Published: 2019-01-23

Oral cancer awareness among university students from Karachi, Pakistan

Dnyanesh Limaye, Patrick Ziesenis, Vaidehi Limaye, Mansoor Ahmad, Farah Saeed, Mahboob Alam, Ramla Rizvi, Atul Kapadi, Sushama Sathe, Gerhard Fortwengel


Background: Oral cancers (OC) are malignant lesions occurring in the oral cavity that include squamous cell carcinomas (SCC), salivary gland and odontogenic neoplasms. Even though it is the eighth most common malignancy globally but in Pakistan it is the second commonest type of cancer. Lack of awareness about ill-effects of preventable risk factors of oral cancer increases the burden of disease due to the associated high cost of treatment, permanent impairment and high mortality. Hence, awareness can be very helpful in prevention, control and early diagnosis of oral cancer.

Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during April to May 2018. Three hundred students were approached to participate in the study of which 277 agreed to participate. Pretested questionnaire was distributed and collected data was analysed using IBM SPSS version 23.

Results: There were 125 (45%) males and 152 (55%) females in the study and response rate was 94%. Sixty one percent (154/250) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost one third (74%; 184/250) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Sixty six percent (164/250) respondents believed that oral cancer is curable. Mean score of knowledge was higher in females (61%) than males (53%). Significantly higher number of females compared to male participants answered correctly to questions regarding cause of oral cancer, spread of disease and occurrence of oral cancer in AIDS patients.

Conclusions: Participants showed poor knowledge about oral cancer. Female participants showed better knowledge compared to male counterparts. Details about oral cancer should be incorporated in the university curriculum and periodic awareness programs should be organized for students.


Knowledge, Karachi, Oral cancer, Pakistan, Smoking, Tobacco, University students

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Bhurgri Y, Bhurgri A, Hussainy AS, Usman A, Faridi N, Malik J, et al. Cancer of the oral cavity and pharynx in Karachi-identification of potential risk factors. Asian Pacific J Cancer Prevention. 2003;4(2):125-30.

Sawair FA, Al-Mutwakel A, Al-Eryani K, Al-Surhy A, Maruyama S, Cheng J, et al. High relative frequency of oral squamous cell carcinoma in Yemen: qat and tobacco chewing as its aetiological background. Inter J Env Health Res. 2007;17(3):185-95.

Ariyoshi Y, Shimahara M, Omura K, Yamamoto E, Mizuki H, Chiba H, et al. Epidemiological study of malignant tumors in the oral and maxillofacial region: survey of member institutions of the Japanese Society of Oral and Maxillofacial Surgeons, 2002. Inter J Clin Oncol. 2008;13(3):220.

Kruaysawat W, Aekplakorn W, Chapman RS. Survival time and prognostic factors of oral cancer in Ubon Ratchathani Cancer Center. J Med Assoc Thailand Chotmaihet Thangphaet. 2010;93:278-84.

Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009;45:309-16.

Ferlay J. Cancer incidence, mortality and prevalence worldwide. GLOBOCAN2002. 2004.

Moore SR, Johnson NW, Pierce AM, Wilson DF. The epidemiology of mouth cancer: a review of global incidence. Oral Dis. 2000;6(2):65-74.

IARC. Cancer incidence in five continents, 2010. Available at: Accessed 27th October 2018.

Cancer Registry and Clinical Data Management (CRCDM)-Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCHandRC). Report based on cancer cases registered at SKMCHandRC from December 1994 - December 2011, 2012. Available at: Accessed 20th December 2018.

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Inter J Cancer. 2010;127(12):2893-917.

Choi S, Myers JN. Molecular pathogenesis of oral squamous cell carcinoma: implications for therapy. J Dental Res. 2008;87(1):14-32.

Idrees R, Fatima S, Abdul-Ghafar J, Raheem A, Ahmad Z. Cancer prevalence in Pakistan: meta-analysis of various published studies to determine variation in cancer figures resulting from marked population heterogeneity in different parts of the country. World J Surg Oncol. 2018;16(1):129.

Rehman S, Khan M. Awareness of oral cancer in undergraduate medical and dental students. Pakistan Oral Dental J. 2012;32(3):385-88.

Kazmi F, Chaudhary MA, Mumtaz M, Bhatti MU, Khawaja N. Oral cancer knowledge and awareness amongst undergraduate dental students of Lahore-pakistan. Pakistan Oral Dental J. 2011;31(1):64-7.

Kassim NK, Adnan MM, Wern CW, Ru LZ, Hanafi MH, Yusoff A. Awareness and knowledge of oral cancer among siamese ethnic group in Tumpat, Kelantan. Malaysian J Med Sci: MJMS. 2017;24(4):47.

Chia-ching JW, Silverberg MJ, Abrams DI. Non-AIDS-defining malignancies in the HIV-infected population. Current Infectious Dis Rep. 2014;16(6):406.

Coelho KR. Challenges of the oral cancer burden in India. J Cancer Epidemiol. 2012;2012.

Shenoy N, Ahmed J, Saranya B, Shenoy AK, Kamath P, Srikant N, et al. Oral cancer awareness among undergraduate medical students of Dakshina Kannada, India. Scholars J Applied Med Sci. 2013;1(5):632-6.

Fotedar V, FOtedar S, Gupta M, Manchanda K, SharMa M. Oral cancer knowledge, attitudes and practices: a survey of undergraduate medical students in Himachal Pradesh, India. JCDR. 2015;9(8):XC05.

Usman G, Kumar S, Irfan MA, Agha S, Taj A. Prevalence of pan, gutka, betalnut, naswar and cigarette smoking in university students of Karachi. InMed Forum 2015;26(1):41-4.