Smoking-Alcohol-Sex Exposure and Knowledge About Oral and Oropharyngeal Cancer Among Brazilian Adolescents: An Exploratory-Observational Approach

Santos, Gracielle Bezerra Gracino dos; Wanderley, Arthur Eric Costa; Menezes, Pedro de Lemos; Santos, Vanessa de Carla Batista dos; Barbosa, Kevan Guilherme Nóbrega; Ferreira, Sonia Maria Soares

doi:10.1590/pboci.2020.084

Gracielle Bezerra Gracino dos Santos

Professional Master in Health Research, Cesmac University Center, Maceió, AL, Brazil.

http://orcid.org/0000-0003-2461-224X

Arthur Eric Costa Wanderley

School of Dentistry, Cesmac University Center, Maceió, AL, Brazil.

http://orcid.org/0000-0001-8286-1805

Pedro de Lemos Menezes

Professional Master in Health Research, Cesmac University Center, Maceió, AL, Brazil.

http://orcid.org/0000-0003-1999-5055

Vanessa de Carla Batista dos Santos

Professional Master in Health Research, Cesmac University Center, Maceió, AL, Brazil.

http://orcid.org/0000-0002-3990-327X

Kevan Guilherme Nóbrega Barbosa Author to whom correspondence should be addressed: Kevan Guilherme Nóbrega Barbosa, Mestrado Profissional Pesquisa em Saúde, Centro Universitário Cesmac, Rua Cônego Machado, 918, Farol, Maceió, AL, Brazil 57051-160. Phone: +55 83 998393586. E-mail: kevanguilherme@gmail.com.

Professional Master in Health Research, Cesmac University Center, Maceió, AL, Brazil.

http://orcid.org/0000-0002-9410-7356

Sonia Maria Soares Ferreira

Professional Master in Health Research, Cesmac University Center, Maceió, AL, Brazil.

http://orcid.org/0000-0002-4825-171X

Author to whom correspondence should be addressed: Kevan Guilherme Nóbrega Barbosa, Mestrado Profissional Pesquisa em Saúde, Centro Universitário Cesmac, Rua Cônego Machado, 918, Farol, Maceió, AL, Brazil 57051-160. Phone: +55 83 998393586. E-mail: kevanguilherme@gmail.com.

Academic Editors: Alessandro Leite Cavalcanti and Wilton Wilney Nascimento Padilha

Authors’ Contributions

GBCS Investigation, Writing - Original Draft Preparation and Writing - Review and Editing.

AECWInvestigation, Writing - Original Draft Preparation and Writing - Review and Editing.

PLM Formal Analysis, Validation and Writing - Review and Editing.

VCBS Conceptualization, Methodology and Writing - Review and Editing.

KGNB Formal Analysis, Validation and Writing - Review and Editing.

SMSF Conceptualization, Methodology, Supervision and Writing - Review and Editing.

All authors declare that they contributed to critical review of intellectual content and approval of the final version to be published.

Conflict of Interest

The authors declare no conflicts of interest.

	Gender			OR^unadjusted
Variables	Boy	Girl	Total	(CI-95%)	p-value
	N (%)	N (%)	N (%)
Age
14 Years	11 (39.3)	17 (60.7)	28 (100.0)	1
15 Years	70 (43.2)	92 (56.8)	162 (100.0)	1.17 (0.51-2.66)	0.69
16 Years	61 (57.0)	46 (43.0)	107 (100.0)	2.04 (0.87-4.79)	0.09
17 Years	26 (44.8)	32 (55.2)	58 (100.0)	1.25 (0.50-3.14)	0.62
18 Years	15 (38.5)	24 (61.5)	39 (100.0)	0.96 (0.35-2.61)	0.94
19 Years	10 (33.3)	20 (66.7)	30 (100.0)	0.77 (0.26-2.26)	0.63
Location of Institute
Arapiraca	14 (38.9)	22 (61.1)	36 (100.0)	0.78 (0.32-1,87)	0.58
Coruripe	8 (33.3)	16 (66.7)	24 (100.0)	0.61 (0.22-1.69)	0.34
Maceió	22 (44.9)	27 (55.1)	49 (100.0)	1
Maragogi	22 (57.9)	16 (42.1)	38 (100.0)	1.68 (0.71-3.96)	0.23
Marechal Deodoro	9 (42.9)	12 (57.1)	21 (100.0)	0.92 (0.32-2.58)	0.87
Murici	7 (25.0)	21 (75.0)	28 (100.0)	0.40 (0.14-1.13)	0.08
Palmeira dos Índios	21 (60.0)	14 (40.0)	35 (100.0)	1.84 (0.76-4.43)	0.17
Penedo	7 (29.2)	17 (70.8)	24 (100.0)	0.50 (0.17-1.43)	0.20
Piranhas	13 (40.6)	19 (59.4)	32 (100.0)	0.84 (0.34-2.07)	0.70
Santana do Ipanema	11 (44.0)	14 (56.0)	25 (100.0)	0.96 (0.36-2.54)	0.94
Satuba	26 (49.1)	27 (50.9)	53 (100.0)	1.18 (0.54-2.57)	0.67
Viçosa	35 (57.4)	26 (42.6)	61 (100.0)	1.65 (0.77-3.52)	0.19
Grade
1^st year	122 (47.5)	135 (52.5)	(100.0)	1
2^nd year	53 (50.5)	52 (49.5)	(100.0)	1.12 (0.71-1.77)	0.60
3^rd year	9 (37.5)	15 (62.5)	(100.0)	0.66 (0.28-1.57)	0.66
4^th year	11 (27.5)	29 (72.5)	(100.0)	0.42 (0.20-0.87)	0.02
Ethnicity Self-Reported^* * Indigenous were excluded as 2 expected frequencies < 5.
Brown	117 (47.2)	131 (58.3)	248 (100.0)	1.25 (0.77-2.01)	0.35
White	40 (41.7)	56 (52.8)	96 (100.0)	1
Black	33 (46.5)	38 (53.5)	71 (100.0)	1.21 (0.65-2.25)	0.53

	Gender			OR^unadjusted
Variables	Boy	Girl	Total	(CI-95%)	p-value
	N (%)	N (%)	N (%)
Have you ever tried cigarette smoke even one or two puffs?
Yes	19 (38.8)	30 (61.2)	49 (100.0)	0.73	0.31
No	173 (46.4)	200 (53.6)	373 (100.0)	1
During your life, on how many days have you had at least one drink of alcohol?
1 or 2 Days	44 (44.4)	55 (55.6)	99 (100.0)	1
3 to 9 Days	19 (45.3)	23 (54.8)	42 (100.0)	1.03	0.93
10 to 19 Days	17 (54.8)	14 (45.3)	31 (100.0)	1.51	0.31
≥ 20 Years	19 (39.6)	29 (60.4)	48 (100.0)	0.81	0.57
How old were you when you had your first drink of alcohol other than a few sips?
17 or More Years Old	7 (36.8)	12 (63.2)	19 (100.0)	1
15 or 16 Years Old	33 (47.1)	37 (52.9)	70 (100.0)	1.52 (0.53-4.34)	0.42
13 or 14 Years Old	35 (38.0)	57 (62.0)	92 (100.0)	1.05 (0.37-2.92)	0.92
11or 12 Years Old	20 (50.0)	20 (50.0)	40 (100.0)	1.71 (0.56-5.25)	0.34
≤ 9 Years Old	12 (54.5)	10 (45.5)	22 (100.0)	2.05 (0.58-7.21)	0.26
During the past 30 days, on how many days did you have at least one drink of alcohol?
0 Days	152 (47.8)	166 (52.2)	318 (100.0)	1
1 or 2 Days	18 (29.5)	43 (70.5)	61 (100.0)	0.45 (0.25-0.82)	0.01
3 to 5 Days	11 (45.8)	13 (54.2)	24 (100.0)	0.92 (0.40-2.12)	0.85
≥ 6 Days	11 (61.1)	7 (38.9)	18 (100.0)	1.71 (0.64-4.54)	0.27
During the past 30 days, how did you usually get alcohol you drank?
Convenience Store, Supermarket or Gas Station	12 (66.7)	6 (33.3)	18 (100.0)	^a a Not calculated: 6 expected frequencies < 5;	^a a Not calculated: 6 expected frequencies < 5;
I Bought it at a Restaurant, Bar, or Club	4 (33.3)	8 (66.7)	12 (100.0)	^a a Not calculated: 6 expected frequencies < 5;	^a a Not calculated: 6 expected frequencies < 5;
I Bought at Parties, Shows or Sporting Events	11 (44.0)	14 (56.0)	25 (100.0)	^a a Not calculated: 6 expected frequencies < 5;	^a a Not calculated: 6 expected frequencies < 5;
I Gave Someone Money	1 (14.3)	6 (85.7)	7 (100.0)	^a a Not calculated: 6 expected frequencies < 5;	^a a Not calculated: 6 expected frequencies < 5;
Someone Gave it to Me	8 (24.2)	25 (75.8)	33 (100.0)	^a a Not calculated: 6 expected frequencies < 5;	^a a Not calculated: 6 expected frequencies < 5;
A Family Member Gave Me	4 (36.4)	7 (63.6)	11 (100.0)	^a a Not calculated: 6 expected frequencies < 5;	^a a Not calculated: 6 expected frequencies < 5;
Other Way	2 (40.0)	3 (60.0)	5 (100.0)	^a a Not calculated: 6 expected frequencies < 5;	^a a Not calculated: 6 expected frequencies < 5;
Have you ever had sexual intercourse?
Yes	70 (57.9)	51 (42.1)	121 (100.0)	2.16 (1.40-3.32)	<0.001
No	113 (38.8)	178 (61.2)	291 (100.0)	1
How old were you when you had sexual intercourse for the first time?
19-18 Years	4 (44.4)	5 (55.6)	9 (100.0)	^b b Not calculated: 1 expected frequency < 5;	^b b Not calculated: 1 expected frequency < 5;
17-16 Years	17 (45.9)	20 (54.1)	37 (100.0)	^b b Not calculated: 1 expected frequency < 5;	^b b Not calculated: 1 expected frequency < 5;
15-14 Years	28 (58.3)	20 (41.7)	48 (100.0)	^b b Not calculated: 1 expected frequency < 5;	^b b Not calculated: 1 expected frequency < 5;
< 13 Years	21 (80.8)	5 (19.2)	26 (100.0)	^b b Not calculated: 1 expected frequency < 5;	^b b Not calculated: 1 expected frequency < 5;
During your life, with how many people have you had sexual intercourse?
1 Person	22 (42.3)	30 (57.7)	52 (100.0)	1
≥ 2 People	46 (68.7)	21 (31.3)	67 (100.0)	2.98 (1.40-6.35)	0.004
During the past 3 months, with how many people have you had sex intercourse?
1 Person	24 (40.0)	36 (60.0)	60 (100.0)	1
≥ 2 People	19 (76.0)	6 (24.0)	25 (100.0)	4.75 (1.65-13.6)	0.004
Did you drink alcohol or use drugs before you had sexual intercourse the last time?
Yes	9 (75.0)	3 (25.0)	12 (100.0)	^c c Not calculated: 1 expected frequency < 5.	^c c Not calculated: 1 expected frequency < 5.
No	70 (59.8)	47 (40.2)	117 (100.0)	^c c Not calculated: 1 expected frequency < 5.	^c c Not calculated: 1 expected frequency < 5.
The last time you had sexual intercourse, did you or your partner use a condom?
Yes	29 (35.8)	52 (64.2)	81 (100.0)	0.53 (0.24-1.15)	0.10
No	20 (51.3)	19 (48.7)	39 (100.0)	1

	Gender			OR^unadjusted
Questions	Boy	Girl	Total	(IC-95%)	p-value
	N (%)	N (%)	N (%)
Have you ever heard about HPV?
Yes	223 (57.3)	166 (42.7)	(100.0)	4.79 (2.02-11.3)	<0.001
No	7 (21.9)	25 (78.1)	(100.0)	1
Do you think that an infected person with HPV would feel symptomatology?
Yes	164 (57.7)	120 (42.3)	284 (100.0)	0.33 (0.12-0.91)	0.03
No	61 (49.6)	62 (50.4)	123 (100.0)	0.46 (0.16-1.31)	0.46
Do Not Know	6 (31.6)	13 (68.4)	19 (100.0)	1
Can orogenital contact transmit HPV?
Yes	98 (44.3)	123 (55.7)	221 (100.0)	0.84 (0.53-1.32)	0.45
No	31 (39.7)	47 (60.3)	78 (100.0)	0.69 (0.38-1.25)	0.22
Do Not Know	54 (48.6)	57 (51.4)	111 (100.0)	1
Can contact with skin and mucosa transmit HPV?
Yes	33 (47.8)	36 (52.2)	69 (100.0)	0.96 (0.53-1.76)	0.91
No	96 (41.7)	134 (58.3)	230 (100.0)	0.75 (0.48-1.19)	0.75
Do Not Know	54 (48.6)	57 (51.4)	111 (100.0)	1
Can contact with intimate objects transmit HPV?
Yes	56 (40.0)	84 (60.0)	140 (100.0)	0.69 (0.41-1.14)	0.15
No	73 (45.6)	87 (54.4)	160 (100.0)	0.87 (0.53-1.41)	0.57
Do Not Know	54 (49.1)	56 (50.9)	110 (100.0)	1
Can sexual intercourse using condom transmit HPV?
Yes	10 (40.0)	15 (60.0)	25 (100.0)	0.70 (0.29-1.70)	0.43
No	119 (43.4)	155 (56.6)	274 (100.0)	0.81 (0.52-1.26)	0.35
Do Not Know	54 (48.6)	57 (51.4)	111 (100.0)	1
Have you ever heard about oral cancer?
Yes	89 (40.8)	129 (59.2)	128 (100.0)	1
No	104 (50.7)	101 (49.3)	205 (100.0)	1.49 (1.01-2.19)	0.04
Have you ever heard about oropharyngeal cancer?
Yes	38 (40.0)	57 (60.0)	95 (100.0)	1
No	154 (47.4)	171 (52.6)	325 (100.0)	1.35 (0.84-2.15)	0.20
Do you think that HPV can cause oral cancer?
Yes	89 (46.1)	104 (53.9)	193 (100.0)	1.36 (0.90-2.08)	0.14
No	65 (38.5)	104 (61.5)	169 (100.0)	1
Do you think that HPV can cause oropharyngeal cancer?
Yes	82 (47.4)	91 (52.4)	173 (100.0)	1.49 (0.97-2.29)	0.06
No	65 (37.6)	108 (62.4)	173 (100.0)	1
Tobacco is a risk factor for oral / oropharyngeal cancer?
Yes	127 (43.1)	168 (56.9)	295 (100.0)	0.65 (0.34-1.24)	0.20
No	45 (51.1)	43 (48.9)	88 (100.0)	0.91 (0.43-1.89)	0.80
Do Not Know	23 (53.5)	20 (46.5)	43 (100.0)	1
Alcohol is a risk factor for oral / oropharyngeal cancer?
Yes	81 (43.8)	104 (56.2)	185 (100.0)	0.67 (0.34-1.31)	0.25
No	91 (46.0)	107 (54.0)	198 (100.0)	0.74 (0.38-1.43)	0.37
Do Not Know	23 (53.5)	20 (46.5)	43 (100.0)	1
Sun exposure is a risk factor for oral / oropharyngeal cancer?
Yes	21 (56.8)	16 (43.2)	37 (100.0)	1.14 (0.47-2.76)	0.77
No	151 (4.6)	195 (56.4)	346 (100.0)	0.67 (0.35-1.27)	0.22
Do Not Know	23 (53.5)	20 (46.5)	43 (100.0)	1

Questions	OR^adjusted (CI-95%)	p-value	β
Have you ever heard about HPV?
Yes	4.76 (1.70-13.6)	0.003	1.56
No	1
Have you ever heard about oral cancer?
Yes	1
No	1.60 (1.03-2.49)	0.03	0.47
Do you think that HPV can cause oropharyngeal cancer?
Yes	1.57 (1.01-2.45)	0.04	0.45
No	1

[1] Author to whom correspondence should be addressed: Kevan Guilherme Nóbrega Barbosa, Mestrado Profissional Pesquisa em Saúde, Centro Universitário Cesmac, Rua Cônego Machado, 918, Farol, Maceió, AL, Brazil 57051-160. Phone: +55 83 998393586. E-mail: kevanguilherme@gmail.com.

Brasil

Brasil

Smoking-Alcohol-Sex Exposure and Knowledge About Oral and Oropharyngeal Cancer Among Brazilian Adolescents: An Exploratory-Observational Approach

Abstract

Objective:

Material and Methods:

Results:

Conclusion: