Alarming rise in oral cancer cases in city

With A large number of youths and aged people falling victim to oral cancer, Allahabad is fast on way to becoming the cancer capital of the State. The 'age specific incidence rate and pathological spectrum of oral cancer' study conducted by Department of Pathology MLN Medical College indicates some alarming facts about oral cancer in Allahabad.

With A large number of youths and aged people falling victim to oral cancer, Allahabad is fast on way  to becoming the cancer capital of the State. The 'age specific incidence rate and pathological spectrum of oral cancer' study conducted by Department of Pathology MLN Medical College indicates some alarming facts about oral cancer in Allahabad.

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A single institutional retrospective study of 11 years from 1990 to 2000 was done in which data was collected year-wise using the tumour registry figure. A total of 40,559 biopsies were examined in the department during 1990-2000, out of which 759 biopsies related to the oral cavity. The data was analysed with emphasis on age, sex, risk factors, site and histology.

A comparison of the age specific incidence rates of oral cancer during 1990-2000 in Allahabad showed that the incidence was maximum in the 50-59 years age group and squamous cell carcinoma grade I (a cell type which does not respond to chemotherapy or other cancer treatment) was the most prevalent type. Of the total 759 biopsies of oral cavity, there were 303 malignant cases.

Of them 232 (76.57%) were males and 71 (23.43% were females with a male to female ratio of 3.27:1.

The tongue was the most frequently involved site--found in 42.57% cases. On an average, 63 new cases of oral cavity cancer per annum were detected during this period.

The study also revealed that the incidence of oral submucous fibrosis in the population has increased manifold--especially among younger generation, possibly leading to a further increase in the incidence of oral cancer.

Year-wise trend revealed maximum incidence of 15.58 oral cancer cases per 1000 biopsies examined in 1997 followed by 11.67 per 1000 during 1999.

Examination of biopsies from oral cavity revealed 267 (35.17%) benign lesions, 127 (16.73%) pre-malignant lesions including leukoplakia (white discolouration of the oral cavity) and 303 (39.92%) cases of oral cancers of different grades while 62 (8.17%) cases remained inconclusive. Among both males and females, squamous cell carcinoma (SCC) of grade I was most prevalent. All cases of SCC grade III were males.

Dr Ravi Mehrotra who was an instrumental in conducting the study said the distribution of histological findings among males and females were found to be statistically significant.

Majority of benign cases were reported in the age group 20-29 years, whereas maximum (13 cases, 20.97%) found inconclusive belonged to the 40-49 years age group. Pre-malignant lesions like leukoplakia were found to be more prevalent in the age group of 50-59 years. Majority of malignant cases were observed in 50-59 years age group and all 4 cases of grade III belonged to this age group.

"The data reflects our specific patient population reporting to the hospital and not the community as a whole. Most of the patients had similar smoking or tobacco chewing habits," he added.

Dr Mehrotra said there is an urgent need for appropriate prevention and cessation strategies for smoking and smokeless tobacco products along with a social war against alcoholism by intensive education programme to revert back the present trend of preventable oral cancers.