Incidence And Prevalence
Cancer has overtaken heart disease as the world's top killer in 2011, part of a trend that will more than double global cancer cases and deaths by 2030, according to a study by World Health Organisation (WHO). Cancer diagnoses around the world have steadily been rising and are expected to hit 12 million this year. Global cancer deaths are expected to reach 7.9 million, according to the new report by WHO. That means new cancer cases will likely mushroom to 27 million annually by 2030, with deaths hitting 17 million.

Annually, over 3,00,000 new cases of oral cancer are diagnosed all over the world where the majority are diagnosed in the advanced stages III or IV. Such data make the oral cancer an important public health matter which is responsible for 3% to 10% of cancer mortality worldwide. It is therefore possible to conclude that, the incidence and mortality rates of oral cancer can be reduced by means of health promotion policies, early detection and healthy lifestyle.It is estimated that oral cancer deaths are due to tabacco use, unhealthy diets, alcohol consumption and inactive lifestyles.

The Global Scenario
There is a wide variation in the incidence and mortality rates of oral cancer in different regions around the world. Highest rates are reported in South Asian countries such as India and Sri Lanka. The Indian sub-continent accounts for one-third of the world burden. The incidence and mortality from oral cancer is rising in several regions of Europe, Taiwan, Japan and Australia. Every year in Europe, around 100,800 people are diagnosed with head and neck cancer and almost 40,000 die from the disease. In the USA alone, 30,000 Americans are diagnosed with oral or pharyngeal cancer each year. About 90 percent of head and neck cancers are of the squamous cell variety.

WHO - Oral cancer standardized incidence rate (1/100.000) per primary site from 1988 to 1993. Oral cancer incidence rates in four countries.
The following facts present a grim picture of the status worldwide :
  • Oral or oropharyngeal cancer is the eleventh most common cancer worldwide with over 300,000 new cases annually.
  • Tobacco use, including smokeless tobacco and excessive alcohol consumption are estimated to account for about 90% of oral cancers.
  • Usually cancer begins with white patches, leukoplakia or red patches, erythroplakia, associated with risk factors such as tobacco or/and alcohol.
  • Tobacco users – smoked, chewing or both – developed most oral lesions with an annual incidence rate ranging from 5.2/1,000 to 30.2/1,000, whereas non-user develop the fewest oral lesions ranging from 0.6/1,000.
  • An increasing number of young people are being affected and 25% of the cases have no associated risk factors.
The Indian Scenario
Oral cancer is the most common cancer in India; as 4 in 10 of all cancers are oral cancers. Annually 130,000 people succumb to oral cancer in India which translates into approximately 14 deaths per hour. The reason for high prevalence of oral cancer in India is primarily because tobacco is consumed in the form of gutka, quid, snuff or misri. Rising tobacco use in India, where 40 per cent of the world's smokers live has contributed to this trend. In comparison, in US oral cancer represents approximately 13% of all cancers thereby translating into 30,000 new cases every year.

Facts about oral cancer in India

  • Recently, a trend has been observed towards increased incidence of oral cancer among young adults. This increase in incidence is only observed in patients with tongue cancer.
  • In fact, in India, 60-80% of patients are present with advanced disease as compared to 40% in developed countries. Early detection would not only improve the cure rate, but it would also lower the cost and morbidity associated with treatment.
  • Increasing prevalence of oral submucous fibrosis, especially in younger individuals, caused by gutka, an industrially manufactured food item has been seen.

    The above facts state that, cancer cases in general, are increasing in India and it is high time that planners, social activists and government give adequate stress for prevention, early diagnosis, treatment and rehabilitation of these populations.

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