Oral Cancer Burden in Pakistan
In Pakistan, oral cancer is the second leading cause of cancer-related deaths, accounting for 11.27% of all cancer deaths in 2020. Oral Squamous Cell Carcinoma (OSCC), which accounts for almost 90% of all oral cancers, results from the uncontrolled and abnormal growth of cells lining the oral cavity. These abnormal cells form lesions that cause functional impairment and are associated with high mortality rates.
Role of Tobacco and Betel Quid
The high prevalence of oral cancer is largely due to a lack of public awareness regarding the persistent use of betel quid and smoked as well as smokeless tobacco. The continued use of these seemingly less harmful substances causes premalignant changes in the oral cavity. For example, Oral Submucous Fibrosis, a condition characterised by restricted mouth opening, is becoming increasingly common. It eventually progresses to Oral Squamous Cell Carcinoma and may lead to distant metastasis, significantly worsening the overall prognosis.
New Saliva Biomarker: MUC-4 Protein
This research focuses on a new, non-invasive biomarker found in human saliva known as the MUC-4 protein. The level of this salivary protein changes with the progression of the disease and can be detected at a very early stage. Through this biomarker and the research conducted by PhD scholar Faiqua Mahmood under the supervision of Prof. Dr. Asim Aslam, Department of Pathology, University of Veterinary and Animal Sciences, Lahore, Pakistan, the early diagnosis of oral cancer can be improved, benefiting the general public and enhancing overall disease prognosis.
Microbiota Changes and Next-Generation Sequencing
Another significant finding was a shift in the normal oral flora and microbiota from healthy species to those that promote tumour progression and contribute to the tumour microenvironment. These microbial changes may also help predict individuals who are at greater risk of developing the disease. A newly emerging testing technique, Next-Generation Sequencing (NGS), was used to analyse healthy and diseased tissue samples to further explore the process of carcinogenesis. The study was conducted at various tertiary care hospitals in Lahore.
Potential Impact on Early Detection
This study has the potential to significantly improve the early detection and prevention of Oral Squamous Cell Carcinoma through a simple saliva sample, thereby helping reduce the mortality rate associated with the disease.
