Pune: There has been a sharp and worrying increase in the number of oral cancer patients amid a rise in screenings, with 250 confirmed cases reported in Maharashtra in April and May alone. In 2025-26, 3,677 cases were registered under the state's Non-Communicable Disease (NCD) screening programme, up from 1,018 in 2021-22. Doctors said patients are getting younger and cancers more aggressive.
Younger Patients and Aggressive Cancers
"Two decades ago, the average age was about 50 years, now it's around 30," said Dr Sunil Deshmukh, head and neck surgery at the State Cancer Institute, Chhatrapati Sambhajinagar. He reported faster spread and rarer, harder-to-treat incidences. State data for 2026 showed that 11,885 patients, of which 8,758 are men, were under treatment.
Screening Challenges
Dr Nitin Ambadekar, director of health services, Maharashtra, said, "We screen patients via the four finger test, which can be done by nurses or our trained medical staff on ground, and the visual screening done by experts who travel village to village in our diagnostic vans. The state runs a cancer diagnostic van in eight circles. Hesitation and stigma keep most people away, while follow-ups are tedious with patients dropping out of the system. It is important to close every referral until diagnosis and ensure every diagnosed case is treated. Oral cancer patients often reach out at a late stage, when limited treatment options are available."
World No Tobacco Day Focus
On World No Tobacco Day, marked on May 31, experts reiterated that Maharashtra was a hotspot for tobacco-driven oral cancers despite a statewide ban on gutka and paan masala. Informal workers, slum residents, migrant labourers and tribal communities face the greatest risk and the least screening. Impediments include lost wages, distance to facilities, stigma and limited awareness. Additionally, frontline health workers are overburdened and often lack simple tools to spot early lesions during busy camps or OPDs.
National Screening Rates
National data showed India's oral-cancer screening rate averages just 4.4 per 1,000 people. A 2025 study in Oral Oncology using National Family Health Survey data found that people living in high-tobacco-prevalence states were 42% less likely to be screened than those in low-prevalence states.
Role of Technology
Ambadekar said, "Our cancer vans have paramedical staff and a doctor or a dentist. Screening is based on the doctor's discretion and samples are collected, if needed, for biopsy — the only confirmatory test for oral cancer. Shortage of skilled manpower is a problem and we schedule the visits to cover as many villages as possible. If there are any advanced technologies that may help the community in screening, diagnosing or treating patients, we are open to it."
Experts said mobile diagnostic vans, smartphone-based imaging and AI-assisted triage could transform every ASHA visit, Aanganwadi meeting or workplace check-up into a screening opportunity. Integrating AI with inter-operable registries would let health departments map tobacco and lesion hot spots in real time, target cessation support and fast-track referrals, thus complementing clinical examination and histopathology.
Call to Action
In order to reduce Maharashtra's mounting oral-cancer burden, policymakers must expand accessible screening, equip frontline workers, and adopt validated AI tools, especially for the communities that currently fall through the cracks, said doctors.
