The Gadchiroli district of Maharashtra claims a dubious distinction. It is the Indian district with the highest rate of oral cancer.
The district is home to more than a million people and reports an estimated 550 cancer cases every year. Oral cancer accounts for 28 percent of these cases, including forty percent of cancers in men and twenty percent in women.
According to data from a new cancer registry, oral cancer affects twelve out of every one lakh women and twenty out of every one lakh men in the district. The registry – jointly developed by the Tata Memorial Hospital and the Society for Education, Action, and Research in Community Health (SEARCH) – identifies oral cancer as the second leading cancer among women after cervical cancer. Dr Yogesh Kalkonde, a public health researcher with SEARCH – deemed this a “highly unexpected” finding.
“50.4 percent of residents of the Gadchiroli district use tobacco…fifty percent of cancers in men and thirty percent of cancers in women are tobacco-related.”
A high proportion of tobacco use in the district is believed to be responsible for the high incidence of oral cancer in the area. According to a prior SEARCH study, 50.4 percent of residents of the Gadchiroli district use tobacco. As such, Dr Kalkonde states that fifty percent of cancers in men and thirty percent of cancers in women are tobacco-related.
The Government of Maharashtra has banned some oral tobacco products including Gutkha and scented tobacco in the state, while alcohol is banned in Gadchiroli district since 1993. In spite of the ban, people in the district consume alcohol and tobacco on a large scale.
The registry marks an effort to map cancer burden among tribal populations. Gadchiroli is a notified tribal district, with some blocks registering up to 81.5 percent of its populace as being tribal. The district also has a low rate of urbanisation, varying block-by-block between zero percent and 37.1 percent.
The registry marks an important initiative in aiming to map the health concerns of tribal populations, often a neglected demographic when it comes to the conversation surrounding health and development in India. It also shines a light on the continued health burden of tobacco use in India. 3,500 lives are lost each day to the health consequences of tobacco use, at a cost of Rs 1.04 trillion to the exchequer. Gadchiroli spotlights this and serves as a reminder of the health implications of using tobacco and why a pushback against the habit is a public health necessity.