Cancer specialist warns of epidemic in PNG and Melanesia

Transcript

An Australian oral cancer expert says Melanesia and in Papua New Guinea in particular may be experiencing an undiagnosed oral cancer epidemic.

Associate Professor Carsten Palme from the University of Sydney is an Ear, Nose and Throat surgeon who has been working in Papua New Guinea.

He says Melanesia has the highest rates of oral cancer in the world and many of those suffering from the cancer in Papua New Guinea are women.

CARSTEN PALME: If you look at the rates of oral cavity cancer around the world you know the incidence in the Western World is probably around about six per hundred thousand cases in the male population but if you look at some of the data from 2008 the rate of oral cavity cancer in Melanesia of which Papua New Guinea is part of is round about 24 cases per hundred thousand and in women its about 12 per hundred thousand cases and that if you compare it to places in the other parts of the Pacific, Europe is by far the highest rate by at least two to one.

KOROI HAWKINS: And what is the cause of this why are the rates so high?

CP: The classic causes of oral cavity cancer are smoking, cigarette smoking and alcohol and both factors together are actually quite synergistic. You know if you are an abuser of both substances then your risk of oral cavity cancer is many times higher than the individual use of both. So they are the classic factors and the classic causative factor in Papua New Guinea appears to be the habit of betel nut chewing. Now betel nut appears to be quite a ubiquitous drug used around Asia, South East Asia and the Pacific. We certainly see quite high levels of oral cavity cancer in India for example, where betel nut is chewed and particularly where betel nut is  used in conjunction with Tobacco. Again there appears to be some evidence again not a lot of research has come out of Papua New Guinea but it appears to be that betel nut is a significant factor in causing the oral cavity cancers.

KH: You are saying that there is a real chance or threat of an epidemic?

CP: Well my feeling is I think it is already happening, I don't think we have actually recognised, I think the number of oral cavity cancers appear staggering compared to the Western World. So I think there is already an epidemic. I don't think we necessarily know exactly how many cases because I think this is something that is really missing. We need to sort of gather a little bit more data to quantify exactly the number of places but it appears from all reports and anecdotal evidence that you know the numbers are massive when compared to the Western World. You know in the Western World we have seen generally a decrease in cancers of the head and neck. Mainly because of decreased smoking rates you know the smoking rates are being halved around the world and therefore we are seeing a significant decrease in larynx cancer and tongue cancer throughout the Western World. But its the betel nut and also the smoking particularly in third world countries where I guess you know, tobacco is basically being targeted which is causing an explosion of this problem. And concerningly I think it is more younger and younger people who are chewing betel nut and smoking. So I think we are going to see these number of cases continue for some time yet.

KH: What are the concrete actions that can be taken to stop this?

CP: I think it is a highly preventative disease, I think this is one of the things that we know from epidimeology if we reduce the risk factors then we are going to reduce you know the instances of these cancers. Clearly that is not the entire story their is going to be other things you know. For example viral factors such as the human papillomavirus virus, you know oral hygiene, good nutrition etc. these are all other co-factors but appear to be weaker. So if we can curb the risk of smoking and betel nut chewing then I think we are going to go a long way towards reducing the incidence of this terrible disease.