Retrospective analysis of oral cancers in Shimla-Himachal Pradesh (2011-2018): a hospital-based study

Shailee Fotedar, Vikas Fotedar, Manish Gupta, Vinay Bhardwaj, Purnima Thakur, Shabnan Thakur


Background: Oral cancer ranks in the top three of all cancers in India, and oral cancer control is quickly becoming a global health priority. To analyse the epidemiological and clinical profile of oral cancer patients treated in Tertiary Care Center, IGMC, Shimla from 2011-2018.

Methods: A retrospective study of patients with oral cancers treated from 2011-2018 at TCC, IGMC, Shimla was conducted. Demographic characteristics, tobacco use and oral cancer characteristics related to site, histology and stage at presentation were recorded from patient file records at TCC, Shimla. Data was analysed by Statistical package for social sciences (SPSS) version 16. Statistical test used was chi square test. A p value of 0.05 was considered to be statistically significant.

Results: Oral cancer represents 1.53% of overall cancers. The total number of subjects were 246 out of which 205 were men and 41 were women thus making a male female ratio of 5:1. Peak age of occurrence is the 5th and 6th decade. The most common site involved was tongue (37.5%) followed by buccal mucosa (35.5%). Buccal mucosa was significantly associated with male gender, age group of less than 40 years. Lip was significantly associated with female gender, more than 60 years and with no habits. Floor of the mouth was significantly associated with males, 40-60 year age group and tobacco smoking.

Conclusions: Strategies to overcome the present situation must be undertaken at state level by oral health programs for the early diagnosis and prevention and to support a tobacco free environment.



Oral cancer, Tobacco, Alcohol

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Sankaranarayanan R, Ramadas K, Thomas G, Muwonge R, Thara S, Mathew B, et al. Effect of screening on oral cancer mortality in Kerala, India: A cluster-randomised controlled trial. Lancet. 2005;365:1927-33.

Gupta B, Ariyawardana A, Johnson NW. Oral cancer in India continues in epidemic proportions: evidence base and policy initiatives. International Dental Journal. 2013;63:12-25.

Lawoyin JO, Lawoyin DO, Aderinokun G. Intra – oral squamous cell carcinoma in Ibadan: a review of 90 cases. Afr J Med MedSci. 1997;26:187-8.

Howell RE, Wright BA, Dewar R. Trends in the oral cancer in NovaScotia from 1983 to 1997. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:205-12.

Hernandez-Guerrero JC, Jacinto-Aleman LF, Jimenez-Farfan MD. Prevalence trends of oral squamous cell carcinoma. Mexico City’s General Hospital experience. Med Oral Patol Oral Cir Bucal. 2013;18:306-11.

Balaram P, Sridhar H, Rajkumar T. Oral Cancer in Southern India: the influence of smoking, drinking, pan chewing and oral hygiene. International Journal of Cancer. 2002;98(3):440-5.

Schantz SP, Yu GP. Head and neck cancer incidence trends in young Americans, 1973-1997, with a special analysis for tongue cancer. Arch Otolaryngol Head Neck Surg. 2002;128:268-74.

Rautava J, Luukkaa M, Heikinheimo K, Alin J, Grenman R, Happonen RP. Squamous cell carcinomas arising from different types of oral epithelial differ in their tumor and patient characteristics and survival. Oral Oncol. 2007;43:911-9.

Fotedar S, Sogi GM, Sharma KR. Retrospective analysis of oral cancer at Shimla, Himachal Pradesh, India (2003-2007): A Hospital Based Study. Journal of Indian Association of Public Health Dentistry. 2009;14:107-13.

Barnes L, Eveson JW, Reichart P, Sidransky O. Pathology and Genetics of Head and Neck Tumors. Geneva: WHO. World Health Organisation stageification of tumor. 2005;168-75.

Bhattacharjee A, Chakraborty A, Purkaystha P. Prevalence of head and neck cancers in the North East - An institutional study, Indian Journal of Otolaryngology and Head and neck. 2006;58(1):15-9.

Mehrotra R, Singh M, Gupta RK, Singh M, Kapoor AK. Trends of prevalence and pathological spectrum of head and neck cancers in North India Indian Journal of Cancer. 2005;42(2):89-93.

Padmakumary G, Varghese C. Annual Report. 1997. Hospital Cancer Registry. Thiruvananthapuram; Regional Cancer Centre. 2000;3-7.

Tandon A, Bordoloi B, Jaiswal R, Srivastava A, Singh RB, Shafique U. Demographic and clinicopathological profile of oral squamous cell carcinoma patients of North India: A retrospective institutional study. SRM J Res Dent Sci. 2018;9:114-8.

Singh MP, Kumar V, Agarwal A, Kumar R, Bhatt MLB, Misra S. Clinico-epidemiological study of oral squamous cell carcinoma: A tertiary care centre study in North India. journal of oral biology and craniofacial research. 2016;6:31-4.

Shenoi R, Devrukhkar V, Chaudhuri, Sharma BK. Demographic and clinical profile of oral squamous cell carcinoma patients: A retrospective study. Indian J Cancer. 2012;49:21-6.

Jayasooriya PR, Pitakotuwage TN, Mendis BR, Lombardi T. Descriptive study of 896 oral squamous cell carcinomas from the only university based oral pathology diagnostic service in Sri Lanka. BMC Oral Health. 2016;16:1-14.

SinghaniaV,Jayade BV, Anehosur V, Gopal Krishnan K, Kumar N. Carcinoma of Buccalmucosa:A site specific clinical audit.Indian J Cancer. 2015;52:605-10.

Singh MP, Kumar V, Agarwal A, Kumar R, Bhatt ML, Misra S, et al. Clinico ‑epidemiological study of oral squamous cell carcinoma: A tertiary care centre study in North India. J Oral BiolCraniofac Res. 2016;6:31‑4.

Sharma P, Saxena S, Aggarwal P. Trends in the epidemiology of oral squamous cell carcinoma in western UP: An institutional study. Indian J Dent Res. 2010;21:316‑9.

Krishna A, Singh RK, Singh S, Verma P, Pal US, Tiwari S. Demographic Risk Factors, Affected Anatomical Sites and Clinicopathological Profile for Oral Squamous Cell Carcinoma in a North Indian Population. Asian Pacific journal of cancer. 2014;15(16):6755-60.

Kiran G, Shyam NDVN, Rao J. Demographics and histopathological patterns of oral squamous cell carcinoma at a tertiary level referral hospital in hyderabad, India: A 5-year retrospective study. J Orofac Res. 2012;2:198-201.

Saraswathi TR, Ranganathan K, Shanmugam S. Prevalence of oral lesions in relation to habits: cross sectional study in South India. Indian J Dent Res. 2006;17: 121-5.

Sankaranarayan R. Oral cancer in India, an epidemiologic and clinical review. Oral Surg Oral Med Oral Pathol. 1990;69:325-30.

Gupta PC, Murti PR, Bhonsle RB, Mehta FS, Pindborg JJ. Effect of cessation of tobacco use on the incidence of oral mucosal lesion in a 10 yr follow-up study of 12,212 users. Oral Dis. 1995;1:54-8.

Chattopadhyay A. Epidemiology study of oral cancer in eastern India. Indian J Dermatol. 1989;34:59-65.

Iype ME, Pandey M, Mathew A, Thomas G, Sebastian P, Nair KM. Squamous cell carcinoma of the tongue among young Indian adults. Neoplasia. 2001;3:273-7.

Santos LRM, Cernea CR, Kowalski LP et al. Squamous-cell carcinoma of the lower lip: A retrospective study of 58 patients.sao Paulo Medical Journal. 1996;114(2):1117-26.

Domínguez‑Gordillo A, Esparza‑Gómez G, García‑Jiménez B, Cerero‑Lapiedra R, Casado‑Gómez I, Romero‑Lastra P, et al. The pattern of lip cancer occurrence over the 1990‑2011 period in public hospitals in Madrid, Spain. J Oral Pathol Med. 2016;45:202‑10.

Chidzonga MM, Mahomva L. Squamous cell carcinoma of the oral cavity, maxillary antrum and lip in a Zimbabwean population: A descriptive epidemiological study. 2006;42(2):184-9.

Smitha T, Mohan CV, Hemavathy S. Clinicopathological features of oral squamous cell carcinoma: A hospital-based retrospective study. J NTR Univ Health Sci. 2017;6:29-34.

Madani AH, Dikshit M, Bhaduri D, Jahromi AS, Aghamolaei T. Relationship between selected socio‑demographic factors and cancer of oral cavity – A case control study. Cancer Inform. 2010;9:163‑8.

Kademani D. Oral cancer. Mayo Clin Proc. 2007;82:878‑87.

Scully C. Oral cancer aetiopathogenesis; past, present and future aspects. Med Oral Patol Oral Cir Bucal. 2011;16:306‑11.

Mehrotra R, Yadav S. Oral squamous cell carcinoma: Etiology, pathogenesis and prognostic value of genomic alterations. Indian J Cancer. 2006;43:60‑6.

Global Adult Tobacco Survey Fact sheet 2016-2017. Accessed on 20th May, 2021.

Mehrotra R, Singh M, Kumar D. Age specific incidence rate and pathological spectrum of oral cancer in Allahabad. Indian J Med Sci. 2003;57:400-4.

Addala L, Pentapati CK, Thavanati PK. Risk factor profiles of head and neck cancer patients of Andhra Pradesh, India. Indian J Cancer. 2012;49:215-21.