JAMSHORO: Oral cancer remains a major public health concern in Sindh, where registry data place it as the most common cancer among adult men and the second most common among adult women after breast cancer. At the National Cancer Conference 2026, a session led by a senior oral pathology specialist brought these findings into focus alongside community screening reports that illustrate the challenges of prevention and early detection.
Prof. Dr. Sana Mirza, Professor of Oral Pathology and Chairperson of the Department of Oral Pathology at Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, led the session titled “Oral Cancer Control & Awareness: Community Action & Registry — Registry Numbers, Field Camps and the Chewing Habit Behind Them.” The conference was held at LUMHS from October 19 to 21.
The session connected cancer registry evidence with findings from community outreach activities, highlighting how epidemiological data, awareness programmes and oral screening can help strengthen prevention efforts. It also drew attention to the continued use of smokeless tobacco and other chewing products, particularly in communities where dependence, stress and affordability can make harmful habits difficult to abandon.
Registry data highlight the scale of oral cancer in Sindh
The discussion drew on the Hyderabad Cancer Registry’s first four-year report, covering 2020–2023 and published in the Journal of the College of Physicians and Surgeons Pakistan in 2025.
The registry received 7,169 malignant cancer cases from across Sindh during the four-year period. Of these, 3,310 cases, or 46.2%, were among males, while 3,859, or 53.8%, were among females. The report found that oral cavity cancer ranked first among cancers affecting adult men and second among adult women, after breast cancer.
Among adult men, oral cavity cancer had an age-standardised incidence rate of 60.58 per 100,000. This measure adjusts for differences in population age structures, allowing cancer incidence to be compared more meaningfully across populations.
The findings underscore the importance of prevention, public awareness and timely clinical assessment. They also demonstrate why reliable cancer registration matters: systematic data collection helps health professionals and policymakers understand which cancers are placing the greatest demands on communities and where prevention and early-detection efforts may be most needed.
The registry report identified oral cancer as a particularly important concern in Sindh, where chewing habits are recognised as a major contributing risk factor. However, registry findings describe the distribution of diagnosed cancers; they do not, on their own, establish the cause of an individual case.
Why awareness alone may not be enough to change chewing habits
The session also incorporated findings from a 2025 study published in BMC Oral Health, titled “Rural Pakistan’s smokeless tobacco epidemic: a need for tailored interventions.” Prof. Mirza was among the study’s co-authors.
The qualitative research explored smokeless tobacco use in Gadap Town, a rural area near Karachi, and examined how social and economic circumstances influence continued use. Its findings highlighted the roles of dependence, stress, affordability and cultural context in sustaining chewing habits, including among people who understand the associated health risks.
The research points to a challenge for oral cancer prevention: providing information about health risks is essential, but awareness campaigns may not be sufficient when people face dependence or other barriers to changing their behaviour.
Effective prevention therefore needs to go beyond warnings. Public health efforts must also consider accessible cessation support, community-specific education and measures that reduce exposure to harmful products. Dental professionals can contribute by discussing chewing habits with patients, explaining their risks without stigma and encouraging people to seek appropriate help to stop using them.
Community screening takes prevention beyond the clinic
A central part of the session focused on outreach activities conducted by The DentEd Collective, a student-led dental education organisation for which Prof. Dr. Sana Mirza serves as Chief Advisor.
Its 2026 screening and awareness activities extended across schools and communities in Jamshoro, Hyderabad, Karachi, Mirpurkhas and Digri. The initiatives included activities undertaken with partners such as LUMHS, MedCore Society and Smile2Serve.
The camps combined oral screening with oral health education and toothbrush distribution, bringing preventive services and information directly to community settings.
According to the camp report presented during the session, dental caries affected approximately 40–60% of the individuals screened across five numbered camps. The report also recorded cases of oral submucous fibrosis (OSF) and trismus among people screened at community camps in Hyderabad and Digri.
OSF is a chronic condition associated with restricted mouth opening and is linked to areca nut, commonly known as betel nut, and certain chewing products. Trismus refers to difficulty opening the mouth fully and can have several causes. Both findings warrant appropriate clinical assessment, particularly when reported alongside potentially harmful chewing habits.
These camp observations offer a practical view of oral health needs in the communities reached by the programme. However, they represent findings among people screened at the reported camps and should not be interpreted as prevalence estimates for the wider population.
Children’s dental visits and an adolescent’s warning sign
One of the more concerning findings presented during the session concerned access to routine dental care among children.
At one camp, only 18 of 89 children reported having ever visited a dentist. The finding highlights a potential gap in access to preventive dental care and the importance of reaching children before oral health problems become more difficult to manage.
The same camp identified a 15-year-old who reported a two-year betel nut habit and presented with a white patch on the palate.
A white patch in the mouth does not, by itself, establish a diagnosis of oral cancer. However, an unexplained or persistent patch warrants assessment by a qualified dental or medical professional, particularly when a person reports a potentially harmful chewing habit. The case illustrated why awareness initiatives need to be accompanied by clear referral pathways and timely clinical evaluation when an abnormality is identified.
For younger people, these encounters also underline the importance of prevention before chewing habits become established. School-based education, accessible dental check-ups and early conversations about the risks of betel nut and smokeless tobacco use can help bring oral health into everyday health awareness.
From screening findings to meaningful follow-up
The session highlighted the complementary roles of cancer registries and community screening. Registries help document the burden and distribution of diagnosed disease, while outreach programmes can raise awareness, identify oral health concerns and encourage people to seek further assessment.
Neither function can achieve its full potential in isolation. Screening findings need appropriate clinical evaluation, and suspicious lesions must not be treated as confirmed cancer without diagnostic assessment. Likewise, identifying harmful chewing habits is an important first step, but lasting prevention may require sustained counselling, cessation support and follow-up.
The community reports presented at LUMHS also highlighted the role dental professionals and students can play beyond conventional clinical settings. By engaging with schools and communities, they can help make oral health information more accessible, encourage preventive practices and direct people towards appropriate care.
For programmes such as The DentEd Collective, collaboration with academic institutions and community partners provides a way to connect dental education with public health needs. Continued evaluation of outreach activities, including screening outcomes, referrals and follow-up, can also help demonstrate where programmes are making a difference and where additional support is needed.
Sustained action is essential for oral cancer control
The session led by Prof. Dr. Sana Mirza brought together registry evidence, research into smokeless tobacco use and observations from community screening to highlight the multiple challenges involved in oral cancer prevention.
The findings reinforce the need for a coordinated approach that combines reliable cancer data, targeted awareness, prevention of harmful chewing habits, access to dental services and timely assessment of suspicious oral lesions.
They also highlight the importance of tailoring interventions to the circumstances of the communities they are intended to reach. When dependence, stress and affordability influence behaviour, effective prevention must address those realities alongside the health risks themselves.
The message emerging from the session was clear: documenting the burden of oral cancer is essential, but reducing that burden also requires sustained community engagement, evidence-based prevention and early clinical assessment.
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