Betel quid with tobacco, khaini, and gutka are some of the smokeless tobacco products that are responsible for the rapid rise of oral cancer cases in India. Areca nut or betel nut has also helped India in topping South Asia in oral cancer cases, according to a new study. This type of cancer affects the mouth and the back of the throat. It not only leaves your throat sore, but you can also have difficulty swallowing, chewing or even speaking. The rising cases of oral cancer in India are alarming. It is also a major health concern in countries like Bangladesh, Pakistan, China, and Myanmar.

Study on oral cancer

India was found to have the highest number of oral cancer cases in South Asia, as per a study led by the International Agency for Research on Cancer (IARC), and published in The Lancet Oncology in October 2024. Gutka, betel quid with tobacco, khaini, and areca nut are some of the smokeless tobacco products that are widely consumed in India. These products were found to be the major causes of the rise in oral cancer cases in the country. Betel nut, often wrapped in betel leaf, is regarded as a type 1 carcinogen, as per a 2015 research published by the National Library Of Medicine.

India has highest number of oral cancer cases in South Asia. Image courtesy: Adobe Stock

India accounted for 83,400 of the 120,200 oral cancer cases in the world in 2022, according to the study. Betel nut consumption (30 percent) was found to be the leading cause of oral cancer cases among women in India. This was followed by betel quid with tobacco (28 percent), gutka (21 percent) and khaini (21 percent). Among men, khaini (47 percent) was the main reason behind them having oral cancer. Other causes were gutka (43 percent), betel quid with tobacco (33 percent) and betel nut (32 percent).

After India, oral cancer was found to be common in Bangladesh (9,700), and Pakistan (8,900). The list also included China (3,200), Myanmar (1,600), Sri Lanka (1,300), Indonesia (990), and Thailand (785).

“Smokeless tobacco and areca nut products are available to consumers in many different forms across the world, but consuming smokeless tobacco and areca nut is linked to multiple diseases, including oral cancer,” said Dr Harriet Rumgay, a scientist in the Cancer Surveillance Branch at IARC.

The study also highlighted that 31 percent of all oral cancer cases could be avoided by not consuming smokeless tobacco and betel nut.

What is oral cancer?

Oral cancer is a term often used to describe a number of cancers that start in the mouth area. They develop under, and at the base of the tongue, and on the tissue lining the gums and mouth. The area of the throat at the back of the mouth is also affected, according to the US National Institute of Dental and Craniofacial Research.

Apart from smokeless tobacco and areca nut products, oral cancer, which usually occurs in people over the age of 40, is also caused by alcohol, and the human papilloma virus. Here are the causes:

• Using pipe, cigarette, and cigar, and electronic cigarette smoking can lead to oral cancer.
• Chewing tobacco also puts you at risk for developing oral cancer.
• Heavy alcohol use also increases the risk. Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) may lead to oral cancer.
• Oral cancer risk increases with age.
• Cancer of the lip can be due to excessive sun exposure.
• A diet with less fruits and vegetables may cause oral cancer.
• Individuals with inherited defects in genes may cause middle throat and mouth cancer.

Loss of voice is one of the symptoms of oral cancer. Image courtesy: Freepik

Symptoms of oral cancer

• Irritation in the lip, mouth or throat
• A red or white patch in the mouth
• Persistent sore throat
• Loss of voice
• A lump in the neck
• Difficulty chewing, and swallowing
• If you find it hard to speak
• Difficulty moving the jaw
• Bleeding in the mouth
• Numbness in the mouth

If you notice any of these symptoms for more than 14 days, go to a doctor.

How to diagnose oral cancer?

Early detection is important, as oral cancer can easily spread. An oral cancer examination, which is painless, can detect early signs of cancer.

• During the oral cancer examination, your dentist will check your mouth, the back of the throat face, neck, and lips for possible signs of cancer.
• If your dentist finds anything unusual, you will be asked to go to a specialist.

Oral cancer treatment

Oral cancer can be treated with surgery, as per the US National Institute of Dental and Craniofacial Research. You may be referred to:

• Head and neck surgeons
• Dentists who specialise in surgery of the mouth, jaw, and face.
• Ear, nose, and throat doctors.
• Medical and radiation oncologists, who are doctors who specifically treat cancer

You may also be asked to undergo radiation therapy or chemotherapy. Targeted therapy is another option that uses drugs to precisely identify then attack the cancer cells. Immunotherapy as oral cancer treatment may work with the body’s natural defenses to improve immune function.

Oral cancer is a cause of concern in India, and other countries. But you can prevent it by staying away from tobacco, and products like betel nut.

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