title: Oral cancer in India continues in epidemic proportions: evidence base and policy initiatives.
abstract: OBJECTIVE
  India has the highest number of cases of oral cancer in the world and this is increasing. This burden is not fully appreciated even within India, despite the high incidence and poor survival associated with this disease. Because the aetiology of oral cancer is predominantly tobacco-related, the immense public health challenge can be ameliorated through habit intervention.
  
  
  METHODS
  We reviewed current rates of incidence, mortality and survival, and investigated the determinants of disease and current prevention strategies.
  
  
  RESULTS
  In addition to tobacco smoking and the myriad other forms of tobacco use prevalent in India, risk factors include areca nut consumption, alcohol consumption, human papillomavirus, increasing age, male gender and socioeconomic factors. Although India has world-leading cancer treatment centres, access to these is limited. Further, the focus of health care services remains clinical and is either curative or palliative.
  
  
  CONCLUSIONS
  Although the efforts of agencies such as the Ministry of Health and Family Welfare and the Indian Dental Association are laudable, enhanced strategies should be based on common risk factors, focusing on primary prevention, health education, early detection and the earliest possible therapeutic intervention. A multi-agency approach is required.
authors: Global Disease Detection Centre India, National Centre for Disease Control, New Delhi, India.
authors: Bhawna
authors: B
authors: Gupta
authors: Anura
authors: A
authors: Ariyawardana
authors: Newell W
authors: NW
authors: Johnson
mesh_terms: D017677:Age Distribution; D000428:Alcohol Drinking / Q000009:adverse effects; D001114:Areca / Q000009:adverse effects; D003625:Data Collection; D003753:Dental Health Surveys; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016134:Organizational Policy; D030361:Papillomavirus Infections / Q000150:complications; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D012953:Societies, Dental; D014026:Nicotiana