Tobacco – Still the leading cause of Oral Cancer!

Dr. Mayuri Rajapurkar,
Consultant Head & Neck Surgeon,
Aster Medcity, Kochi

Tobacco consumption at high levels

Oral cancer is the sixth most common malignancy in the world. It is of particular significance in India where there is a worrying rise in Oral cancer. And fingers point to tobacco as the leading cause with the Global Adult Tobacco Survey India conducted by the Ministry of Health and Family Welfare revealing that 35% of adults used tobacco.

A report of the Indian Council for Medical Research states that cancers of the mouth and tongue taken together are more than cancers of the lung, and in cities such as Delhi, Mumbai, Aurangabad and Kollam, cancer of the mouth is the second most common cancer among males.

The Danger

Tobacco in all its forms is the single greatest risk factor for oral cancer. Be it smoking it in the form of cigarettes, cigars, pipes, bidis, hookahs and even smokeless tobacco or chewing tobacco, oral snuff, khaini (oral tobacco with lime), mawa, mishri, nass (naswar, niswar), zarda that is often mixed with areca nut (supari) and with betel leaf (paan).

Even second-hand smoke is hazardous. The use of betel leaf with tobacco increases the risk of oral cancer 2-6 times compared to smoking tobacco. Hookahs (water pipes) are harmful too as there still exist high levels of toxic compounds and carcinogens even after passing through water.

Nicotine is believed to have carcinogenic potential. Tobacco can damage cells in the lining of the oral cavity and oropharynx. Because of this damage, cells start to grow more rapidly to repair the damage with an increased risk of turning cancerous. It is believed that DNA-damaging chemicals in tobacco are linked to the increased risk of oral cancer.

Apart from cancer, tobacco is a risk factor for over 25 diseases including other life-threatening conditions such as heart disease, stroke and lung disease. Cigarettes also contain other toxic substances like formaldehyde and acetaldehyde which are carcinogenic, nitrosamines, heavy metals.

The World Health Organization (WHO) reports the worldwide death toll from tobacco use is 4 million annually. The death toll is expected to rise to 10 million per year by the 2020’s, with 7 million deaths occurring in developing countries. The WHO estimates that there are approximately 1.1 billion regular smokers in the world, which is one-third of the global population aged 15 years and older.

And there is one thing that is deadlier than tobacco and that is tobacco and alcohol together. Heavy drinkers who are heavy smokers have a 35 times increased risk of oral cancer compared to non-smokers and non-drinkers.

There is hope!

All tobacco related oral cancers can be primarily prevented by avoiding these addictive items in your lifestyle. The risk of developing these cancers can be reduced by stopping these habits.

Early detection also helps in finding the cancer and treating it at an early stage. This can be through regular oral examination and check-ups. A simple oral examination in clinic with early detection has been proven to improve survival outcomes. With improved public health education and promotion, the fight against oral cancer can be won!