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Fig. 4.5 Squamous cell carcinoma. A Exophytic growth involving the left buccal mucosa and overlying skin in a 65 year old male who chewed betel quid and smoked tobacco. B An exophytic growth arising from the left palate. C Squamous cell carcinoma of the tongue. D Early squamous cell carcinoma of lateral border of the tongue.

Fig. 4.5 Squamous cell carcinoma. A Exophytic growth involving the left buccal mucosa and overlying skin in a 65 year old male who chewed betel quid and smoked tobacco. B An exophytic growth arising from the left palate. C Squamous cell carcinoma of the tongue. D Early squamous cell carcinoma of lateral border of the tongue.

cal step in the multistage process of carcinogenesis at these sites.

Prevention

Recent work on risk factors in younger cases emphasises the importance of early and heavy tobacco and alcohol use, the protective effect of diets rich in fresh fruits and vegetables, but with a substantial minority without these established risk factors {1534}. The protective effect of diets rich in trace elements and antioxidant vitamins is well demonstrated in many countries, especially in Italian studies {1628,2563}. Though more controversial, a contribution from poor oral hygiene is also suggested {108,2548}.

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