A test, which was used to screen cervical cancer in women, will find a wider use in early detection of oral cancer, a leading cause of death in India.
Traditionally, Papanicolau (PAP) smear test is conducted in sexually active women for early detection of cervical cancer. It involves collection of swabs containing cells from outer opening of the cervix in the uterus. These cells are examined to track abnormal cell growth.
In a study which involved using the PAP smear for oral cancer screening, dentists from Yashwant Rao Chavan Memorial Dental College in Aurangabad have found encouraging results. Up to 44 patients, including those who had developed white or red patches suspected to be pre-cancerous lesions, were studied for three years. “A fine bristled nylon brush was used to extract cells from multiple epithelial layers of the inner cheek. These cells were stained with dye used in PAP smear test and studied,” said Dr Dinesh Rajput, associate professor, Yashwant Rao Chavan Memorial Dental College.
The study threw up results which categorised up to 34 patients having high-grade cancer, four low-grade cancer and 10 as normal. “Thirty-four patients’ samples showed abnormal cell growth which was cancerous. The PAP technique is non-invasive and does not cause inconvenience to subjects,” said Rajput. “PAP smear is preferred for screening because biopsy, the only alternative, is painful and invasive. Only if PAP smear results are positive, biopsy of the oral cavity should be advised.”
Every year, around 80,000 new cases of oral cancer are reported in India. “It is highly prevalent in India as a large population chews gutkha, tobacco and pan masala. Lung and oral cancer are leading causes of death in India,” said Dr Pankaj Chaturvedi, professor, head and neck department, Tata Memorial Hospital in Parel.
Poor screening and late detection cause maximum deaths which can be averted through mass PAP smear test. “Around 1.5 lakh persons will be screened in Mumbai, Aurangabad and Pune until March 2015. We are in talks with police force, BMC officials, newspaper vendors, corporate houses such as TCS, Siemens and Edelweiss to screen employees for pre-cancerous oral lesions through PAP test,” said Sunil Ikhe, director, Virtus Health Services, India.