Not just tobacco, alcohol can also cause oral cancer: Study

Studies have shown that about 60 percent of oral cancer cases in India have a five-year survival rate.

Not just smoking, alcohol consumption is also a major cause of oral cancer in many countries, a group of experts has found after the first evaluation of oral cancer prevention strategies.

The group of international experts conducted this study under the aegis of the International Agency for Research on Cancer (IARC) between September through December 2021 across 14 countries, including India.

Their report, published in the New England Journal of Medicine recently, calls for screening of high-risk populations by clinical oral examination to reduce mortality risks.

Smokeless tobacco, areca nut major villains

A wide range of genetic, environmental, and behavioural factors contribute to the risk of oral cancer, but they are dominated by the consumption of tobacco, both smoked and smokeless, and alcohol, says the report.

In fact, smokeless tobacco and chewing of areca nut products were the top causes of oral cancer in many countries, mainly in South and Southeast Asia, the report pointed out.

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Highlighting that there is paucity of data in the area of oral cancer prevention, the review called for additional research.

“Nonetheless, the working group established that cessation of tobacco and alcohol consumption, and areca nut use will contribute to a significant reduction in oral cancer risks,” it said.

Such measures will also contribute to the overall objective of the resolution on oral health adopted by the World Health Assembly in May 2021 to control and prevent oral diseases, including oral cancer, by 2030, the report noted.

“This is in an important review that should have policy implications for preventing oral cancer in India and several other countries,” senior oncologist Dr Ravi Mehrotra, a co-author of the paper, said. He is a former head of the Indian Council of Medical Research’s National Institute of Cancer Prevention and Research.

Oral cancer in India

It is the most common cancer in India among men (accounting for nearly 12 percent of all cancers), and the fifth-most frequently occurring cancer among women (4.3 percent of all cancers).

Several studies have directly associated tobacco with approximately 80 percent of oral cancers, mainly in older men over 40 years of age. But a worrying trend -- the rise in the incidence of this cancer among women and young adults – has emerged over the last few decades.

Youth and women are increasingly consuming smokeless tobacco either as imitation or peer pressure, it has been observed.

Studies have also shown that about 60 percent of oral cancer cases in India have a five-year survival rate, and this number has shown to increase from 70-90 percent merely through early detection in stages I and II.

In 2020, cancer in lips and oral cavity was estimated to rank 16th in incidence and mortality worldwide, and was a common cause of cancer deaths in men across much of South and Southeast Asia and the Western Pacific.