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The chief strengths of this study are the large sample size, quality control of the baseline survey, availability of a partial resurvey (allowing assessment of the long-term relevance of the information collected at baseline), active follow-up of deaths (ensuring near-completeness, except in demolished areas), verbal autopsy methods (allowing better assessment of causes of death than from official records and reducing the number of unspecific and unknown causes of death), the experience of the Chennai-based researchers in conducting large-scale epidemiological studies (which also accounts for the studys location) and exclusion of individuals with chronic disease at recruitment (helping avoid biases owing to reverse causality)

Normal squamous cells become cancerous when their DNA changes and cells begin growing and multiplying