KARACHI – Oral cancer is one of the most common cancers worldwide with high mortality and low 5-year survival rates. It is the second most common malignancy in Pakistan; insufficient information is available regarding its etiological assessment and molecular characterization. People using Paan are about 8-9 times more likely to develop oral cancers as compared to non-users. Smokeless tobacco, including Gutka and Niswar, are also extremely addictive substances with a high rate of use in younger age groups. Like many other cancers in Pakistan, oral cancers are observed in a relatively younger population with 30 per cent of cases occurring in patients 40 years and younger. Furthermore, about 50 per cent of the cases are advanced (Stage II) at presentation.
These views were expressed by Dr Shahid Pervez, Senior Professor and Consultant Pathologist at Aga Khan University Hospital, while speaking at the 15th Public Awareness Seminar on “Oral Cancer”, held at Latif Ebrahim Jamal National Science Information Center, International Center for Chemical and Biological Sciences, Karachi University (KU) on Thursday (January 31). The seminar was jointly organised by Dr Panjwani Center for Molecular Medicine and Drug Research (PCMD), KU and Virtual Education Project Pakistan (VEPP). Health professionals, students, research scholars, NGO representatives, and general public attended the program.
Dr Pervez said that oral cancer represent the second most frequent malignancy among both men and women with the highest reported incidence in the world. This is largely associated with extremely prevalent chewing habits, he said, adding that the most popular chewing products are ‘Paan’, ‘Chalia’, ‘Gutka’, ‘Niswar’ and ‘Tumbaku’.
He said, “There are various ways of preparing these products but the main ingredients are always betel, areca and/or tobacco. Betel-quid extract is known to contain some areca derived nitrosamines which are potent carcinogens. This is compounded with high incidence of cigarette smoking. The most common histological type of oral cancers is squamous cell carcinoma (OSCC) comprising more than 90 per cent of all cases.”
He said that poor oral hygiene is another contributory factor in this population; interplay of these hazards is contributing towards endemic rise of oral cancers in Pakistan particularly in Southern Pakistan. As OC is largely a preventable cancer, a concentrated effort is required to educate the general public about the hazards of chewing and smoking; on the other hand there is an urgent need to introduce screening programs in high risk populations to diagnose at a very early stage where cure is possible, he said.