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'Oral cancer on the rise among youths' Oral cancer (OC) is one of the most common cancers worldwide with high mortality and low five-year survival rates. OC is the second most common malignancy in Pakistan but insufficient information is available regarding its etiological assessment and molecular characterization. People using Paan are about eight to nine times more likely to develop OC as compared to non-users. Smokeless tobacco, including Gutka and Niswar are also extremely addictive substances with a high rate of use in younger age groups. Like many other cancers in Pakistan, OC is observed in a relatively younger population with 30 per cent of cases occurring in patients of 40 years or younger. About 50 per cent of the cases are in advanced Stage-II. These views were expressed by the Senior Professor and Consultant Pathologist at Aga Khan University Hospital, Dr Shahid Pervez, while speaking at the 15th Public Awareness Seminar on "Oral Cancer", held at Latif Ebrahim Jamal National Science Information Centre, International Centre for Chemical and Biological Sciences, University of Karachi (KU), the other day. The seminar was jointly organised by Dr Panjwani Centre for Molecular Medicine and Drug Research (PCMD), KU and Virtual Education Project Pakistan (VEPP). Health professionals, students, research scholars, NGO representatives, and general public attended the program. Dr Pervez said that OC represents the second most frequent malignancy among both men and women with the highest reported incidence in the world. "This is largely associated with extremely prevalent chewing habits like taking Paan, Chalia, Gutka, Niswar and tobacco," he added. According to him, there are various ways of preparing these products but the main ingredients are always betel, areca and/or tobacco. Betel-quid extract is known to contain some areca-derived nitrosamines which are potent carcinogens. This is compounded with high incidence of cigarette smoking. The most common histological type of OC is squamous cell carcinoma (OSCC) comprising more than 90 per cent of all cases. Poor oral hygiene is another contributory factor in this population; interplay of these hazards is contributing towards endemic rise of oral cancers in Pakistan, particularly in the southern Pakistan. "As OC is largely a preventable cancer, a concentrated effort is required to educate the general public about the hazards of chewing and smoking, and on the other hand there is an urgent need to introduce screening programs in high risk populations to diagnose at a very early stage where cure is possible," Dr Pervez said.