Oral cancer screening in India: Insights from the National Family Health Survey-5

Oral cancer is the leading cancer among males and the fourth most common cancer in India. Primary screening is recommended for early detection of oral cancer among high-risk groups, particularly tobacco users, considering the long natural history of the disease. This study explores the contributing factors of oral cancer screening among adults aged 30-49 years in India based on National Family Health Survey-5 (NFHS-5) data.

Data on socio-demographics, tobacco and alcohol habits, and awareness about screening among those who underwent screening were obtained from the NFHS-5 survey. To account for rare events, Firth's logistic regression was used to identify the crude and adjusted odds ratio (AOR) and 95% confidence interval (CI) of potential factors of oral cancer screening.

The proportion of men who underwent oral cancer screening was 1.2%. Irrespective of the wealth index category, respondents from the southern regions and Union Territories had a high chance of getting screened. Furthermore, tobacco users (AOR = 1.31; 95% CI: 1.15, 1.49) and alcohol users (AOR = 1.39; 95% CI: 1.11, 1.75) had a higher likelihood of getting screened compared to non-users of these products.

The fifth round of NFHS has exposed the void in screening common cancers in India. Prioritizing screening for oral cancer among high-risk groups is essential in our country, where exposure to tobacco and betel quid products is relatively high. In short, coordinated efforts at the decentralized level to address prevention and early detection using trained healthcare providers could yield the best results in oral cancer control.