KARACHI, Oct 13: The overuse of betel nut and gutka is fuelling the frequency of oral cancer in the country, which may be as high as 40 per cent of all cancer cases.

This was stated by some experts at a seminar held by the Pakistan Medical Association in the PMA House on Wednesday. The speakers demanded that the government ban the import of both betel nut and gutka. The sale of paan, betel nut and gutka should also be prohibited.

They pointed out that the sale of tobacco was not permitted to people of 18 years or less. However, this rule was regularly flouted, leading to all sorts of problems. Fatima Surayya Bajia - an adviser to the chief minister who herself suffered from mouth cancer - related her story on the occasion, describing how she had to be operated upon to remove a cancerous growth.

She said an abscess had developed in her mouth which was not taken care of promptly and properly. Later on, it was discovered that it was malignant. Dr Javed Alam of the Dow University of Health Sciences said cancers could be diagnosed early on, provided biopsies and CT scans were undertaken in far greater numbers when compared to their frequency today. He said many people unnecessarily shied away from getting their biopsies done.

The effectiveness of the treatment, he said, depended on the careful diagnosis of the stage a cancer was in. "And this in turn depends on the efficiency with which an examination like biopsy and CT scan is carried out."

To deal with oral and facial cancers close cooperation between dentists, ENT specialists and oncologists was required, said Dr Alam. The main cause of the rise of oral cancers was the overuse of betel nut and gutka, he added.

Dr Tariq Rafi of the Jinnah Postgraduate Medical Centre said sweetened betel nut was sold in the market after processing with artificial sweeteners and colours which were harmful to the body. Traditionally, oral cancer and submucous fibrosis largely affected the old and middle-aged people, but now even teenagers were complaining of these ailments.

Dr Qaiser Sajjad of the Pakistan Medical Association said globally oral cancers accounted for three per cent of all cancer cases. "But for Pakistan this number is as high as 40 per cent."

He said that more than 120 brands of gutka and sweetened betel nut were available in the local market. Most of these were manufactured under unhygienic conditions. Tobacco was being sold openly to people of 18 years or less, in clear violation of the relevant rules. He also spoke of the possibility that some of the gutka and betel nut brands might be laced with addictive material.

He demanded that the government prohibit the sale of these products in schools and colleges. "In fact, the sale should be banned in a 1km radius of every educational institution." Dr Sajjad said the ban on the import of betel nut, which had been lifted recently, should be reintroduced. Dr Aleem Qadir and Dr Amir Raza also spoke on the occasion.