Tobacco is the most important risk factor for head and neck cancer - Make Sense Campaign
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Dr. Sourav Kr. Mishra

April 8-15 is celebrated as Oral, Head and Neck Cancer Awareness Week.
Since tobacco is the most common risk factor for this category of cancer, large-scale awareness is necessary.

What is the incidence of head and neck cancers in India?

Head and neck cancers can arise in the mouth, cheek, lips, gingivum, nose, sinuses, voice box , thyroid, or salivary glands.
Overall, 58% of all head and neck cancers in the world are diagnosed in Asia.
In India, they account for 30% of all cancers. A total of 2 lakh new cases are diagnosed every year, of which 80,000 are cancers of the mouth.
Broadly, head and neck cancer is the most common form of cancer in Indian men.

What are the common risk factors?

Tobacco (smoked or smokeless) is the most important risk factor. It contains 29 types of cancer-causing chemicals.

Smoked tobacco includes beedi, cigarettes, hookah, chillum, etc. Reverse chutta smoking includes smoking with the burnt end inside the mouth, and is prevalent in some parts of Andhra Pradesh and Odisha.

Smokeless tobacco includes betel quid (paan), zarda, gutkha , khaini, mawa , gudakhu, etc. Cancer usually occurs in the mouth in those places where betel quid is kept for a long period of time.

The other risk factors for cancer of head and neck include consumption of alcohol, advancing age, and infection with Human Papilloma Virus. The latter leads to cancer of the oropharynx (base of the tongue or tonsils), mainly in young people who are non-smokers and non-alcoholics.

What are the most common symptoms of head and neck cancer?

Patients may present with mouth pain or non-healing mouth ulcers, loosening of teeth, difficulty in swallowing solid and liquid food, weight loss, and bleeding.

If a patient exhibits swelling in the neck, it usually suggests advanced-stage cancer.

Patients with laryngeal cancer present with hoarseness of voice.

Nasopharyngeal cancer and cancer of sinuses present with bleeding from the nose.

Is screening useful in cancers of the head and neck?

Oral cancer occurs in sites that are generally accessible by physical examination.

Thus, cancer of the head and neck has great potential for prevention through routine mouth examinations in high-risk individuals. This is known as screening.

In Kerala, screening was done by healthcare workers. In persons with a high risk of head and neck cancer (smokers and alcoholics), it was possible to detect the disease at an earlier stage and thus reduce the incidences of death.

What steps should be taken to prevent head and neck cancer?

Since tobacco is the most important risk factor, the first step is to avoid the consumption of tobacco in any form. Further, people should be educated about the harms of using tobacco.

Visual inspection of the mouth should be carried out in high-risk individuals to detect pre-cancerous lesions.

This article has been written by Dr. Sourav Kumar Mishra, MD (BHU), DM (Cancer Institute, Chennai), ECMO Associate Professor, Department of Medical Oncology, IMS & SUM Hospital, Bhubaneswar.