and age ≥۵۰ (aOR ۲.۸۳) were significant. NNS was ۱۸۲ (۹۵% CI: ۱۳۵–۲۴۴).Conclusion: This study identifies smokeless tobacco use and poor oral hygiene as key correlates of oral premalignant and malignant lesions in a rural Konkan population. Findings are associative given the cross-sectional design, limited events, and potential residual confounding. Penalized regression and multiple-testing correction strengthen analysis, though limitations remain. Preventive oncology OPDs may support early detection, pending prospective, adequately powered external validation.

کلیدواژه ها:

Oral Potentially Malignant Disorders ، smokeless tobacco ، Oral hygiene ، Preventive oncology ، rural screening