Omar Museedi, Bashar Abdullah, Saman Warnakulasuriya
{"title":"中东地区文化习俗与口腔癌风险：一项系统综述。","authors":"Omar Museedi, Bashar Abdullah, Saman Warnakulasuriya","doi":"10.1111/odi.70060","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To systematically review evidence on how cultural practices influence oral squamous cell carcinoma (OSCC) risk in Middle-Eastern populations.</p><p><strong>Methods: </strong>This PRISMA-conform systematic review searched PubMed, Scopus, and regional databases (1990-Dec 2024) for studies examining cultural practices and OSCC risk in the Middle East. Forty studies were qualitatively synthesized; 20 provided data for random-effects meta-analyses.</p><p><strong>Results: </strong>Smokeless tobacco (shammah: pooled OR 3.9, 95% CI 2.5-6.2) and qat chewing (pooled OR 2.7, 1.9-3.8) were major risk factors, exhibiting dose-response relationships and contributing to significant regional incidence variations. Opium use was associated with increased risk in one Iranian study (OR 2.55, 1.47-4.43). Waterpipe (pooled OR 2.6, 1.8-3.9) and cigarette smoking (pooled OR 3.7, 2.9-4.8) also significantly increased risk. A Mediterranean dietary pattern showed protection (pooled OR 0.6, 0.4-0.9). Education below secondary level tripled risk (pooled OR 2.6, 1.9-3.5). Female-to-male incidence ratios approached parity in high-shammah use regions, diverging from typical global patterns.</p><p><strong>Conclusions: </strong>Culturally embedded, dose-dependent tobacco and qat habits are primary drivers of OSCC risk in the Middle East, modified by sex and socioeconomic status. Prevention strategies must extend Framework Convention measures to smokeless tobacco, address combined tobacco-qat use, and employ gender- and equity-sensitive approaches, guided by the unique cultural context.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cultural Practices and Oral Cancer Risk in the Middle East: A Systematic Review.\",\"authors\":\"Omar Museedi, Bashar Abdullah, Saman Warnakulasuriya\",\"doi\":\"10.1111/odi.70060\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To systematically review evidence on how cultural practices influence oral squamous cell carcinoma (OSCC) risk in Middle-Eastern populations.</p><p><strong>Methods: </strong>This PRISMA-conform systematic review searched PubMed, Scopus, and regional databases (1990-Dec 2024) for studies examining cultural practices and OSCC risk in the Middle East. Forty studies were qualitatively synthesized; 20 provided data for random-effects meta-analyses.</p><p><strong>Results: </strong>Smokeless tobacco (shammah: pooled OR 3.9, 95% CI 2.5-6.2) and qat chewing (pooled OR 2.7, 1.9-3.8) were major risk factors, exhibiting dose-response relationships and contributing to significant regional incidence variations. Opium use was associated with increased risk in one Iranian study (OR 2.55, 1.47-4.43). Waterpipe (pooled OR 2.6, 1.8-3.9) and cigarette smoking (pooled OR 3.7, 2.9-4.8) also significantly increased risk. A Mediterranean dietary pattern showed protection (pooled OR 0.6, 0.4-0.9). Education below secondary level tripled risk (pooled OR 2.6, 1.9-3.5). Female-to-male incidence ratios approached parity in high-shammah use regions, diverging from typical global patterns.</p><p><strong>Conclusions: </strong>Culturally embedded, dose-dependent tobacco and qat habits are primary drivers of OSCC risk in the Middle East, modified by sex and socioeconomic status. Prevention strategies must extend Framework Convention measures to smokeless tobacco, address combined tobacco-qat use, and employ gender- and equity-sensitive approaches, guided by the unique cultural context.</p>\",\"PeriodicalId\":19615,\"journal\":{\"name\":\"Oral diseases\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-08-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oral diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/odi.70060\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oral diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/odi.70060","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Cultural Practices and Oral Cancer Risk in the Middle East: A Systematic Review.
Objective: To systematically review evidence on how cultural practices influence oral squamous cell carcinoma (OSCC) risk in Middle-Eastern populations.
Methods: This PRISMA-conform systematic review searched PubMed, Scopus, and regional databases (1990-Dec 2024) for studies examining cultural practices and OSCC risk in the Middle East. Forty studies were qualitatively synthesized; 20 provided data for random-effects meta-analyses.
Results: Smokeless tobacco (shammah: pooled OR 3.9, 95% CI 2.5-6.2) and qat chewing (pooled OR 2.7, 1.9-3.8) were major risk factors, exhibiting dose-response relationships and contributing to significant regional incidence variations. Opium use was associated with increased risk in one Iranian study (OR 2.55, 1.47-4.43). Waterpipe (pooled OR 2.6, 1.8-3.9) and cigarette smoking (pooled OR 3.7, 2.9-4.8) also significantly increased risk. A Mediterranean dietary pattern showed protection (pooled OR 0.6, 0.4-0.9). Education below secondary level tripled risk (pooled OR 2.6, 1.9-3.5). Female-to-male incidence ratios approached parity in high-shammah use regions, diverging from typical global patterns.
Conclusions: Culturally embedded, dose-dependent tobacco and qat habits are primary drivers of OSCC risk in the Middle East, modified by sex and socioeconomic status. Prevention strategies must extend Framework Convention measures to smokeless tobacco, address combined tobacco-qat use, and employ gender- and equity-sensitive approaches, guided by the unique cultural context.
期刊介绍：
Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.
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