Head and neck squamous cell cancer (HNSCC) is maximally encountered in India across the globe and the environmental practices herein probably have the biggest contribution in carcinogenesis.
This prospective study presents the possible association of various environmental determinants on 707 histologically proven HNSCC patients
The data was collected on (1) age, (2) sex, (3) religion, (4) education status, (5) income status, (6) site of involvement [categorized as per ICD-10 into nose, oral cavity, pharynx including oropharynx/ nasopharynx/ hypopharynx , larynx,, salivary gland including parotid/ submandibular gland, and ear, (7) passive smoking at home, (8) passive smoking at workplace, (9) severity of smoking, (10) age when became a regular smoker, (11) evidences of gastroesophageal reflux disease, (12) age when stopped smoking, (13) use of other tobacco products, (14) age at starting alcohol, (15) age at quitting alcohol, (16) current use of multivitamins and minerals.:
The incidence of preventable cancer showed most significant association with tobacco, educational- and income status. Many other interesting observations have emerged from this study that may need to be further worked up. The rarity of malignancy tympanomastoid in a population with prevalence of ear discharge (chronic suppurative otitis media) of 15% (rural) raises the question against the predisposition of cancer by CSOM in Indian population. Secondly the significantly increased rate of pharyngeal cancer in 5th decade is unique
Two points have emerged from this study that are likely to have the highest impact on cancer control policy in India: (1) implementing compulsory education till class VI and (2) Enhancing family income to Rs 4000/ INR per month. With crude / non-standardized products being marketed a standardization-policy needs to be universally implemented by the government of India especially in the rural areas