{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T01:55:36Z","timestamp":1785894936825,"version":"3.56.0"},"reference-count":53,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,10,27]],"date-time":"2015-10-27T00:00:00Z","timestamp":1445904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2016,3,15]]},"abstract":"<jats:p>The International Agency for Research on Cancer (IARC) has concluded that there is sufficient evidence in humans for the carcinogenicity of smokeless tobacco (SLT) for mouth, oesophagus and pancreas, based largely on Western studies. We wanted to confirm this by conducting a systematic review using Indian studies because India faces the biggest brunt of SLT\u2010attributable health effects. A systematic search was conducted for published and unpublished studies. Two authors independently reviewed the studies and extracted data. Summary odds ratio (OR) for each cancer type was calculated using fixed and random effects model. The population attributable fraction (PAF) method was used to calculate the attributable burden of incident cases. A significant association was found for oral\u20145.55 (5.07, 6.07), pharyngeal\u20142.69 (2.28, 3.17), laryngeal\u20142.84 (2.18, 3.70), oesophageal\u20143.17 (2.76, 3.63) and stomach\u20141.26 (1.00, 1.60) cancers. But in random effects model, laryngeal\u20141.79 (0.70, 4.54) and stomach\u20141.31 (0.92, 1.87) cancers became non\u2010significantly associated. Gender\u2010wise analysis revealed that women had a higher risk (OR\u2009=\u200912.0 <jats:italic>vs<\/jats:italic>. 5.16) of oral but a lower risk (1.9 <jats:italic>vs<\/jats:italic>. 4.5) of oesophageal cancer compared with men. For oral cancer, studies that adjusted for smoking, alcohol and other factors reported a significantly lower OR compared with studies that adjusted for smoking only or smoking and alcohol only (3.9 <jats:italic>vs<\/jats:italic>. 8.4). The annual number of attributable cases was calculated as 49,192 (PAF\u2009=\u200960%) for mouth, 14,747 (51%) for pharynx, 11,825 (40%) for larynx, 14,780 (35%) for oesophagus and 3,101 (8%) for stomach.<\/jats:p>","DOI":"10.1002\/ijc.29884","type":"journal-article","created":{"date-parts":[[2015,10,7]],"date-time":"2015-10-07T09:00:48Z","timestamp":1444208448000},"page":"1368-1379","source":"Crossref","is-referenced-by-count":88,"title":["Smokeless tobacco\u2010associated cancers: A systematic review and meta\u2010analysis of <scp>I<\/scp>ndian studies"],"prefix":"10.1002","volume":"138","author":[{"given":"Dhirendra N.","family":"Sinha","sequence":"first","affiliation":[{"name":"Surveillance, (Tobacco Control), Tobacco Free Initiative Unit World Health Organization, Regional Office for South\u2010East Asia New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizwan Suliankatchi","family":"Abdulkader","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Velammal Medical College Hospital and Research Institute Madurai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash C.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Healis \u2010 Sekhsaria Institute for Public Health Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10,27]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Smokeless tobacco and public health: a global perspective. 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