Oral cancer

[Anonymous]

Cancer is one of the major threats to public health in the developed world and increasingly in the developing world. In developed countries cancer is the second most common cause of death. According to the World Health Report 2004, cancer accounted for 7.1 million deaths in 2003 and it is estimated the overall number of new cases will rise by 50% in the next 20 years. Oropharyngeal cancer is more common in developing than developed countries. The prevalence of oral cancer is particularly high among men, the eighth most common cancer worldwide. Incidence rates for oral cancer vary in men from 1 to 10 cases per 100 000 population in many countries. In south-central Asia, cancer of the oral cavity ranks among the three most common types of cancer. In India, the age standardized incidence rate of oral cancer is 12.6 per 100 000 population. It is noteworthy that sharp increases in the incidence rates of oral/pharyngeal cancers have been reported for several countries and regions such as Denmark, France, Germany, Scotland, central and eastern Europe and to a lesser extent Australia, Japan, New Zealand and the USA.
In the United States, studies performed during a 20 year period beginning in the 1960’s revealed that there was a near four-fold increase of oral cancer in males ages 30-39 in the State of Connecticut. Similarly, studies by Ribeiro et al and Iamaroon et al, also suggest high incidence of oral cancer in young adults. African Americans in the United States have a higher risk of developing oropharyngeal cancer than do Caucasians. The increased risk appears to be due to environmental factors; possible genetic factors have not been determined.
The cancer is epidemic in developed countries, and increasingly in developing countries, is due to the combined effect of the ageing of populations, and the high or increasing levels of prevalence of cancer risk factors.
In the published data from 1990, oral and pharyngeal sites remain the sixth most common neoplasm, however, mouth, pharynx are the third most common site for malignant disease among men in developing countries. Cancer rates in India are lower than those seen in Western countries, but are rising with increasing migration of rural population to the cities, increase in life expectancy and changes in lifestyles. In India, rates for oral and oesophageal cancers are some of the highest in the world. The databases from which these estimates are derived are far from ideal in many parts of the world produce no data at all, in others the data may come from localized atypical regions. Hospital based cancer registries naturally gather biased information. Thus in many developing countries cases may not come to attention at all, either because of fear or morbidity of poor people to access hospital services.

        

[Anonymous]

Brush test’ biopsy, the path breaking technology of detecting oral cancer, has been brought to India and is expected to reduce oral cancer cases in coming years.

The Brush technology is painless and does not involve any incision like the current procedure, Nanavati Hospital Oncology Department head Dr Zahra Hussaini said here.

The specially designed disposable brush is sterile having two cutting surfaces. Brush biopsy collects cells from all three epithelial layers, superficial, intermediate and basal, Hussaini, who is also the director of International Health Continuing Educational Providers (IHCEP), said.

Hussaini, who brought the technology developed by the multinational company Oral, said the sample can be taken by any dentist with an Oral CDx (brush biopsy test).

This is collected by rotating the end of the brush on the affected part of the mouth. Oral CDx is a computer-assistedmethod of analysis of the oral brush biopsy in detection of precancerous and cancerous lesions. The advent of Oral CDx testing has made oral cancer a potential preventable disease, she said.

Oral CDx can prevent oral cancer by facilitating routine painless testing of the abnormal spots that appear in the adult population. "Several years before oral cancer can start, the patient can identify pre-cancerous cells by Oral CDx and thus, prevent development of oral cancer years before it can even start," she said.

"In the last one year, we have trained 2,000 dentists, ENT and head and neck cancer surgeons across India and we expect them to take up the oral cancer detection in a big way so that India will no longer remain number one in having oral cancer cases," Hussaini said.

"The Brush test is a quick and painless method that dentists use to test the common small white and red oral spots that most people have in their mouth at one time or another.

It is used to determine if a common oral spot contains abnormal cells (known as dysplasia) that, if left alone for several years, may develop into oral cancer," she said.

The use of Oral CDx is simply scrapping the area in the mouth and the sample will have to be sent to US for detection using a standard test in the most sophisticated laboratory, Hussaini said.

"Over 25 per cent of oral cancer victims do not use tobacco or alcohol," she said, adding it could be even due to stress, hsarp teeth, bad oral hygiene.

"We are very much optimistic that just like the Pap smear is used to detect precancerous cells to help prevent cervical cancer has drastically reduced the number of cervical cancer in India, oral cancer will also be reduced in the coming years," the oncologist said.

Oral Cancer is a major health problem in India and is estimated that there are about 92,000 new cases of it diagnosed every year, Hussaini said.

Eighty per cent of these are in the late stages. The five-year survival is in the range of 30 per cent (as majority are in the late stages).

"This means that there is a death due to oral cancer every seven minutes in our country," she mentioned.

In the last two months, the doctors have done the biopsy on 250 patients.

"Since for testing we have to send sample to US, we are trying to reduce the cost of the test within a couple of hundred rupees so that people from all strata of the society can get the test on a routine basis," she added.

        

[Anonymous]

altough this is spreading like anything the majority of people in the rural area are still unaware about this lifethreat

public health programmes are required to overcome the problem

        

[sushantpatel_doc]

I agree…a lot of public health awareness is required to counter this problem..this includes patient education followed by a strong follow-up..

        

[Anonymous]

Awareness and motivation play amajor role here

        

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