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Non-parametric verification using Mann-Whitney U testing corroborated the parametric analysis findings (p=0.009), demonstrating that the observed differences were not dependent on distributional assumptions

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An important conclusion was that while chewing tobacco is considered a carcinogen, the literature predominantly examined its relationship with lip, oral cavity, and esophageal cancer, highlighting the need for more high-quality studies on associations with other cancers of the head and neck

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Morbidity and Mortality Weekly Report, 2018