Do the recorded cases of oral cancer correspond to the actual numbers in India: The necessity of properly designed screening and surveying initiatives.

Abstract

Objectives: To evaluate whether recorded cases of oral cancer in India align with actual prevalence, identify gaps in screening efforts, and propose strategies for effective nationwide screening and surveying initiatives.

Study design: A comprehensive review of secondary data, including global and national surveys, government statistics, and published studies, to analyze the prevalence of oral cancer and tobacco use and identify barriers to screening.

Methods: Data from GLOBOCAN 2022, National Family Health Survey-5 (NFHS-5), Global Adult Tobacco Survey-2 (GATS-2), and related studies were analyzed to assess oral cancer prevalence, tobacco usage, and screening participation. The study examined screening uptake by demographic and geographic factors, challenges in program implementation, and cost-effective strategies for improving screening outreach.

Results: Oral cancer is the second most prevalent cancer in India, with 143,759 new cases and a mortality rate of 8.7%. However, screening participation is low, with only 1.2% of men and 0.9% of women screened, varying widely across states. Tobacco use is widespread, with 29% of adults consuming tobacco, often starting at a young age, and involuntary smokeless tobacco use remains prevalent due to its incorporation into dental care products. Studies show that mass or high-risk group screening, conducted every 10 years, can significantly reduce oral cancer mortality. Challenges such as lack of awareness, inadequate healthcare infrastructure in rural areas, and insufficient trained professionals hinder effective screening.

Conclusions: The disparity between recorded and actual oral cancer cases necessitates nationwide screening programs, particularly targeting individuals under 30. Telemedicine, community-based strategies, and the involvement of Accredited Social Health Activists (ASHA) and volunteers can address barriers, enhance early detection, and reduce oral cancer burden in India. These measures will help guide future national survey programs and improve oral health outcomes.