India's Oral Cancer Burden Due to Smokeless Tobacco and Areca Nut Consumption

Smokeless tobacco and areca nut use accounts for one-third of oral cancer cases causing more than one lakh cases of oral cancer worldwide. The study was published in the journal The Lancet Oncology ().

It was revealed that most oral cancers due to smokeless tobacco and areca nut use were common in India among South-Central Asia regions.

‘Globally, 300 million people use #smokeless_tobacco while 600 million use #arecanut. Smokeless tobacco and areca nut use causes most of the #oral_cancers in #India. #medindia’

Globally, 300 million people use smokeless tobacco while 600 million people use areca nut. The use of smokeless tobacco and areca nut is highest in regions of South-Central Asia, South-East Asia and Melanesia.

Effect of Smokeless Tobacco and Areca Nut in Oral Cancer

Smokeless tobaccos are available in many forms around the world. They are consumed without burning. They can be chewed, inhaled or applied locally. Areca nut or betel nut is a traditional form of tobacco which is consumed with betel leaves.

Consumption of these products are linked to multiple diseases and the most common disease is oral cancer. The study highlighted that 9 in 10 of all oral cancers due to smokeless tobacco and areca nut use occur in the region of South-Central Asia.

More than 95% of cases occurred in low and middle income countries. These findings reveal that smokeless tobacco and areca nut plays a significant role in oral cancer prevalence.

It can be concluded that by quitting the use of smokeless tobacco or areca nut, one-third of oral cancers can be avoided.

Global Hotspots for Oral Cancer

In South-Central Asia, among 1,05,500 oral cancer cases due to smokeless tobacco and areca nut use, India ranked first followed by Bangladesh, Pakistan and Sri Lanka.

In South-East Asia, a total of 3,900 cases were reported. Myanmar showed more cases followed by Indonesia and Thailand. In East Asia, China reported the highest number of oral cancer cases due to these factors.

They also analysed which product among them caused most of the cases. In India, consumption of areca nut (30%) and betel quid with tobacco (28%) were responsible for the most oral cancer cases among women, followed by gutka (21%) and khaini (21%).

Among men, the products that caused the largest proportions of oral cancer cases were khaini (47%), gutka (43%), betel quid with tobacco (33%), and areca nut (32%). Areca nut was responsible for 84% of oral cancer cases among both genders in 2022.

The highest proportions of oral cancers caused by smokeless tobacco and areca nut use were in Melanesia, Micronesia, and Polynesia (79%), followed by South-Central Asia (58%) and South-East Asia (20%).

Although men are the main consumers of smokeless tobacco or areca nut in most regions of the world, in these regions the prevalence of smokeless tobacco or areca nut use among women is higher than that among men.

Therefore, gender-sensitive policies must be implemented to ensure reduction of areca nut and smokeless and smoked tobacco use in diverse cultural contexts.

Smokeless tobacco control must be prioritized, and a framework for areca nut prevention should be integrated into cancer control programmes.

Reference:

1. Global burden of oral cancer in 2022 attributable to smokeless tobacco and areca nut consumption: a population attributable fraction analysis - (https:www.sciencedirect.com/science/article/abs/pii/S1470204524004583)

Source: Medindia