Jaipur, Every year nearly ten 10 lakhs persons in India are diagnosed with oral cancer and half of them die within a year of diagnosis. The main cause of the deaths and disabilities due to oral cancer is known in medical term as Head Neck Squamous Cell Carcinoma (HNSCC).
As we observe the .World Head Neck Cancer Day (WHNCD) on July 27, it is an apt occasion to remind ourselves about the government of India’s failure to implement an effective ban on sale of tobacco products such as Gutka, bidi, cigarettes whose consumption leads to growing number of oral cancer deaths.
Voice of Tobacco Victims Campaign (VoTV) is a voluntary organization devoted to creating awareness about oral cancer. VoTV Rajasthan patron and Sawai Man Singh Hospital’s associate professor Dr. Pawan Singhal says a large number of people across India fall prey to oral cancer owing to a combination of factors including late detection of the decease , inadequate treatment and unsuitable rehabilitation.
“People mainly in the age group of 60-70 years used to be prone to oral and throat cancer till as late as 30 years ago”, Dr Singhal say, adding, “ now people as young as 30 to 50 years are being diagnosed for oral cancer”.
Blaming growing influence of western life style in the young generation, Dr Singhai says even youths in the 20-25 years age group have become vulnerable to oral cancer due to smoking ,which many of them mistakenly consider a style statement.
India has the dubious distinction of having largest amount of chewing tobacco consumption in the world. It is a cheap and easily available addiction and its growing consumption in the last two decades has contributed to alarming rise in oral cancer.
The Indian Council of Medical Research (ICMR) in a report in 2008 observed that in 90% of the head and neck cancer cases that were diagnosed consumption of alcohol, Gutka, tobacco and betel nut emerged as the root cause of the cancer which is preventable.
The ICMR report also revealed that tobacco consumption was diagnosed as reason of cancer among 50 % male and 25% female victims. Nearly 90% of these victims (male and female) suffered due to oral cancer.
The report pointed out that smokeless tobacco products such as chewing tobacco, Khaini, Gutka contain 3000 chemical compounds and 29 of them could be potential cause for oral cancer. India has the largest population of oral cancer patients in the world.
According to Dr. Singhal, head and neck cancer cases are proving an additional burden on not only the national healthcare services but also on the affected communities, families and individuals.
“Most of the head and neck cancer cases are treatable and preventable, if detected in early stage. But millions succumb to the disease due to late detection, inadequate treatment and rehabilitation”, he rues.
Tata Memorial hospital professor and cancer surgeon Dr. Pankaj chaturvedi, who is heading campaign against head and neck cancer globally, stresses the need for multi-pronged and coordinated efforts by governments, voluntary organizations, health workers, educational institutes and industries to check cases of Neck Squamous Cell Carcinoma (HNSCC).
It was with the aim to draw the world’s attention to the HNSCC cases that the World Head and Neck Cancer Day (WHNCD) is observed on July 27. Its observance was proposed by International Federation of Head and Neck Ontological Societies (IFHNOS). The federation has support from several government and non government organizations, 55 head and neck cancer institutions and 51 nations.
A comparative chart below, published in the Asia Pacific Journal of Cancer Prevention illustrates an alarming growth of cancer of all types in male and female between 2001 and 2016 in India.
In 2014, the Johns Hopkins University Bloomberg School of Public Health and the World Health Organization conducted a study in India to assess the impacts of Gutka ban. Surveys were conducted with 1,001 current and former Gutka users and 458 tobacco product retailers in seven states including Assam, Bihar, Gujarat, Karnataka, Madhya Pradesh, Maharashtra, Orissa and Delhi.
The survey concluded that 90% respondents desired that the government should ban manufacturing, sale and distribution of other forms of smokeless tobacco. It found there was virtually no retail outlet where pre-packaged Gutka was on display. As many as 92% respondents supported the ban and 99% agreed that bans are good for the health of India’s youth.
Of the respondents who continue to use pre-packaged Gutka (available illegally), half of them reported they consume less since the ban was imposed. . Over 80% believed that ban will motivate them to quit and nearly half of them actually tried quitting. Of the respondents who quit since the ban, a substantial proportion in each state (from 41- 88%) reported that they quit using Gutka because of the ban.
According to the Index of Industrial Production (IIP) data, output of tobacco, which includes cigarettes, bidis and chewable tobacco products, declined by 12.1% in March 2015 from a year ago.
As an impact of the chewing tobacco products (Gutka and Pan Masala), the Euromonitor International report shows tremendous decline in overall smokeless volume. It is in 2011 : 2% ; 2012: 26% ; 2013: 80% . It is predicted that the smokeless volume would have declined in 2016 to 30% and 2018 to 25% in consumption.