“Oral cancer: one of the most common cancers found in Indian population”

Today, the entire world is observing the World Cancer Day, an initiative led by the Union for International Cancer Control (UICC). Theme for this year is ‘Close the Care Gap’.

Some statistics — Global & India

In the year 2021, there was an estimated 20 million people diagnosed with cancer and 10 million have died. (WHO) It is the leading cause of death worldwide. According to Globocan data 2018, there were more than 11 lakh cases and over 7 lakhs deaths in India.

While all cancers can be treated, many of them can be prevented & cured, the numbers will continue to rise in the decades ahead.

The reasons for this continued rise in numbers are many. One big reason is “Inequity” around cancer care. There is a huge margin of difference in treatment between high (90%) and low (15%) income countries.

New cancer cases in 2020 worldwide, made on canva

Most common cancers, causes & risk factors

Globally, the most common cancers are breast, lung, colon, rectum and prostate. In India, they are breast, oral, cervical, gastric and lung cancers.

Globally, around one third of deaths from cancer are due to tobacco use, high BMI, alcohol, low consumption of fruits and vegetables.

Stages in cancer

Cancers are transformation and uncontrolled growth of normal cells to tumour cells. This transformations takes place in multi-stage process, that is from pre-cancerous lesion to deadly tumours. This happens due to the interaction of body genes with external elements like: UV & ionising radiation, tobacco, ALCOHOL, arsenic, bacterial infections, viruses and parasites.

Oral cancer in India

Oral cancer is defined as cancer (unexplained growth) of mouth parts like lip, cheeks, sinuses, tongue, etc. Oral cancers are very common in India. It is a major public health issue. Globally, India ranks second in oral cancer numbers. However, there are very few studies reporting the incidence of it.

Every year 77,000 new cases and 52,000 deaths are reported in India. Though it is preventive still a large number of population gets affected by it every year. People living with low incomes & with less exposure to dental health care, high tobacco use are more prone it. People with oral cancers are often presented to a doctor late for treatment. This delay not only brings difficulty but also brings an expensive treatment. A primary study was conducted to analyse the psychosocial factors affecting health seeking behaviour of oral cancer patients in India. 70 percent of the surveyed patients were at the advanced stage at the time of treatment.

Below image shows gender based classifications of oral cancer in India.

Gender based classification of oral cancers across India, image credit: Oral cancer diagnosis and perspectives in India (nih.gov)

Oral cancer stages

Treatment of any kinds begins with what level of problem one currently has. Cancer treatment is no different. What stage of oral cancer one has, is thus very important to determine.

Doctors use various diagnostic techniques to find what stage one person has. Initially, when traces of oral lesions in the mouth are observed by health care professional, he/she refers patient to the oral surgeon who conducts further tests. In India, self examination is considered to be the most effective method of early diagnosis of oral malignancy. Dentist could play a very important role in promoting dental care.

India which is considered as the world capital for oral cancers, needs both preventive and curative care to reduce the disease burden. Out of pocket expenses in treating oral cancers in India is huge, leaving patients to stop their treatment midway is another problem.