Analysis of Sub-Mucous Fibrosis and Micronucleus in Tobacco and Supari Users: A Review

Introduction: Oral cancer is one of the most prevalent cancers worldwide including India. The most common cause of oral cancer has been established as tobacco chewing. Tobacco and Supari are chewed by people all over the world. But the long-time consumption of tobacco and Supari can lead to many diseases related to mouth like Trismus (reduced opening of the jaw), oral leukoplakia, erythroplakia that can eventually develop into oral cancer. OSF (oral sub-mucous fibrosis) is a precancerous condition that can develop into squamous cell carcinoma. Chewing of areca nut can also damage the exfoliated cell of buccal mucosa in which the frequency of micronucleus, an indicator of genetic damage increase as well as increased cytogenetic damage can be seen in the peripheral blood lymphocytes and exfoliated buccal mucosal cells of pan masala chewers. The current review work explores the role of tobacco and supari chewing habits in causing precancerous lesions that have the potential to ultimately develop into oral cancer. Methods: We conducted a thorough electronic search by Cochrane, EMBASE and PubMed to identify relevant studies. Studies published on the role of tobacco and supari and such products on the development of oral sub-mucous fibrosis and eventually oral cancer were included. Studies on micronucleus assay in reference to oral cancer development were also included. After assessing and selecting articles based on eligibility criteria, studies were analyzed and elaborated according to the objective. Results: The various studies successfully established the huge role that tobacco and supari products play in the carcinogenesis process and early prelesions are significant in these users that can be utilized for early diagnosis and treatment.