Daijiworld Media Network - New Delhi
New Delhi, Dec 24: More than six out of 10 cases of mouth (buccal mucosa) cancer in India are linked to frequent alcohol consumption and the chewing of smokeless tobacco products such as gutkha, khaini and paan, with locally brewed alcoholic drinks posing the highest risk, according to a major study published on Wednesday.
The study, conducted by researchers from the Centre for Cancer Epidemiology and the Homi Bhabha National Institute in Maharashtra, found that even very low levels of alcohol intake significantly increased the risk of buccal mucosa cancer. Consumption of less than 2 grams of beer a day was associated with a heightened risk, while 9 grams of alcohol per day — roughly one standard drink — raised the risk of mouth cancer by about 50 per cent.
When alcohol use was combined with chewing tobacco, the researchers estimated that it accounted for nearly 62 per cent of all buccal mucosa cancer cases in the country. The findings were published in the open-access journal BMJ Global Health.
The study noted that more than 11 per cent of all buccal mucosa cancer cases in India are attributable to alcohol consumption, with the figure rising to around 14 per cent in states with a high disease burden such as Meghalaya, Assam and Madhya Pradesh.
“Alcohol was a contributory factor to the heightened risk of mouth cancer, irrespective of how long tobacco had been used,” said the research team led by Grace Sarah George. They explained that ethanol may alter the fat content of the inner lining of the mouth, increasing its permeability and making it more susceptible to carcinogens present in chewing tobacco.
The researchers also pointed to possible contamination of locally brewed alcohol with toxins such as methanol and acetaldehyde, which may explain the higher cancer risk linked to these unregulated drinks.
Mouth cancer is the second most common cancer in India, with an estimated 1.43 lakh new cases and nearly 80,000 deaths reported annually. Disease rates have steadily increased and currently stand at just under 15 cases per 1,00,000 Indian men. The most common form affects the soft pink lining of the cheeks and lips, known as the buccal mucosa, and less than half of patients survive beyond five years.
The study analysed data from 1,803 patients with confirmed buccal mucosa cancer and 1,903 individuals without the disease, drawn from five centres between 2010 and 2021. Most participants were aged between 35 and 54, with nearly 46 per cent of cases occurring among those aged 25 to 45.
Compared to non-drinkers, the risk of buccal mucosa cancer was 68 per cent higher among alcohol consumers. The risk increased to 72 per cent for those consuming widely recognised alcoholic beverages such as beer, whisky, vodka, rum and breezers, and to 87 per cent for those consuming locally brewed drinks like apong, bangla, chulli, desi daru and mahua.
“Our study shows that there is no safe limit of alcohol consumption for buccal mucosa cancer risk,” the researchers said, adding that strong public health measures to curb alcohol and tobacco use could largely eliminate this form of cancer in India.