Oral cancer makes up 40 percent of cancers in parts of India
In Britain, cancers of the mouth account for about 4 percent of all cancers. In India the figure reaches up to 40 percent. Much of that gap traces to chewing betel quid and areca nut, often mixed with tobacco, habits that on their own roughly double the risk of the disease.
The disease affects the lining of the lips, mouth and upper throat. Inside the mouth it usually begins as a painless red or white patch that thickens, ulcerates and keeps growing; on the lip it tends to look like a crusted sore that never heals. In 2018 about 355,000 people worldwide developed it and 177,000 died of it. American figures between 1999 and 2015 show incidence edging up 6 percent while deaths fell 7 percent.
Tobacco is the largest single cause, raising risk three to six times and accounting for around 40 percent of cases, including those linked to snuff and chewing tobacco. Alcohol is behind roughly 20 percent worldwide, and people who both drink and smoke face 15 times the risk of those who do neither. Part of the explanation lies with acetaldehyde, a chemical that bacteria in the mouth produce from alcohol, which peaks in saliva about two minutes after a drink and can alter the DNA of cells lining the mouth. The human papillomavirus clearly drives cancers of the tonsils and tongue base, but a 2023 analysis found it in only 6 percent of cancers within the mouth itself.
Some tumours start from precancerous patches: white leukoplakia, red erythroplakia, or a mixture. In South Asia a stiffening of the mouth lining called oral submucous fibrosis, tied to betel chewing, steadily limits how wide the mouth can open.
Confirming a diagnosis needs a tissue biopsy examined under a microscope, followed by scans to measure the tumour and check for spread. Stage matters greatly: American five-year survival is 88 percent when the cancer is still localised, 69 percent once it reaches neck lymph nodes and 37 percent after distant spread.
Source: Oral cancer
