An Overview on Oral Cancer: Global and Myanmar Perspectives

Abstract

Oral cancer remains a critical global health challenge, with rising trends, particularly in South and Southeast Asia. In Myanmar, the disease represents a significant public health crisis, consistently ranking among the top ten causes of morbidity and mortality. Epidemiological data shows that oral cancer is the 3rd leading malignancy in males and 8th in females.  Epidemiological studies identified betel quid chewing, tobacco use, and alcohol consumption as the primary risk factors driving high mortality rates, particularly among men.  In Myanmar, the habit of betel quid chewing daily had been reported among 51.4% of adult males and 39% of females. The quid—typically a mixture of areca nut (a Group 1 carcinogen), tobacco, and slaked lime—causes chronic mucosal damage and fibrosis. Because many users keep the quid in their cheek for extended periods, the buccal mucosa is the most frequent subsite for malignancy, accounting for 62% of cases. Squamous cell carcinomas constitute the majority of these malignancies, which are typically aggressive and associated with poor prognosis. Although the oral cavity is easily accessible for screening, most cases in Myanmar are diagnosed at advanced stages due to limited public awareness and late-stage hospital presentations. This is particularly tragic as early detection can increase survival rates from approximately 20% to over 80%. To address this, research in Myanmar has validated modified oral brush biopsy techniques as cost-effective screening tools with reasonable sensitivity (80%) for detecting early epithelial dysplasia. In conclusion, while oral cancer is largely preventable in Myanmar, improving survival rates requires a significant shift in public health education and early detection infrastructure. A multifaceted public health approach focusing on primary prevention to stop habit initiation among adolescents and secondary prevention through regular visual screenings for high-risk adults. Without addressing the social acceptance of betel quid and improving early diagnostic infrastructure, oral cancer will remain a leading preventable cause of death.