Written By: Dr. Shweta Garg | Published : April 18, 2026 2:05 PM IST
It started as something trivial. A small ulcer inside the mouth no pain, no urgency. "I thought it would heal on its own " This is something I hear almost every day.
April, observed as Oral Cancer Awareness Month, is not just about spreading information it is about confronting a silent crisis that is growing rapidly across India. Oral cancer does not appear suddenly. It gives early warnings. The real danger is that most people choose to ignore them.
India carries one of the highest burdens of oral cancer globally. Each year, over 1 lakh new cases are reported, and nearly 70,000 75,000 lives are lost due to this disease. Traditionally, oral cancer has been more common in men, but now cases among women are also increasing, making it a serious concern for the entire population.
One pattern stands out clearly in India is gutkha and smokeless tobacco chewing. In my clinical experience, a large number of oral cancer patients both men and women have a history of gutkha, paan, or khaini use. These substances are often kept in the mouth for long durations, causing continuous irritation to the lining of the oral cavity.
Over time, this irritation leads to changes such as white patches, reduced mouth opening, and eventually cancer.
Studies suggest that 90 95% of oral cancer cases in India are directly linked to tobacco use, and gutkha chewing is one of the biggest contributors, especially in rural and semi-urban populations.
What makes it more dangerous is how normalized it has become often starting at a young age and continuing silently for years.
As a pathologist working in a government district hospital, I see the ground reality every day. Over the past decade, we have screened more than 1.5 lakh individuals, diagnosed over 6000 cancer cases, and a significant proportion of these have been oral cancers many linked to long-term gutkha use.
Patients often come at advanced stages. When asked, they recall noticing an ulcer or patch months earlier but ignored it, assuming it was minor. Today, we are also seeing younger patients (30 40 years) and increasing cases among women, especially those exposed to smokeless tobacco or passive habits.
Oral cancer often begins with visible and detectable changes:
These symptoms may seem harmless initially but they are early warning signs.
One of the most important truths about oral cancer is:
Simple tests like FNAC or biopsy are safe, quick, and essential. They do not cause harm they provide clarity and enable timely treatment. Unfortunately, many patients delay testing due to fear or myths.
This April, awareness must turn into action:
During our rural outreach programs, we have identified many precancerous lesions early especially in gutkha users and prevented progression to cancer.
Oral cancer does not happen overnight. It builds slowly silently often starting with a habit as small as a pouch of gutkha. This April, make one decision
Quit the habit before it becomes a diagnosis. Because sometimes what seems like "just a small ulcer" is the first warning your body is giving you.
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