Factors affecting oral cancer awareness in a high-risk population in India.

OBJECTIVES: To evaluate the awareness of oral cancer, its risk factors and to estimate the prevalence of risk factors in a high-risk semi-urban population in India. METHODS: A questionnaire-based survey was carried out by house-to-house interview on a single day by 120 health volunteers. The data were analyzed using SPSS 11.0 software for links between prevalence of risk factors and oral cancer awareness, as well as other confounding variables. RESULTS: A total of 1885 persons participated in the survey. Of the surveyed population, 86% had heard about oral cancer and 32% knew someone with oral cancer. Sixty-two percent of the subjects correctly identified the causes; this included 77% of the subjects who identifying smoking, 64% alcohol and 79% pan chewing as a cause of oral cancer. More than 42% believed that poor oral health could lead to oral cancer and 53% thought that oral cancer is an incurable disease. Forty percent of males and 14% females had one or more high-risk habits. It was observed that the awareness was proportional to the education level (p<0.001) and inversely proportional to the prevalence of risk factor habits (p<0.001). Eighty-two percent of the smokers, 75% of the tobacco chewers and 66% of those who consumed alcohol were aware that their habits could lead to oral cancer. CONCLUSIONS: Overall, the awareness of oral cancer in this high-risk population was satisfactory, though certain gaps exist, pointing to a need for targeted health education and risk factor cessation counseling.

Trends of head and neck cancers in urban and rural India.

BACKGROUND: The sub-site predilection of head and neck squamous cell carcinoma (HNSCC) reflects the risk profile of a community and there are suggestions that these are changing over time. OBJECTIVE: To determine the change in head and neck cancer in rural and urban populations in India. METHODS: Cancer registry data of an urban and a rural population were reviewed over a period of 13 and 11 years, respectively. Age adjusted rates (AAR) and age specific incidence rates were used for data analysis. RESULTS: Oral cancers formed the majority of the head and neck cancers with a predilection for tongue, except in rural males, in whom the pharynx was the predominant sub-site. Overall there was a reduction in the incidence of HNSCC, which was more pronounced in urban females and rural males (p< .001). Among the sub-sites, oral cavity cancers showed a decreasing trend in urban females (p< .01) and rural males (p< .01). However, the trend was towards increase of incidence of tongue cancers. Pharyngeal cancer showed reduction in urban females (p< .01), whereas it increased in rural females. The recent increase in incidence of young adults with HNSCC reported in developed countries was not observed. CONCLUSIONS: Overall, incidence of HNSCC is reducing. This may be attributed to the decreased prevalence of tobacco use. The increase in incidence of tongue cancer may suggest factors other than tobacco and alcohol in its genesis.