Reducing oral cancer in India
Cancer is the second leading cause of death globally, surpassed only by cardiovascular disease.
Diseases such as cancer disproportionately affect low and middle income countries, including India.
In India, cancer rates are increasing, with oral cancer being the third most common type. Rates of oral cancer vary between states in India, with the highest rates found in the north east of the country.
Healthcare under pressure
So why is this happening? There are a multitude of contributory factors, including accelerating population growth and ageing, as well as broader economic and environmental factors.
Healthcare systems are under pressure to curb costs whilst maintaining quality services.The growing number of people suffering from multiple diseases challenges health care providers to develop more integrated and comprehensive case management. Primary care is now needed more than ever, with the Indian Government committed to strengthening health care services.
A pioneering project led by the University of Warwick’s Professor Paramjit Gill, is being undertaken to help contribute to a reduction in oral cancer across India.
Oral submucous fibrosis is a chronic premalignant disease of the oral cavity, which can lead to cancer. It is very common in Southeast Asia
A UK-India partnership
Patients wait to be screened
“Despite numerous global and regional commitments and action plans, progress in preventing and managing these diseases is inadequate. Maintaining the status quo means that it’s unlikely that the UN Sustainable Development Goal of a 30% reduction in premature mortality from these diseases will be achieved” he explains.
So how is Professor Gill’s work contributing towards this crucial goal? Through the development of a UK-India partnership on oral cancer, Professor Gill and his team are developing a screening strategy.
The screening strategy involves training community health workers to conduct screening and utilise mobile digital technology. “The ultimate aim of this project is to prevent oral cancer through oral screening, benefitting the population of India by reducing early death rates” he explains.
The project includes screening patients over the age of 30 in urban and rural locations in the regions of Assam and Delhi. This involves participants completing a questionnaire, as well as a visual oral examination. High resolution photographs will be taken and any abnormalities detected will be referred to local hospitals.
This also included tobacco/alcohol cessation services. Critical to the project are community health workers, who play a vital role in helping tackle the growing challenge of healthcare access and delivery.
Influencing policy and training healthcare professionals
“Current capacities for disease surveillance in India are inadequate and urgently require strengthening. We are producing preliminary data for future research, and built local research capacity by offering bespoke training in oral cancer prevention, sharing examples of good practice and offering mentorship" continues Professor Gill.
"We’re also developing a sustainable research partnership through a strong interdisciplinary research team, creating links with academic, governmental and advocacy organisations.” Professor Gill’s team is providing bespoke training in oral cancer prevention - sharing examples of good practice and offering mentorship.
Screening with a camera - designed to detect premalignant conditions, such as oral submucous fibrosis
“The research will provide robust evidence for policymakers on training health professionals to identify and manage oral cancer. This will help enable people to function socially, economically and participate fully in civic life.”
By generating momentum for research, the project is paving the way for continued work to provide lasting and impactful solutions to some of the world’s most devastating diseases.
Project partners from India included:
- Indian Council of Medical Research-National Institute for Cancer Prevention and Research, Delhi
- Department of Oral Medicine and Radiology, KLES Institute of Dental Sciences
- Department of Computational and Data Sciences, Indian Institute of Science
- Biocon Foundation, Bengaluru
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh
The project links to the United Nations Sustainable Development Goals of Good Health and Well-Being and Reduced Inequalities.
