India and Sri Lanka have the highest rates of oral cancer worldwide. Oral cancers can usually be detected just by clinical examination by a dentist. Despite this, 60-80 percent of oral cancers in India are diagnosed at a late stage, which results in high mortality and morbidity.

Oral cancers detected at an early stage can be successfully treated, with high cure rates and a good prognosis. However, detection at an advanced stage requires aggressive treatment, involving chemotherapy, radiotherapy and surgery, which often have a poor outcome.

Oral Cancer: Facts & Figures

• 11^th most common cancer worldwide
• 640,000 cases are diagnosed every year worldwide
• 460,000 people will die of oral cancer each year worldwide by 2030
• Oral cancer kills one person, every hour, every day, all year round
• 40 percent of newly diagnosed oral cancer patients will die within 5 years
• Incidence of oral cancer has increased by one-third over the past decade
• Around 60,000 people will be diagnosed with oral cancer over the next decade
• 85 percent of all head and neck cancers worldwide are due to oral cancer
• Oral cancer is more prevalent above the age of 40 years
• 25 percent of oral cancer cases are not associated with any risk factors
• Oral cancer risk in men is double that of women

Oral Cancer: Warning Signs

• A mouth ulcer that refuses to heal within three weeks
• Red or white patches inside the mouth or on the lips
• Unusual lumps, swellings, or thickened tissues in the mouth or neck
• Pain and tenderness inside the mouth
• Numbness in lower lip and chin
• Difficulty swallowing, chewing or speaking
• Loose teeth and bleeding in the mouth

Oral Cancer Prevention: Indian Initiatives

• National Oral Health Program: The National Oral Health Program was drafted by the Indian Dental Association (IDA), which highlights the importance of oral health for overall health, wellbeing and quality of life. The program aims to ensure 'Optimal Oral Health for All by 2020'
• National Oral Cancer Registry: The National Oral Cancer Registry is an initiative of IDA that collects data on oral cancer and precancerous conditions. It accesses data from population-based and hospital-based cancer registries
• Oral Cancer Foundation: The Oral Cancer Foundation is a "Call to Action" Program led by dental professionals, which aims to improve oral health and reduce the burden of oral cancer in India
• Tobacco Intervention Initiative: This is a "Call to Action" Program that is aimed at eradicating tobacco addiction for creating a 'Tobacco Free India' and promoting oral health for all Indians 

The Way Forward

It will be possible to forge a way forward by properly addressing the following key areas:

• Education: Access to accurate information and knowledge can empower the people to make informed choices about health issues, including oral cancer
• Prevention: Preventive and risk reduction strategies are important as these can effectively reduce the number of oral cancer cases
• Equity & Access: Access to oral health facilities should be available to all, irrespective of social standing, so that oral cancer can be detected early and treated promptly
• Government Action: Proactive action by the government in the area of health planning and execution could reduce the burden of oral cancer to create a healthy nation
• Social Support: Providing social support is an important aspect of the management of cancer patients. This involves not only physical, but also emotional and mental support
• Economics: Financial investment in cancer prevention and control can be more cost-effective than cancer treatment and will ensure economic gains by increased productivity of a healthy workforce
• Training: Increased numbers of adequately trained healthcare professionals will help to reduce the skills gap that currently exists and is a major hindrance towards effective cancer control

This April, let us all get together to raise awareness about oral cancer across the globe to ensure 'Optimal Oral Health for All by 2020'.

References :

1. Coelho KR. Challenges of Oral Cancer Burden in India. J Cancer Epidemiol. 2012; 2012: 701932 - (http://dx.doi.org/10.1155/2012/701932)
2. Indian Council for Medical Research (ICMR). Three-Year Report of Population Based Cancer Registries 2012-2014. Bengaluru, India: National Center for Disease Informatics and Research - National Cancer Registry Program, 2016.  - (http://ncdirindia.org/NCRP/ALL_NCRP_REPORTS/PBCR_REPORT_2012_2014/ALL_CONTENT/PDF_Printed_Version/Preliminary_Pages_Printed.pdf)
3. Oral Cancer Awareness Month - American Dental Association - (https://www.ada.org/en)
4. Mouth Cancer Action Month - Oral Health Foundation, UK - (https://www.dentalhealth.org/pages/category/mouth-cancer-action-month)
5. Global Data on Incidence of Oral Cancer - World Health Organization - (https://www.who.int/oral_health/publications/oral_cancer_brochure.pdf?ua=1)
6. Mouth Cancer - Mouth Cancer Foundation, UK  - (https://www.mouthcancerfoundation.org/get-info/mouth-cancer)
7. National Oral Cancer Registry - Indian Dental Association - (http://nocr.org.in/#/home)
8. Oral Cancer Foundation - Indian Dental Association  - (http://ocf.org.in/#/home)
9. Tobacco Intervention Initiative - Indian Dental Association - (http://tii.org.in/#/home)

Source: Medindia