|Year : 2019 | Volume
| Issue : 4 | Page : 207-209
Knowledge and risk perception of oral cancer among rickshaw drivers in Karad City, Maharashtra, India
Hitesh Patil, Nupura A Vibhute, Unnati Shah, Rajendra Baad, Uzma Belgaumi, Vidya Kadashetti, Sushma Bommanavar, Wasim Kamate
Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
|Date of Submission||25-May-2018|
|Date of Decision||05-May-2019|
|Date of Acceptance||11-Jul-2019|
|Date of Web Publication||21-Nov-2019|
Nupura A Vibhute
Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to be University, Karad - 415 110, Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Rickshaw drivers, who provide an important mode of public transport in urban and semiurban areas in India, are exposed to harmful environmental pollutants, unhealthy lifestyle, irregular meals, poor work posture, and most importantly habits such as tobacco and alcohol. Keeping all this in view, the present study was planned to analyze the knowledge and risk perception of oral cancer among rickshaw drivers in Karad city. Materials and Methods: This cross-sectional, descriptive study was carried out among 300 autorickshaw drivers of Karad city from Western Maharashtra, India. The questionnaire used consisted of various items including tobacco and alcohol consumption, their working hours, and more importantly their awareness toward oral cancer including its early symptoms as well as their self-perceived risk assessment. Results: Out of the 300 autorickshaw drivers studied in the present study, 260 (86.7%) were either smoking or chewing tobacco in some of its forms. Only 36 (12%) of 300 participants thought they should undergo regular screening for oral cancer. Conclusion: Thus, the findings of this study reflect a significant need of increasing cancer awareness among the population of rickshaw drivers. Targeted counseling programs and oral cancer screening programs would enable catching the early signs of cancer and nipping it in its bud.
Keywords: Awareness, oral cancer, rickshaw drivers
|How to cite this article:|
Patil H, Vibhute NA, Shah U, Baad R, Belgaumi U, Kadashetti V, Bommanavar S, Kamate W. Knowledge and risk perception of oral cancer among rickshaw drivers in Karad City, Maharashtra, India. CHRISMED J Health Res 2019;6:207-9
|How to cite this URL:|
Patil H, Vibhute NA, Shah U, Baad R, Belgaumi U, Kadashetti V, Bommanavar S, Kamate W. Knowledge and risk perception of oral cancer among rickshaw drivers in Karad City, Maharashtra, India. CHRISMED J Health Res [serial online] 2019 [cited 2019 Dec 9];6:207-9. Available from: http://www.cjhr.org/text.asp?2019/6/4/207/271335
| Introduction|| |
Oral cancer is a major problem in the Indian subcontinent, where it ranks among the top three types of cancer in the country. Early cancer detection significantly reduces the morbidity and mortality associated with the disease. Hence, knowledge and awareness of oral cancer is an important tool in the fight against cancer. For example, tobacco and alcohol users over the age of 40 years are at the highest risk for this disease, but often do not appreciate their own heightened risk status.,
Rickshaw drivers, who provide an important mode of public transport in urban and semiurban areas in India, constitute a unique population in this regard. These drivers are exposed to harmful environmental pollutants, unhealthy lifestyle, irregular meals, poor work posture, and most importantly habits such as tobacco and alcohol. Thus, the present study was planned to assess the knowledge and risk perception of oral cancer among rickshaw drivers in Karad city.
| Materials and Methods|| |
This cross-sectional, descriptive study was carried out among 300 autorickshaw drivers of three-wheeler nonmotorized vehicle of Karad city from Western Maharashtra, India, after obtaining the ethical clearance from the institutional ethical committee.
Participants were explained the purpose of the study and their informed consent was obtained. The pretested questionnaire used included questions regarding tobacco and alcohol consumption, their working hours, and awareness toward oral cancer including its early symptoms as well as their self-perceived risk assessment. Data were entered using the SPSS Version 19.0 and were analyzed (IBM Corp., Armonk, NY, USA).
The permission was taken from Institutional Ethics Committee prior to starting the project. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
| Results|| |
In the present study, out of 300 autorickshaw drivers, maximum were in the 21–40 years' age group, including 102 (34%) in the age group of 31–40 years and 83 (27.7% in the age group of 21–30 years as indicated in [Table 1].
Consumption of tobacco products and alcohol showed a high prevalence with 260 (86.7%) and 204 (68%), respectively, from the study population. Only 25 (8.3%) responders had ever tried to quit tobacco and 32% of responders had abstained from alcohol drinking.
In the study population, TV and radio were the most popular source 278 (92.7%) for providing information regarding causes and prevention of cancer, while 45 (15%) gathered the harmful effects of tobacco from the cigarette packing as indicated in [Table 2].
|Table 2: Distribution of sources of information regarding cancer among the participants|
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Regarding early symptoms of cancer, a nonhealing mouth ulcer, growth in mouth, and bleeding gums were the commonly known findings with 239 (79.7%), 183 (61%), and 160 (53.3%) out of 300 participants, respectively, as indicated in [Table 3].
|Table 3: Awareness regarding signs and age-wise distribution of the study population|
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When the responders were asked if they thought they were at risk for development of cancer, only 19 (6.3%) out of 300 rickshaw drivers replied in affirmative. Only 36 (12%) out of 300 participants thought they should undergo regular screening for oral cancer as depicted in [Table 4].
|Table 4: Attitude toward cancer risk perception and screening among the participants|
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| Discussion|| |
Rickshaw drivers constitute a unique working class of the population, who work tirelessly behind the wheels, ferrying passengers from one destination to the next, without adequate food, rest, and sleep. These people often have odd working hours with frequent changes to their work schedule often compounded by delays and breakdowns, leading to constant changes to their sleep patterns and other regular lifestyle functions.
Very few studies in India have assessed the prevalence of oral diseases among people employed in specific occupational groups like the autorickshaw drivers. Hence, this study was designed to determine the oral cancer-related knowledge and self-perceived risk perception among this population of autorickshaw drivers.
In the present study, out of 300 autorickshaw drivers, 185 (61.7%) were in the 21–40 years' age group. This is similar to the findings of the study conducted by Ray et al., where among total study participants, 52% belonged to 20–40 years of age. In a similar study conducted in Jaipur city, Rajasthan, majority 46.8% of participants were in the age group of 21–35 years. Conventionally, oral cancer was considered as a disease mainly affecting people of older ages, a predominant in the third and fourth decades of life. Thus, this unique vulnerable age group should now be targeted in cancer awareness and prevention programs.
High tobacco (86.7%) and alcohol (68%) consumption prevalence in our study is comparable to the findings of the study conducted by Ray et al., where 61.4% of participants consumed tobacco. In another study conducted in Dhaka city, the prevalence of smoking was 20.9%, whereas a similar study conducted in Jaipur, Rajasthan, found that the prevalence of smokeless tobacco consumption was 87%. A study conducted in North Central India found that the prevalence of smoking and tobacco chewing was 52.25% and 64.25%, respectively.
The burden of tobacco-related cancers in India by 2001 has been estimated to be nearly 0.33 million cases annually. It is predicted that there will be 7-fold increase in the incidences of tobacco-related cancer morbidity between 1995 and 2025 and 220% increase of cancer deaths. Hence, awareness regarding tobacco and alcohol should be pivotal in cancer awareness programs for the general population.
Up to 70% of oral cancers are preceded by precancerous oral lesions, such as persistent red or white patches in the mouth. In the present study, though nonhealing mouth ulcer was recognized as an early sign of cancer by 259 (79.7%) responders, other signs such as pain or difficulty in swallowing were poorly identified with only 67 (22.3%) and 77 (24.3%) out of 300 identifying these as signs of oral cancer, respectively. Early recognition of signs and symptoms is of paramount importance in significantly reducing the fatality rate and tissue destruction associated with various treatment modalities such as surgical excisions. This factor should be incorporated in designing the awareness programs when used for mass education.
Self-perceived risk and willingness to undergo regular oral cancer screening was not encouraging in this study as only 19 (6.3%) out of 300 rickshaw drivers appreciated the risk and only 36 (12%) out of 300 participants thought they should undergo regular screening for oral cancer. Oral health professionals are in a strong position to screen high-risk patients for early signs of oral cancer, yet the opportunity for a simple oral examination is frequently missed. Regular visits to a dentist for thorough oral health checkup are imperative.
| Conclusion|| |
Thus, the findings of this study reflect a significant need of increasing cancer awareness among the population of rickshaw drivers. Targeted counseling programs and oral cancer screening programs would enable catching the early signs of cancer and nipping it in its bud. The authors' experience on conducting such as awareness and oral screening camp elicited a positive feedback and follow-up of suspicious cases contributed in the prevention of potential oral cancer development. Similar studies with larger sample size and dedicated programs and regular screening camps for these transport workers can be a huge step in improving their lives.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Elango JK, Gangadharan P, Sumithra S, Kuriakose MA. Trends of head and neck cancers in urban and rural India. Asian Pac J Cancer Prev 2006;7:108-12.
Smart CR. Screening for cancer of the aerodigestive tract. Cancer 1993;72:1061-5.
Lowry RJ, Craven MA. Smokers and drinkers awareness of oral cancer: A qualitative study using focus groups. Br Dent J 1999;187:668-70.
Horowitz AM, Moon HS, Goodman HS, Yellowitz JA. Maryland adults' knowledge of oral cancer and having oral cancer examinations. J Public Health Dent 1998;58:281-7.
John JR, Kesavan P, Sridharan P, Rajendran G. Evaluation of oral health status among road transport drivers in Erode district of Tamil Nadu. J Oral Health Comm Dent 2016;10:35-9.
Gambhir RS, Nirola A, Singh J, Sekhon T, Anand S. Periodontal health status of transport workers of a union territory in India: A cross-sectional study. J Indian Soc Periodontol 2015;19:312-6.
] [Full text]
Ray NK, Awate R, Narasannavar A, Angolkar M, Patil N, Kari A. A cross-sectional study on pattern of tobacco consumption and effects on health among auto rickshaw drivers in Nehru nagar, Belagavi city. Int J Healthc Biomed Res 2017;5:102-8.
Rewar S, Poonia N, Singh NK. A cross-sectional study on tobacco consumption pattern among auto rickshaw drivers in Jaipur city, Rajasthan. J Humanit Soc Sci 2013;14:88-91.
Gupta B, Ariyawardana A, Johnson NW. Oral cancer in India continues in epidemic proportions: Evidence base and policy initiatives. Int Dent J 2013;63:12-25.
Rahman M, Nurullah Awal AS, Fukui T, Sakamoto J. Prevalence of cigarette and bidi smoking among rickshaw pullers in Dhaka city. Prev Med 2007;44:218-22.
Bhatia M, Mishra A, Agrawal A. Prevalence and pattern of tobacco addiction among auto-rickshaw drivers of North central India. Asian Pac J Health Sci 2014;1:312-8.
Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009;45:309-16.
Jin L, Lamster I, Mossey P, Naidoo S, Verenne B, Warnakulasuriya S, et al
. Oral Diseases and health. The challenge of oral disease – A call for global action. In: The Oral Health Atlas. 2nd
ed. Geneva: FDI World Dental Federation; 2015. p. 12-37.
[Table 1], [Table 2], [Table 3], [Table 4]