Global Oral Health Inequalities in Incidence and Outcomes for Oral Cancer

Abstract

The mouth and oropharynx are among the ten most common sites affected by cancer worldwide, but global incidence varies widely. Five-year survival rates exceed 50% in only the best treatment centers. Causes are predominantly lifestyle-related: Tobacco, areca nut, alcohol, poor diet, viral infections, and pollution are all important etiological factors. Oral cancer is a disease of the poor and dispossessed, and reducing social inequalities requires national policies co-ordinated with wider health and social initiatives - the common risk factor approach: control of the environment; safe water; adequate food; public and professional education about early signs and symptoms; early diagnosis and intervention; evidence-based treatments appropriate to available resources; and thoughtful rehabilitation and palliative care. Reductions in inequalities, both within and between countries, are more likely to accrue from the application of existing knowledge in a whole-of-society approach. Basic research aimed at determining individual predisposition and acquired genetic determinants of carcinogenesis and tumor progression, thus allowing for targeted therapies, should be pursued opportunistically.

Socioeconomic Inequality in the Prevalence of Smoking and Smokeless Tobacco use in India

“…In disadvantaged sections c of society, expenditure on tobacco use replaces other essential expenditures. In the long-term, these families suffer serious morbidity and mortality due to tobacco use which widens the inequality gap more (Johnson et al, 2011). Monitoring of tobacco epidemic across states and region will be necessary to increase the effectiveness of existing public health strategies and for development of new interventions.…”

Cell cycle arrest and mechanism of apoptosis induction in H400 oral cancer cells in response to Damnacanthal and Nordamnacanthal isolated from Morinda citrifolia

“…Heavy or regular use of tobacco, excessive alcohol consumption, fruit and vegetable deficiency in diet, chewing paan and betel nut in addition to poor oral hygiene are the major risk factors associated with oral cancer (Balaram et al 2002;Pavia et al 2006). OSCC results in high mortality and morbidity rates around the world, since it is commonly detected in advanced stages prior to treatment (Johnson et al 2011).…”

Emerging and Established Global Life-Style Risk Factors for Cancer of the Upper Aero-Digestive Tract

“…Two thirds of the global burden of these cancer cases occurs in developing countries, with the Indian subcontinent accounting for one third of the global burden for cancers of lip plus oral cavity (Subramanian et al, 2009). These are largely diseases of the poor (Johnson et al 2011).…”

“…The relationship between UADT cancer incidence and socioeconomic inequalities, while recognised, remains relatively under-described and unexplored by age, tumour subtype, and sex (Conway et al, 2008;Johnson et al, 2011;Sharpe et al, 2012) in low and middle income countries. Associations between socioeconomic status and UADT cancer have been observed in several studies, and low SES has been independently linked to an increased incidence and poorer survival (Egger et al, 1997;Menvielle et al, 2004).…”

“…The health policy makers should enforce mandatory cancer registration and reporting of cause of death in all the countries. Sufficient funding should be allocated for research into new and innovative methods for cancer prevention at all stages at population level (Mendis, 2010;Johnson et al, 2011).…”