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World No Tobacco Day: India’s tobacco habit is killing its voice — 1 in 3 oral cancer patients don’t survive five years

 

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India faces a growing oral cancer crisis, with tobacco use as a primary cause. Alarmingly, one-third of patients do not survive beyond five years

 1. Introduction: A Silent Epidemic

On May 31, World No Tobacco Day serves as a stark reminder of the devastating impact of tobacco on public health. In India, the situation is particularly dire, with the country accounting for nearly one-third of global oral cancer cases. This alarming statistic underscores the urgent need for awareness and action. 

Tobacco use, both in smoking and smokeless forms, is deeply ingrained in Indian culture. Products like gutka, paan, and khaini are widely consumed, often starting at a young age. This widespread usage has led to a surge in oral cancer cases, making it one of the most common cancers in the country.

Despite advancements in medical science, the prognosis for oral cancer patients in India remains grim. Approximately one in three patients diagnosed with oral cancer do not survive beyond five years. This high mortality rate is attributed to late diagnoses, lack of awareness, and limited access to quality healthcare.


2. The Prevalence of Oral Cancer in India

India's burden of oral cancer is unparalleled. According to the National Institute of Cancer Prevention and Research, oral cancer accounts for over 30% of all cancer cases in the country. This prevalence is significantly higher than in many other parts of the world. Cancer India

Several factors contribute to this high incidence. The cultural acceptance of tobacco chewing, combined with aggressive marketing by tobacco companies, has normalized its use. Moreover, the affordability and easy availability of these products make them accessible to all socioeconomic groups.

The situation is further exacerbated by a lack of awareness about the early signs of oral cancer. Many individuals dismiss symptoms like persistent mouth sores or difficulty swallowing, leading to delayed diagnoses and treatment.


3. Tobacco: The Primary Culprit

Tobacco use is the leading cause of oral cancer in India. Both smoking and smokeless forms of tobacco contain carcinogenic substances that damage the cells in the mouth, leading to cancerous growths.

Smokeless tobacco products, such as gutka and khaini, are particularly harmful. These products are often mixed with areca nut, which is also a known carcinogen. The combination significantly increases the risk of developing oral cancer.

The aggressive marketing tactics employed by tobacco companies have played a significant role in perpetuating tobacco use. Brightly colored packaging, flavored products, and endorsements by popular figures have made tobacco products appealing, especially to the youth. 


4. The Grim Reality: Survival Rates

The survival rates for oral cancer patients in India are disheartening. Studies indicate that only about 50% of patients survive beyond five years post-diagnosis. This rate is significantly lower compared to developed countries, where early detection and advanced treatment options have improved survival outcomes.

Several factors contribute to the low survival rates in India. Late-stage diagnoses are common, as many individuals seek medical attention only when the cancer has progressed significantly. Additionally, limited access to specialized healthcare facilities, especially in rural areas, hampers timely and effective treatment.

Furthermore, socioeconomic factors play a role. The cost of cancer treatment can be prohibitive for many, leading to discontinuation of therapy or opting for alternative treatments that may not be effective.


5. The Gender Shift: Rising Cases Among Women

Traditionally, oral cancer has been more prevalent among men in India, primarily due to higher tobacco consumption rates. However, recent trends indicate a worrying rise in cases among women. Data from R Ahmed Dental College in Kolkata revealed that in 2024, 133 out of 422 oral cancer cases were women, a significant increase from previous years. 

This shift is attributed to the increasing use of smokeless tobacco products among women. Cultural factors, peer pressure, and targeted marketing have contributed to this rise. Moreover, women often delay seeking medical attention due to societal stigmas and responsibilities, leading to late-stage diagnoses.

The narrowing gender gap in oral cancer incidence underscores the need for gender-specific awareness campaigns and interventions. Empowering women with knowledge about the risks associated with tobacco use and the importance of early detection is crucial in combating this trend.

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