Why head and neck cancers are rising among young Indians

Worldwide 1.3 billion (130 crore) people use tobacco in various forms. Globally, an estimated 300 million (30 crore) use areca nut or supari. The highest rates of use are found in South-Central Asia, South-East Asia, and Melanesia.

According to GLOBOCAN, cancer incidence in India is increasing, with 2.1 million new cases expected by 2040 marking a 57.5% increase from 2020. Mouth cancer is the commonest one amongst males and comprises over 20% of all cancers in them. Head and neck cancers are not confined to a single type or location. They include cancers of the mouth, throat, thyroid gland, and parotid glands, among others. In India, mouth and throat cancers are the most prevalent forms of cancers.

These cancers severely impact the quality of life by causing pain, disfigurement, and difficulty in essential everyday function like eating and speaking, highlighting the importance of increased awareness and early prevention efforts. These cancers pose significant health challenges, particularly due to the widespread use of tobacco and alcohol, which are the primary lifestyle factors contributing to their occurrence.

Tobacco and alcohol are the leading risk factors for head and neck cancers. In India, tobacco use is pervasive and takes various forms, including smoking and chewing tobacco (gutka and paan). Especially concerning is the increasing prevalence of smoking, particularly among young women, often driven by a growing social acceptance of the habit. The combination of tobacco and alcohol consumption exponentially increases the risk of developing mouth and throat cancer. Studies have shown that while smoking increases the risk of cancer threefold and alcohol another threefold, the combined use of both raises the risk to nine times that of the general population.

Additionally, supari (areca nut), commonly consumed in products that may not contain tobacco, is now recognized as a pre-cancerous substance. This was previously debated, but current evidence suggests a clear link between supari consumption and cancer risk. This makes India the head and neck capital of the world, with the highest number of cases globally. Continued widespread usage of these and increasing adoption of smoking in the youth is likely to see continued high incidence of Head and Neck Cancers in India.

Beyond traditional risk factors, an emerging threat is the rise of Human papilloma virus -related throat cancers in India. Human papillomavirus (HPV), a sexually transmitted virus, which can be transmitted through oral sex. India is beginning to see an increase in these cases. Vaping, often projected as a safer alternative to smoking, has become increasingly popular among the youth. It is essential to recognize that vaping is not entirely safe, and its health risks will become clearer as more data becomes available over the coming years.

Quitting tobacco or alcohol will significantly reduce the risk of developing head and neck cancers, but not eliminate it entirely. The body’s ability to repair the damage caused by tobacco and alcohol is limited, meaning that even decades after cessation, individuals carry a residual risk of cancer. Preventing head and neck cancers requires a multifaceted approach. Public health campaigns need to focus on discouraging the initiation of tobacco and alcohol use, especially among the youth. Awareness about the dangers of HPV and the importance of safe sexual practices should be promoted. Additionally, addressing misconceptions about vaping and highlighting its potential risks is crucial for achieving cancer free world.

Head & neck cancer: Key facts

♦ 1.3 billion people worldwide use tobacco in some form.

♦ Around 300 million people consume areca nut (supari) globally

♦ India has one of the world’s highest burdens of head and neck cancers

♦ Mouth cancer is the most common cancer among Indian men, accounting for over 20% of cancers in men.

♦ Head and neck cancers include cancers of the mouth, throat, thyroid and parotid glands

♦ Tobacco and alcohol are major risk factors

♦ Combining tobacco and alcohol can multiply cancer risk significantly.

♦ Gutka, paan and chewing tobacco increase the risk of oral cancers.