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Oral cancer most common disease in world

04 February, 2013

KARACHI: "Oral Cancer (OC) is one of the most common cancers worldwide with high mortality & low 5-year survival rates.

OC is the second most common malignancy in Pakistan; insufficient information is available regarding its etiological assessment and molecular characterisation. 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) recently.

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 programme.

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 was largely associated with extremely prevalent chewing habits, he said, adding that the most popular chewing products were Paan, Chalia, Gutka, Niswa 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 was another contributory factor in this population; interplay of these hazards was contributing towards endemic rise of oral cancers in Pakistan particularly in Southern Pakistan.

As OC was 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 was an urgent need to introduce screening programmes in high risk populations to diagnose at a very early stage where cure was possible, he said.

Children hit by carcinogenic tobacco smoke: In Pakistan 70% of children get exposed to environmental tobacco smoke, globally declared as a class A carcinogen, that is capable to produce cancer.

Experts talking to APP Friday said tobacco smoke is a major cause of contribution to the indoor air-pollution in the country, where people are generally not aware about the harm caused by passive smoking.

Breathing the smoke from other people's cigarette is called passive smoking that consists of smoke from the burning end of the cigarette called "side-stream" smoke and smoke exhaled by the smoker "mainstream" smoke.

Chairperson, pediatric department, Civil Hospital, Karachi Prof Ayesha Mehnaz, in reply to a question about harmful effects of passive smoking on children said it also increases their risk of respiratory infection including pneumonia.

Chronic cough and phlegm, increased risk of asthma, glue ear (chronic middle ear infection), growth retardation and reduction in lung function are also associated health hazards for children, she said.

Dr Shaheena Qayyum, Ojha Institute of Chest Disease referring to available statistics said 1500 children between six to 16 years also take up smoking every day in Pakistan.

These were cited to be kids who are active smokers and are among the 32% male population and 6% female population who actually smoke.

"Lung cancer is the number one cancer among males in Pakistan and over 90% of lung cancer occurs in smokers," said the senior chest specialist. Meanwhile cancer of the mouth, throat, lungs and oesophagus (food pipe) occur ten times more in smokers. Tobacco smoke has also proven to increase the risk of developing bladder, pancreatic, cervical and breast cancer.

The experts registered their serious concern that huge amount of money was being spent by tobacco companies in their promotional activities compared to meagre amount spent on public health education.

It was regretted that the tobacco industry is trying to link smoking to pleasure, relaxation, enjoyment and adventure - with children and teenager as their main targets.

This was again in a scenario where 54% population of the country were consuming tobacco in form of paan, naswar, gutka, mainpuri and so-forth.


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