Increased severity of oral submucous fibrosis in young Pakistani men

Objective—To investigate the influence of age and sex on the incidence of severe oral submucous fibrosis (mouth opening 15 mm or less). Design—Case (severe disease) control (mild disease) study. Setting—University hospital, Pakistan. Subjects—147 patients with severe (mouth opening 15 mm or less) and 83 with mild disease (mouth opening 20 mm or more). Main measures—Influence of sex and age on severity of oral submucous fibrosis. Results—Men were twice as likely as women to have severe disease (odds ratio (OR) 2.0, 95% confidence interval (CI) of OR 1.15 to 3.47, P=0.02). Men in the 20–39 year age group were 4.8 times as likely as women to have severe disease (OR 5.8, 95% CI 2.15 to 15.5, P=0.00004). Men aged 40 years or more were 40% less likely to have severe disease than women (OR 0.6, 95% CI 0.19 to 1.88, P=0.39). Conclusions—Smoking increases the carcinogenic potential of submucous fibrosis. As men in this population smoke more than women, men with severe oral submucous fibrosis may develop oral cancer and die younger. Alternatively, young men may consume more areca nut than women.