Oral Cavity Cancer: Situation in Pakistan and the Role of Pakistan Atomic Energy Commission

2026-02-04 - 00:06

By: Dr. Sadiq Hussain Nohario Director, AECH NORIN, Nawabshah Pakistan Atomic Energy Commission Oral cavity cancer is a major public health challenge worldwide and ranks among the leading causes of cancer-related morbidity and mortality. According to global estimates for 2022, the overall cancer burden reached 20 million new cases and 9.7 million deaths, with oral cancer contributing significantly to this toll. It is the most common malignancy among head-and-neck cancers and progresses through a multi-stage process, including the development of precancerous lesions, local invasion, and eventual metastasis. Globally, oral cancer accounts for approximately 3.8% of all cancer cases, with 389,846 new cases and 188,438 deaths annually. Its incidence varies geographically, with the highest prevalence reported in Asian countries, particularly Southeast Asia. In 2022 alone, Asia recorded 258,440 cases, followed by Europe (62,073 cases) and North America (30,992 cases). These statistics underscore that oral cancer is both a regional and global health concern. In Pakistan, oral cancer is a significant burden on the healthcare system, being the second most common cancer among males (12.9%) and females (9.5%). The high prevalence is largely driven by widespread use of smokeless tobacco, betel quid, and areca nut habits that are culturally ingrained in many regions. Common signs of oral cancer include red or red-and-white patches in the mouth or tongue, leukoplakia larger than 2 cm, and mouth ulcers that do not heal within three weeks. Patients may experience swelling, difficulty in chewing, swallowing, speaking, or moving the tongue, as well as jaw stiffness or pain. Other warning signs include neck pain, hoarseness, unexplained weight loss, taste changes, excessive salivation, ear pain, and swollen lymph nodes, which may indicate disease spread. Late diagnosis remains one of the biggest challenges in Pakistan. Advanced-stage detection significantly reduces survival rates and often necessitates aggressive interventions, including extensive surgery, radiotherapy, and chemotherapy. These treatments can cause facial disfigurement, speech difficulties, impaired nutrition, and long-term functional limitations. Studies show that factors such as tumor site, histological grade, and treatment type also influence recurrence rates and survival outcomes. Oral cancer has a well-established etiology. Major risk factors include tobacco use (smoked and smokeless), betel quid chewing, alcohol consumption, and human papillomavirus (HPV) infection. Additional contributing factors include physical inactivity, ultraviolet radiation exposure, and low socioeconomic status. In Pakistan, smokeless tobacco and betel nut consumption remain the dominant risk factors, explaining the country’s exceptionally high incidence. Treatment depends on the stage and location of the cancer and often involves a combination of approaches. Surgery is used to remove the tumor and affected tissues, while radiation therapy targets remaining cancer cells. Chemotherapy helps control disease spread, and newer approaches, including targeted therapy and immunotherapy, specifically attack cancer cells or boost the immune response. In this critical situation, Pakistan Atomic Energy Commission (PAEC) plays a vital role in combating oral cavity cancer. PAEC operates a nationwide network of 21 Atomic Energy Cancer Hospitals, providing comprehensive cancer care across Pakistan. These hospitals serve hundreds of thousands of patients annually, particularly from low- and middle-income backgrounds, offering diagnostic and treatment services at minimal or no cost. Collectively, PAEC’s Atomic Energy Cancer Hospitals manage more than 80% of the country’s total cancer patient load, making them the backbone of Pakistan’s public cancer care system. PAEC hospitals provide early diagnosis, biopsy services, radiotherapy, chemotherapy, surgery, and long-term follow-up. They adopt a multidisciplinary approach, involving radiation oncologists, surgeons, medical physicists, and allied health professionals, ensuring standardized and evidence-based care. By reducing treatment delays and expanding access to modern radiotherapy technologies, PAEC significantly improves survival outcomes and quality of life, particularly for patients with oral and head-and-neck cancers. On the occasion of World Cancer Day 2026, Dr. Shazia Fatima, Director General of Atomic Energy Cancer Hospitals, reaffirmed PAEC’s commitment to combating oral cancer. She emphasized early diagnosis, modern treatment facilities, and public awareness as pillars in improving cure rates. She also called on healthcare professionals, policymakers, media, and the public to collectively eliminate preventable risk factors, such as tobacco and betel nut use. With timely detection and coordinated national efforts, she stated, oral cancer can be effectively controlled. Oral cavity cancer is a major global and national health challenge, accounting for nearly 390,000 new cases annually worldwide and representing one of the most common cancers among Pakistani males. The high burden in Pakistan is driven by cultural habits, low awareness, and late diagnosis. Pakistan Atomic Energy Commission remains a cornerstone in the fight against this disease by providing accessible, affordable, and high-quality cancer care. Strengthening prevention strategies, expanding early screening programs, and promoting public awareness are essential steps to reduce the burden of oral cancer and save lives in Pakistan.