Browsing by Author "Ariyaratne, M.A.Y."

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    Aetiological factors of oral cancer in Sri Lanka
    (Sri Lanka Medical Association, 2008) Kasturiratne, A.; Ariyaratne, M.A.Y.; Wickremasinghe, A.R.
    OBJECTIVE: To determine aetiological factors of oral cancer in three provinces in Sri Lanka DESIGN, SETTING AND METHODS: A matched case-control study on incident cases of oral cancer and age-sex matched neighbourhood controls was conducted in three provinces of Sri Lanka. Risk factors were analysed using matched pair analyses and conditional logistic regression. RESULTS: Among 658 subjects (329 pairs) [males= 82.1%, mean age = 61.6 (30=12.2) years], a higher monthly income, regular betel chewing, age at starting chewing, duration of a chew, retaining the quid in the mouth at night, regular smoking, duration of smoking, amount smoked daily, type of smoke used, regular alcohol consumption and amount of illicit liquor consumed daily were significantly associated with oral cancer on bivariate analysis. Past history of cancer, family history of cancer and family history of cancer of head and neck were also associated with oral cancer. A higher income (OR=0.65; 95% CI 0.44-0.96) and high consumption of raw fruits (OR=0.64; 95% CI 0.46-0.89) were protective. Regular betel chewing (OR=1.94; 95% CI 1.23-3.07), retaining the quid in the mouth at night (OR=20.45; 95% CI 7.23-57.89), consumption of illicit liquor (OR=4,65; 95% CI 2.49-8.71) and the amount smoked per day (OR=1.04 95% CI 1.01-1.07) were significantly associated with oral cancer on multivariate analysis. CONCLUSIONS: Betel chewing is the most important determinant of oral cancer. Retaining the quid in the mouth should be discouraged. The importance of family history demands for preventive programmes for family members of patients.
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    Survival pattern and prognostic factors of oral cancer in Sri Lanka
    (Sri Lanka Medical Association, 2008) Kasturiratne, A.; Ariyaratne, M.A.Y.; Wickremasinghe, A.R.
    BACKGROUND: Oral cancer is the commonest cancer among men and the second commonest overall in Sri Lanka. Obj ective: To determine the survival pattern and prognostic factors of oral cancer. DESIGN, SETTING AND METHODS: A cohort of patients who were treated for oral cancer at the National Cancer Institute, Maharagama (NCIM) from 1991 to 2000 was traced to their homes to obtain socio-demographic and survival information. Disease and treatment related information were extracted from patient records. The survival of untraced patients was taken up to the last day of contact and censored. RESULTS: Of the 750 patients [mean age-60.6 (SD=11.2) years; males=77.9%] studied, 548 (73.1%) were traced. 465 were dead, and 83 patients were alive on lsl January 2006. Overall 5-year survival rate was 24%. Patients diagnosed in early stages and who underwent surgery had a significantly higher median survival. Overall survival was significantly better in patients who were diagnosed early, patients who had surgery and in patients diagnosed between 1991-1995. The survival probabilities at selected time points were significantly different between patients diagnosed early vs. late, who received surgery vs. not, and patients with cancers of the oral cavity vs. cancers of the oro-pharynx. Age (hazards ratio (HR)=1.01), stage at diagnosis (HR=2.34), waiting time for treatment (HR=0,99) and year of diagnosis (HR=1.21) were significantly associated with survival in Cox's regression analysis. CONCLUSIONS: Established prognostic factors like age, stage at diagnosis and waiting time for treatment are important in Sri Lanka. While the year of diagnosis needs further evaluation, early detection and prompt treatment will be very important for improving survival.