India has highest oral cancer cases due to betel nut in South Asia: Study

The Lancet Oncology study highlighted that South-Central Asia recorded the highest number of oral cancer cases linked to smokeless tobacco and areca nut use

A recent study published in The Lancet Oncology has revealed that India recorded the highest number of oral cancer cases caused by smokeless tobacco and areca nut (also known as betel nut) in South Asia. Out of the 120,200 global cases, India accounted for 83,400, said the study accessed by The Indian Express. Smokeless tobacco is responsible for more than 30 per cent of all oral cancer cases worldwide, with the majority of these cases concentrated in South-Central Asia.

The study highlighted that South-Central Asia recorded the highest number of oral cancer cases linked to smokeless tobacco and areca nut use, with 105,500 cases reported in 2022. Of these, India recorded 83,400 cases, followed by Bangladesh (9,700), Pakistan (8,900), and Sri Lanka (1,300). Other affected regions include South-East Asia and East Asia, where the incidence of oral cancers related to these substances remains high.

One of the study’s co-authors, Pankaj Chaturvedi, raised concerns over the promotion of areca nut products by Bollywood actors. Chaturvedi works as the head and neck cancer surgeon and a director at Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai. He emphasised the severe health risks posed by areca nuts, including the development of submucous fibrosis and incurable mouth cancers, both of which are becoming more prevalent among younger populations. Chaturvedi called for stricter enforcement of existing laws and regulations to control the use of smokeless tobacco and areca nuts.

Smokeless tobacco products and their impact

Smokeless tobacco products are used without burning and can be chewed, sucked, inhaled, or applied locally. Popular forms include gutka (a mix of tobacco, areca nut, flavourings, and spices) and khaini (sun-dried or fermented tobacco leaves). Paan masala, a common product in India, combines areca nut, tobacco, lime, and spices.

Globally, men account for the majority of oral cancer cases linked to smokeless tobacco and areca nuts, with 77 per cent of cases reported among men. However, in regions like South-East Asia and southern Africa, the prevalence of smokeless tobacco use is higher among women than men.

In India, the primary products contributing to oral cancer cases in women were areca nut (30 per cent) and betel quid with tobacco (28 per cent), while men were most affected by khaini (47 per cent) and gutka (43 per cent).