Cervical and oral cancer screening in India

Abstract

Incidence of both cervical and oral cancer are high in India. Although there are no organized cervical or oral screening programmes in the country, a number of research projects are ongoing or recently completed. In cervical screening, a number of studies of visual inspection with various aids and studies of human papillomavirus (HPV) testing are in progress. Long-term follow-up of these will inform policy on cervical screening in limited resource countries. A randomized trial of oral visual inspection for cancer or premalignant lesions in 192,053 subjects has been conducted in Kerala, South India. In the trial population as a whole, the study group showed a non-significant 21% reduction in mortality from oral cancer compared with the control group. In users of alcohol, tobacco or both, in which more than 90% of oral cancer deaths occurred, the reduction was a significant 34% (relative risk = 0.66, 95% confidence interval 0.45-0.95). On the basis of these results, screening for oral abnormalities has the potential to prevent 37,000 deaths per year worldwide.