Rising oral cancer burden in T.N. highlights urgent need for awareness, early detection Premium

Tamil Nadu's rising oral cancer cases call for urgent awareness, early detection, and effective tobacco cessation strategies to combat the epidemic.

Tamil Nadu reported around 8,000 new oral cancer cases in 2025. While the incidence rates are considerably higher in men - 11.6 per 1,00,000 compared to 5.4 per 1,00,000 in women, as per data from the Tamil Nadu Cancer Registry Programme, doctors remain concerned about the persistent trend of late presentation, and highlight the urgent need for stronger early detection and awareness efforts.

Placing this in a broader national and global context, Arvind Krishnamurthy, head of surgical oncology, Cancer Institute, WIA, said, “India bears a disproportionate burden of oral cavity cancer, accounting for nearly one-third of global cases. This epidemic displays distinct epidemiological, etiological, and clinical features compared to Western patterns.”

Unlike high-income countries, where Human Papillomavirus (HPV) and heavy alcohol consumption predominate, India’s oral cancer surge is primarily driven by widespread use of smokeless tobacco products (gutka, khaini, zarda), betel quid/areca nut chewing (with or without tobacco), and beedi smoking, he said, adding: “These deeply entrenched cultural habits promote field cancerisation, leading to multifocal lesions and aggressive involvement of the buccal mucosa and tongue - subsites that dominate the Indian disease profile.”

Demographic and socioeconomic factors further compound the issue. “The disease disproportionately affects lower socioeconomic groups, rural populations, and increasingly younger adults due to early initiation of tobacco habits,” Dr. Krishnamurthy said. “Late presentation remains a major barrier: low awareness, illiteracy, social stigma, and inadequate screening result in 70–80% of cases being diagnosed at advanced stages (III–IV), contributing to a five-year survival rate of approximately 50% - substantially lower than in developed nations,” he added.

Further emphasising the scale of the issue nationwide, Naveen Hedne, senior consultant, head and neck surgical oncology, Apollo Proton Cancer Centre, Taramani, pointed out that the incidence and prevalence of oral cancers in India is very high. “The incidence is about 15 to 20 cases per lakh population. About 80,000 to one lakh new cases are diagnosed every year. The average age of oral cancer presentation compared to any other country in the world is lesser in India; the patients are younger compared to the Western population. Most of the oral cancers are related to tobacco use, mostly different types of tobacco. Oral cancer is the number one cancer in men, and number three in women in India,” he explained.

Importantly, he also underlined the stage at which patients seek care. “In contrast to other countries, persons with oral cancer present in advanced stages in India. About 80% of oral cancers in India present in stage four due to ignorance and accessibility to proper healthcare and early diagnosis,” he added.