Lip and oral cavity cancers in Karachi, Pakistan, and related prevention strategies

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Qureshi and collaborators conducted a study to assess the burden of lip and oral cavity cancer in Karachi, which is the largest city in Pakistan. They noted that Globocan 2018 data for cancer patients in Pakistan showed that lip and oral cavity cancers are among the most commonly found malignancies in males and second most commonly found malignancy in females. However, the data was not a true representation of statistics for people in Karachi. Therefore, the researchers obtained ten-year (2010 to 2019) data from the Dow Cancer Registry in Dow Labs in Karachi. The patients in the study were diagnosed with lip and oral cavity cancer.

The researchers found that 22,858 cases of cancer were registered during that time. Out of these cases of cancers, 4,400 cases were related to lip and oral cavity cancer. Approximately 67.8% cases (n = 2,986) were found in males, and about 32.1% cases (1,414) were found in females. This difference could be attributed to different factors, such as consumption of more tobacco products by males as compared to females in the people with lower socioeconomic status.

The researchers have also reported that age-standardized-rates (ASR) of lip oral cavity cancer are highest in Karachi as compared to overall Pakistan and several countries in the world. The ASR is a method of standardization with the help of which the effects of differences in age on the outcomes are removed as far as possible. One of the factors contributing to high ASR is the lack of knowledge regarding the harmful effects of tobacco.

Qureshi and collaborators also worked on the grades of cancers. There are different grades of cancers, including well-differentiated (grade I tumors), moderately differentiated (grade II tumors), and poorly differentiated (grade III tumors). Well-differentiated refers to the tumor cells that are in an organized form and appear similar to the normal cells. On the other hand, poorly differentiated refers to the grade in which tumor cells don’t appear normal as they are more disorganized under the microscope and spread and grow faster as compared to grade I tumors. The grade that looks neither well-differentiated nor poorly differentiated is referred to as moderately differentiated. The researchers found that most of the cases of lip and oral cancers were moderately differentiated, including 67.7% of the cases (n = 2984) were moderately differentiated. About 16.6% of the cases (n = 726) were poorly differentiated, and nearly 15.7% of the cases (n = 690) were well-differentiated.

Considering this research, it can be said that one of the most beneficial intervention to reduce the risk of lip and oral cavity cancer is to improve the knowledge and awareness of the population in Karachi, Pakistan, regarding cancer and tobacco consumption. Furthermore, the researchers have noted that lip and oral cavity cancers are highly preventable through the implementation of appropriate legislation regarding the consumption of tobacco products. Another strategy would be to implement appropriate health care budget for the diagnosis and treatment of these cancers. Nevertheless, this research could be used in assessing the prevalence of lip and oral cavity cancer in Karachi, Pakistan, and eventually in understanding the importance of implementing appropriate intervention.

Source:

Qureshi, M. A., Syed, S. A., & Sharafat, S. (2021). Lip and oral cavity cancers (C00-C06) from a mega city of Pakistan: Ten-year data from the Dow Cancer Registry. Journal of Taibah University Medical Sciences. https://doi.org/10.1016/j.jtumed.2021.02.001

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