30 Nov 2017

A leading doctor has issued a warning to Asians living in the UK that they could be putting themselves at a significant risk of mouth cancer as a result of traditional high-risk habits.

Dr Chet Trivedy, who is an A&E consultant at Kingston Hospital in London, believes common cultural habits in many British-Asian communities, such as tobacco and betel (areca) nut chewing, is placing thousands at severe risk of developing mouth cancer.

Dr Trivedy, who is also a dentist and trustee of the Oral Health Foundation, says chewing tobacco and betel nut increases a person's risk of developing mouth cancer by up to seven times. 

Highlighting the significance of the issue, Dr Trivedy, wants more British Asians to be aware of the dangers of chewing products containing betel nut and tobacco, also referred to as ‘paan' or ‘paan masala', and emphasises the need for greater education about its links to mouth cancer.

Dr Trivedy says: "I grew up in the Gujarati (Indian) community in Britain and have seen first-hand the devastating effect that mouth cancer can have on our community, not only through my work but also on a personal level. I am therefore incredibly keen to draw attention to this major problem."

A report from the National Institute of Health and Family Welfare (NIHFW), has revealed that mouth cancer is among the top three cancers in India and accounts for 30% of the country's cancer burden. 

Mouth cancer also has incredibly high rates in other Asian nations such as Pakistan, Bangladesh and Sri Lanka and Taiwan. 

"Without a doubt one of the biggest reasons for this is the traditional cultural behaviour of paan masala chewing," Dr Trivedy adds. 

"This highly carcinogenic substance is commonly used in Asian communities as a powerful stimulant and is widely available in most South Asian grocery stores. It's used commonly in religious ceremonies and to aid digestion, you can often spot a betel nut user as it stains their mouths a bright red colour.

"How it is consumed differs between communities, but it is most commonly consumed as a substance called ‘quid' involving a mixture of slaked lime, betel leaf and flavourings such as cardamom and tobacco.

"By including slaked lime, the ‘quid' causes hundreds of tiny abrasions in the mouth which the cancer-causing carcinogens in the betel nut can enter the cells of the mouth.

"Chewing is incredibly unsafe as it allows prolonged exposure to these carcinogens and, dangerously, far too many people are unaware of the severe damage it can cause."

A recent study led by the University of York revealed as many as a quarter of a million deaths worldwide are caused by smokeless tobacco products every year. 

The study found a ‘hotspot' of use in South and South-East Asia, in particular India, which accounts for almost three quarters (74 per cent) of the total global disease burden. 

Dr Trivedy has issued the warning as part of Mouth Cancer Action Month, a campaign which aims to raise awareness of mouth cancer, promote the value of self-examination and encourage regular trips to the dentist, as they perform a visual mouth cancer check during every dental check-up.

The charity campaign is organised by the Oral Health Foundation, sponsored by Simplyhealth Professionals and has further support from Dentists' Provident.

"Mouth cancer awareness in Asian communities is vital as it has a very high mortality rate," Dr Trivedy says.

"Survival chances are closely linked to late diagnosis but far too many cases are being caught too late for effective intervention, particularly with Asian communities who may be less active at accessing healthcare.

"I encourage British Asian communities to spot the warning signs, ulcers which do not heal within two weeks, red or white patches in the mouth and any unusual lumps in the head or neck area. Visit a dentist or doctor if they notice anything unusual. 

"Betel nut chewing is particularly associated with a condition call oral submucous fibrosis (OSF), which causes severe scarring in the mouth resulting in affected patients only being able to open their mouth by a few milometers'. About 7% of those affected will go on to develop mouth cancer. 

"I want the British Asian community to become more involved in mouth cancer awareness and help make a difference by spreading lifesaving messages throughout their communities and beyond." 

As Mouth Cancer Action Month draws to a close today, the Oral Health Foundation is keen to stress that mouth cancer can affect anyone, so everybody needs to be able to recognise and act on the early warning signs all year around in order to improve early diagnosis and help save lives which otherwise could be lost to this terrible disease.

Find out more information about the signs, symptoms and causes of mouth cancer at www.mouthcancer.org.