Oral cancer in India: an epidemiologic and clinical review

This article reviews the epidemiologic and clinical aspects of oral cancer in India, where the disease ranks number one among all cancers in male patients and number three among cancers in female patients. Causal association between oral cancer and the chewing of betel quids containing tobacco leaves or stem and other tobacco habits has been extensively studied. But there is need for more in-depth studies on the role of alcohol, diet, and oral hygiene practices in India. The exciting opportunity provided by the well-established oral precancerous lesions for intervention and early detection programs is also discussed. The peak age frequency of occurrence is at least a decade earlier than that described in Western literature. Sex ratio reveals a 2:1 preponderance of male patients. Only 10% to 15% of cases present in localized stages. The poor survival revealed by existing studies is mainly due to the overwhelming proportion of advanced cases. The excellent opportunity for more research and efforts in prevention and control of oral cancer in India is highlighted in this review.