Oral cancer and cultural practices in relation to betel quid and tobacco chewing and smoking.

Oral cancer is the most common cancer in India, Pakistan, and Sri Lanka and ranks high in several southeast Asian countries. The association of these cancers with cultural practices like chewing was recognized almost a century ago. Continued work since then has identified tobacco use as the most important avoidable cause of oral cancer. Critical appraisal of specific cultural practices that lead to high risk of oral cancer will be presented with a focus on possible strategies for prevention programs. The need to monitor cultural changes such that these changes lead to prevention of cancer and not a shift from one type of cancer to another will be emphasized.