Oral Cancer in India

Cancer is the second most common cause of mortality in India today after heart disease. Oral cancer is the 11^th most common cancer in the world. It accounts for two third deaths in the developing world; out of which one third occurs in the Indian Subcontinent. Oral Cancer is responsible for a huge impact on the health of the community. In comparison with the U.S. population, where oral cavity cancer represents only about 3% of malignancies, it accounts for over 30% of all cancers in India.

The causes:

Tobacco use and Alcohol are known risk factors for cancers of the oral cavity. Estimates indicate 57% of all men and 11% of women between 15–49 years of age use some form of tobacco. Besides smoking, use of smokeless tobacco is also widely prevalent; the use of Pan is very common and is accepted socially and culturally in many parts of India.

Additionally, gutka, zarda, kharra, mawa, and khainni (mostly practiced in Bihar, Jharkhand and Uttar Pradesh) are also widely used by people.

How does the habit start?

Acquisition of the tobacco habit typically occurs early in life through imitation of a family member or peers. Various studies carried out across the country report that at least a third of school students less than 15 years of age have used one form or another of tobacco.

However, with improved public health education, the prevalence of these risk factors is decreasing around the globe, including in India.

Lack of awareness & self detection:

Despite the fact that the oral cavity is can be easily detected early by visual self examination, oral cancers are typically detected in their advanced stages. In fact, in India, 60–80% of patients present with advanced disease as compared to 40% in developed countries. This aspects lead to higher mortality rates.

Early detection would not only improve the cure rate, but it would also lower the cost and morbidity associated with treatment. Mouth self-examination could further reduce the cost of the screening and increase awareness in high-risk communities in India. Such a simple and cost-effective strategy has the potential to have a significant impact on the awareness of oral cancer in the broader community.