553 © 2019 Annals of Medical and Health Sciences Research Original Article Review Article How to Cite this Article: Basha S, et al. The Prevalence of Oral Cancer in Saudi Arabia – A Systematic Review. Ann Med Health Sci Res. 2019;9: 553- 557 This is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as the author is credited and the new creations are licensed under the identical terms. Introduction Oral cancer (OC) refers to malignancies in the mucosal lip, tongue and oral cavity associated with alcohol consumption, exposure to tobacco or both and rarely by traumatic irritation of chronic nature and exposure to human papillomavirus (HPV). [1] Globally, OC is reported to be the tenth most commonly diagnosed cancer with an annual incidence of >300,000 cases. Incidence and mortality of OC are higher in developing countries when compared with developed countries is due to the combined effect of the aging of populations, and the high or increasing levels of prevalence of cancer risk factors. [1] In Kingdom of Saudi Arabia (KSA) lymphoma and leukemia are most common malignancies and oral cancer stands in 3rd position. [2] Among all the head and neck cancers detected yearly in KSA, oral cancer accounts for as much as 26 percent, a majority of them in advanced stage receiving palliative treatment. The frequent use of smokeless tobacco (Shammah and Quat) is considered a strong attribute in the high prevalence of oral cancer in KSA. Several authors [2-13] have documented that the high frequency of oral cancer predominantly in Jazan province and other areas of the southwestern region of the KSA is invariably related to consumption of Shammah. No previous publication has systematically reviewed the existing literature to summarize the prevalence of oral cancer in KSA. The present systematic review is conducted to assess the prevalence and causative factors of oral cancer in KSA. Materials and Methods This review was planned, conducted, and reported in adherence to PRISMA standards of quality for reporting systematic reviews and meta-analyses. [14] The present review was registered in PROSPERO with registration number CRD42017057791. Study eligibility We included studies published in English language only that investigated the prevalence of oral cancer in KSA. Papers were excluded at this stage if they were an editorial letter, case report, in vitro, not investigating the prevalence of OC in KSA. Study identifcation Various research database were searched which include, MEDLINE, CINAHL, EMBASE, Educational Resources Information Center (ERIC), PsychInfo, Scopus and ISI Web of Science using key terms focused on the specifc search strategy (oral, mouth, oral cavity, intraoral, oral mucosa, cancer, malignancy, tumor, carcinoma, malignant, squamous cell carcinoma, prevalence, frequency, epidemiology, incidence, rate, trend, Saudi Arabia, Kingdom of Saudi Arabia). In addition, three key Saudi Journals (Saudi Medical Journal, Annals of Saudi Medicine, Saudi Dental Journal) were searched from their table of contents for relevant articles. No beginning The Prevalence of Oral Cancer in Saudi Arabia – A Systematc Review Sakeenabi Basha 1 *, Roshan Noor Mohamed 2 , Yousef Al-Thomali 3 and Ammar Saleh Al Shamrani 4 1 Department of Preventive and Community Dentistry, Taif University, Taif, KSA; 2 Department of Pedodontics, Taif University, Taif, KSA; 3 Department of Orthodontics, Taif University, Taif, KSA; 4 Department of Endodontics, Taif University, Taif, KSA Corresponding author: Sakeenabi Basha, Department of Preventive and Community Dentistry, Taif University, Taif, KSA, Tel: +966538418544; E-mail: reachdocsaki@gmail.com Abstract Background: Oral cancer is the 10 th most common cancer in the world and third most common cancer in Saudi Arabia. Objectives: The present systematic review is conducted to assess the prevalence and causative factors of oral cancer in Saudi Arabia. Materials and Methods: This review conducted in adherence to PRISMA standards of quality for reporting systematic reviews and meta-analyses and was registered in PROSPERO with registration number CRD42017057791. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was December 2018. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Efective Public Health Practice Project (EPHPP). Results: A total of 82 studies were identifed for screening, and 9 studies were eligible. All the studies were retrospective hospital records based. Oral cancer prevalence varied from 21.6% to 68.6%. Male to female ratio varied from 36.6% to 65.4%. Use of smokeless form of tobacco, Shamma was the main cause for oral cancer. Conclusions: The present review showed a very high prevalence of oral cancer in Saudi Arabia with the main causative agent the use of smokeless tobacco Shamma. Keywords: Systematic review; Oral cancer; Saudi Arabia; Prevalence