By Dr. Nurul Izyan Zainuddin , Oral Cancer Research and Coordinating Centre, 

Faculty of Dentistry, Universiti Malaya 

Oral cancer continues to be a devastating disease, yet it does not receive the same level of attention as other cancers such as breast or lung cancer. In Malaysia, oral cancer remains a significant health concern.  

There is still a widespread misconception that oral cancer is rare or that it only affects older men who smoke and drink heavily. While these are well-established risk factors, oral cancer can affect anyone, and alarmingly, cases among younger individuals are becoming increasingly common. 

The encouraging news is that early detection of oral cancer saves lives and preserves quality of life. This is the most important message for everyone to remember. 

What makes Malaysians Vulnerable? 

Patterns of oral cancer in Malaysia reflect the habits and practices of its diverse communities. Tobacco and alcohol are major risk factors worldwide, but additional cultural influences are also important locally. Betel quid chewing (sirih pinang), a tradition particularly common among Indian and indigenous groups, is strongly associated with oral cancer, as the areca nut is proven to contain carcinogen. Tobacco use in all its forms; whether smoked or smokeless – remains another leading cause across all ethnic groups. Furthermore, the incidence of oral and oropharyngeal cancers linked to human papillomavirus (HPV) is rising globally, with stronger associations seen in oropharyngeal cancer, reflecting its transmission through oral sexual contact. 

It is important to recognize that while certain groups may face higher risks, no one is fully exempt. This highlights the need for universal awareness and proactive screening. 

The signs that shouldn’t be ignored 

Oral cancer often begins with subtle changes that may not cause pain and are therefore easily overlooked. The tongue is the most frequent site, but early signs can develop anywhere in the mouth. Developing the habit of regular self-examination is therefore crucial. 

A sore or ulcer that does not heal within two weeks is the most common early symptom. Red or white patches (leukoplakia or erythroplakia) can signal precancerous or cancerous changes. Lumps or thickenings in the mouth, neck, or throat may also indicate disease progression. Other warning signs include difficulty or pain when swallowing, chewing, or speaking, as well as a persistent sore throat or the sensation of something lodged in the throat. 

A self-check requires less than five minutes. With a mirror and good lighting, individuals can examine the lips, gums, cheeks, tongue, and the roof and floor of the mouth. This simple habit can make a life-saving difference. 

Early detection: A life-saving difference 

According the data published in Annual Reports 2015 by Oral Health Division, Ministry of Health Malaysia, more than 60% of oral cancer cases are diagnosed only when the disease has reached an advanced stage. At this point, the cancer often spreads to lymph nodes or distant sites, complicating treatment and lowering survival rates. 

When detected early, however, oral cancer is far more treatable. Survival rates for Stage I or Stage II disease may reach 80–90%. At this stage, treatment is usually localized and may require only surgery, avoiding the need for aggressive radiotherapy or chemotherapy. Early detection not only increases survival but also helps preserve speech, appearance, and quality of life. 

Taking action together 

The fight against oral cancer begins with awareness and prevention. Simple monthly self-examinations are recommended, and any suspicious changes persisting for more than two weeks should be promptly evaluated by a healthcare professional. Routine dental visits are also vital, as dentists are trained to perform oral cancer screenings during regular check-ups. These screenings are quick, painless, and can save lives. 

Raising awareness within families and communities is equally important. By sharing knowledge about risks, symptoms, and the importance of early detection, we can work collectively to reduce the burden of oral cancer. The disease is both preventable and treatable, but only if action is taken early.