Impact of oral potentially malignant disorder subtypes on all-cause and cause-specific mortality in males

Objectives: To quantify the effect of oral potentially malignant disorder (OPMD) subtypes on mortality from oral cancer and type 2 diabetes among areca nut chewers and/or cigarette smokers. Materials and Methods: A retrospective cohort design was devised to follow 14,749 men attending community-based screening program for oral cancer between 1998 and 2000 and followed until 2010. The Cox proportional hazards regression model was applied to assess the effect of OPMD on death. Results: A total of 1,291(8.75%) patients were detected as OPMD. Among those free of T2DM at baseline, the elevated risk for death from T2DM was noted for OSF (aHR = 3.62, 95% CI: 1.25–10.51) and erythroplakia (aHR = 5.01, 95% CI: 1.17–21.45). The elevated risk for all-cause death for OPMD was mainly explained by deaths from oral cancer and T2DM but not other causes of death. Conclusions: Oral potentially malignant disorder, particularly OSF and erythroplakia, in male cigarette smokers and/or areca nut chewers led to an incremental elevated risk of T2DM mortality in the way of being distal to the occurrence of T2DM, implying that early detection and prevention of OPMD may not only reduce oral cancer mortality but also result in the reduction of T2DM mortality.