Metabolic Syndrome and Health-Related Behaviors Associated With Pre-Oral Cancerous Lesions Among Rural Adults in Taiwan

Purpose:

Few studies have explored associations among health-related behaviors, metabolic syndrome, and pre-oral cancerous lesions in disadvantaged areas. Pre-oral cancerous lesions (POC) are significantly associated with components of the metabolic syndrome. Therefore, the purpose of this study was to explore the associations of health-related behaviors, metabolic syndrome, and risk factors in adults with pre-oral cancerous lesions in rural, disadvantaged communities with a high prevalence of oral cancer.

Methods: This study was a series report of a nurse-led longitudinal study of health promotion for community health development in the southwestern coastal area of Yunlin County, Taiwan. Using a cross-sectional descriptive design, a community-based health screening survey of adult residents was conducted between August 2013 and July 2014. This study was conducted in collaboration with a local hospital and was approved by the institutional review board ethical committee. Assessed parameters included oral leukoplakia, oral submucous fibrosis, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, and waist circumference. Statistical analyses included descriptive statistics, chi-squared tests, and multivariate binary logistic regression.

Results:

The participants were selected using convenience samples from 27 villages of the southwestern coastal area. A total of 6823 community adults participated in the health survey. In total, 5161 participants met the criteria and enrolled for the full statistical analysis. Subjects had a mean age of 49.1 years (SD = 16.0 years), 55.8% were female, and 377 (7.3%) were identified as having POC lesions. High percentage of participants was found to have metabolic syndrome (40%). Participants with POC lesions tended to be male (p < .001), betel nut chewers (p < .001), and smokers (p < .001); have a low level of education (p < .001), seldom undergo dental check-ups (p < .01), irregularly participate in physical activity (p < .01), and have metabolic syndrome (p< .01).

Conclusion: The outcome supports the value of a nurse-led community health promotion program for oral cancer prevention. Although male sex and disadvantaged socioeconomic status are nonmodifiable factors associated with POC and metabolic syndrome in adults, several factors, notably health behaviors, are modifiable. Community health nurses can reduce the incidence and consequences of POC by developing programs for early detection, encouraging regular dental check-ups, and initiating individualized, health-promoting behavior modification programs for reducing risky behaviors associated with oral cancer.