Surge in oral cancer cases due to tobacco

Original Article

World No Tobacco Day: Oral cancer is one of the most common noncommunicable diseases around the world. Tobacco is one of the well-known factors of oral cancer which is preventable

Oral cancer cases are rising at an alarming rate in the country. Tobacco consumption including smokeless tobacco, betel-quid chewing, excessive alcohol consumption, and unhygienic oral conditions are some of the risks for a higher incidence of oral cancer. Early detection is important to lower the mortality rate of patients with oral cancer. Regular dental check-ups and quitting tobacco will aid in timely diagnosis and prompt treatment, doctors say in the wake of World No Tobacco Day that is observed every year on May 31.

What is oral cancer?

Oral cancer is an abnormal growth of tissues in the mouth that turn into cancer. It can spread from mouth to nose, neck area, and other parts of the body. In the beginning, the signs can be white or red spots in the mouth, sores on the tongue, lip, or mouth, bleeding in the mouth, swelling in the oral area, and difficulty in swallowing. It is an important health issue in India as it is one of the most common types of cancer affecting a large population, Dr Suhas Aagre, Oncologist and Hemato-Oncologist at Asian Cancer Institute said.

Risk factors

Tobacco consumption has been the predominant factor causing oral cancer. The use of tobacco in various forms such as gutka, zarda, mawa, kharra, khaini, cigarettes, bidi, and hookah is a major cause of tumour development in the oral cavity in both young and adults. Dr Aagre mentioned, “Mouth cancer is one of several types of cancers falling in the category of head and neck cancers. Tobacco is the prime cause of the occurrence of oral cancer in all age groups. All tobacco products, including cigarettes, cigars, pipe tobacco, chewing tobacco, and snuff, contain poisonous substances (toxins), cancer-causing agents (carcinogens), and nicotine, an addictive substance. There are at least 70 dangerous chemicals found in cigarettes and other forms of tobacco products, getting exposed to these chemicals will lead to oral cancer.”

Despite widespread knowledge of the risk of tobacco exposure and use, it is responsible for a plethora of diseases, an alarming death rate, economic burden, and reduced quality of life,” said Dr Adwait Gore, medical oncologist, Zen Multi Speciality Hospital, Chembur.


Chewing tobacco, and keeping it for a long time in your mouth can cause a higher risk. If you have been consuming tobacco for a long time and notice symptoms like mouth pain, lip sores, or inability to swallow, non-healing ulcers, bleeding from ulcer, development of neck swelling, change in voice, difficulty in swallowing, then immediately see a doctor and get the required check-ups done. Other risk factors of oral cancer are poor oral hygiene, dental irritation, Human Papilloma viral infection, diabetes, and extensive usage of immunosuppressive medicines. “Cases are not just rising in rural areas, but in urban areas as well. Nowadays, there is a shocking trend seen wherein youngsters in the age group of 20-30 are affected with oral cancer,” Dr Aagre noted.

Dr Khozema Fatehi, head and neck, oral oncosurgeon, SRV Hospital, Chembur highlighted that India has a huge burden of oral cancer cases as the use of tobacco is directly associated with approximately 80 per cent of oral cancers in men and women. “Youngsters are increasingly consuming smokeless tobacco either due to imitation and/or peer pressure. The lack of awareness about early oral cancer symptoms is the main reason for cancer being detected at later stages. Early detection improves the chances of survival,” Dr Fatehi said.


The treatment of oral cancer includes surgery, radiation, and chemotherapy.


Oral cancer itself is preventable. Quitting tobacco and other steps can ensure cancer prevention.

“To keep oral cancer at bay, one will have to give up on tobacco. Avoid smoking by opting for a smoking cessation therapy, get enough rest, and eat a well-balanced diet inclusive of fresh fruits, vegetables, whole grains, legumes, and pulses. Cut down on spicy, junk, oily, and processed foods, seek support and encouragement from family, and friends, and don’t miss your regular dental check-ups and regular follow-ups,” concluded Dr Aagre.

“Most people with oral cancer have a history of smoking or other tobacco exposure, like chewing tobacco. Oral tobacco products (snuff, dip, spit, chew, or dissolvable tobacco) are associated with the cancers of the cheek, gums, floor of the mouth (under the tongue), and the inner surface of lips. A large number of people chew gutka, which is a mixture of betel quid and tobacco, and are prone to cancer of the mouth.

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Time to get comfortable discussing HPV

If dental professionals aren’t willing to educate the public on oral cancer and HPV, who will?

Susan Cotten, BSDH, RDH, OMT

Original Article

The day started out like a normal Wednesday, work in the morning and then a trip to Trader Joe’s. I almost didn’t go; my to-do list was long, and the 36-mile round trip would take time away from checking things off that list, but the little voice inside my head was telling me to go.

There’s butter lettuce, and then there’s Trader Joe’s butter lettuce, so it’s always the first thing on my list. Moving through the aisles, I filled my basket with other favorites. With a full grocery cart, I headed to the shortest checkout line. Watching the two young men who were checking and bagging the customers ahead of me was a treat; they were engaging and obviously enjoying their day at work—you could sense the smiles under their masks. As the customers ahead of me left, the checkers turned to me with bright eyes peeking over their masks and said, “How are you today? Thank you for coming in!” After exchanging pleasantries, the checker asked what I do for work. I told him I’m a dental hygienist, and I speak and educate on oral cancer. With that, he stopped scanning my groceries and said, “That’s really specific; I’ve never heard of that. I’m glad neither of us smokes; we won’t ever get that cancer. Do you have any fun or interesting facts or information to share with us about oral cancer?”

From butter lettuce to oral sex

Now I knew why that little voice was telling me to go to Trader Joe’s that day. For reasons unknown to me, I was supposed to share information with these young men. It was the perfect scenario: two young, nonsmoking, white males who believe they are not at risk for oral cancer asking me to share information with them. They didn’t know my passion for this, and sure didn’t know what was about to be shared with them! I said, “I would love to share! Thank you for asking. What we now know is that the human papillomavirus (HPV) is the main cause of oropharyngeal cancer. It’s cancer in the back of the mouth, typically in the tonsils and back part of the tongue, and those most at risk are white, nonsmoking males. We also know that HPV now causes more of this cancer than it does cervical cancer.”1

By this time, the young man bagging my groceries had stopped bagging. Both young men were intent on knowing more and very surprised to learn about this cancer and to find out they could be at risk. They said they had heard about HPV and cervical cancer but not about it causing cancer in the mouth. Both continued to ask questions, wanting more information, including how HPV gets in the mouth, and specifically what they can do to help reduce their chance of getting this cancer. I shared with them that HPV is transmitted through skin-to-skin contact, orally through oral sex, and possibly through open mouth, deep, aggressive kissing. I recommended protection during oral sex just as with conventional sex. We also discussed the HPV vaccine, which they had both had; however, they didn’t know much about it and didn’t know it could aid in protecting them from persistent HPV infections, which could possibly result in cancer. It wasn’t an awkward conversation; they were truly curious and wanted more information, and I was thrilled to get to share this information with them. They both said that they go to the dentist regularly.

Many opportunities to educate

In the last 12 years of being immersed in raising awareness about HPV and oral and oropharyngeal cancer, I wish I’d kept track of the number of conversations like this that have occurred, inside and outside of the operatory. There are simply too many to recall. Another recent conversation took place while in line for Donny Osmond’s VIP preshow in Las Vegas, again with a nonsmoking male. He was in line holding a place for his wife while she was getting ready. He, too, had many questions and asked about transmission of HPV to the mouth. He stated he was aware of HPV causing cervical cancer, but not cancer in the mouth. He was most curious about what signs and symptoms to watch for and what to do if he noticed any of those. We discussed these, and I recommended he see an ear, nose, and throat specialist (ENT) for further investigation if he ever experiences any persistent signs and symptoms.

Also, while writing this article, a phone conversation with a business colleague in his 60s about my work in oral cancer prompted him to inquire further about HPV and how it gets in the mouth. He thought he knew but wanted a little more clarification. And just last week while listening to a radio program with a respected physician as the guest, the topic of HPV was brought up. The physician mentioned HPV and its association with cervical cancer and mentioned the HPV vaccine. However, the vaccine was only referenced in relation to preventing cervical cancers, not head and neck cancers or the other cancers associated with persistent HPV infections. It was a missed opportunity for a large listening audience to learn more about other HPV cancers.

It’s purely my opinion, but I think people inquire further about oral cancer and HPV because they don’t hear much about it in the media, or even in their medical and dental offices. The messaging for cancers such as breast cancer, colon cancer, and cervical cancer is intentional in the media and respective medical offices, but not so much for oral cancer. Dentistry needs to be more intentional about educating and raising awareness about HPV and oral and oropharyngeal cancers.

What we now know is this: the number of HPV-associated head and neck cancers has surpassed the number of HPV-associated cervical cancers. Unfortunately, the messaging about HPV is still focused on cervical cancer.2

Lessons learned

I’ve learned a few things during my years of work in raising awareness about HPV and oral cancer through conversations with patients and the public.

First, if the public is going to be educated and aware of HPV and its association with head and neck/oropharyngeal cancer, it will come from dental professionals. In fact, it is our ethical responsibility to share this information about “our cancer.” If they don’t hear it from us, where else? It’s okay, even essential, to talk about the transmission of HPV via oral sex, its association with head and neck cancers, and the availability of the HPV vaccine that can aid in reducing persistent HPV infections associated not only with oropharyngeal and cervical cancer but also anal, penile, vaginal, and vulvar cancers.

Society is open to hearing this information. The public wants to know how to help prevent cancers and recognize the signs and symptoms for the earliest detection. Most are still of the belief that tobacco is the only risk factor for oral and head and neck cancers. Patients and the public deserve to know this information so they can make informed decisions for themselves about their oral health. This does not need to be a knee-to-knee conversation; the optimal time to share information is during the extraoral and intraoral evaluation (EOIO). Information can also be shared in newsletters the dental office sends to patients, in social media posts, and in brochures and flyers in the office.

The public and some medical and dental professionals are misinformed about HPV. It is still the common belief that HPV is most associated with causing cervical cancer and the purpose of the HPV vaccine is to help prevent cervical cancers in females. Statistics released by the US Cancer Statistics Data Briefs, No. 26 in December 2021 based on data from 2014–2018 reveals that there are approximately 10,600 cases of oropharyngeal cancer in males and 1,800 cases of oropharyngeal cancer in females each year that are attributable to HPV types 16 and 18.2 The US FDA added prevention of oropharyngeal cancer to the HPV vaccine’s indication: “The human papillomavirus (HPV) recombinant 9-valent vaccine (Gardasil 9) received FDA approval for an expanded indication to include the prevention of oropharyngeal and other head and neck cancers caused by HPV types 16, 18, 31, 33, 45, 52, and 58.”3

People are listening! The public and our patients are listening, and they are looking for health-care professionals to share our expertise and have courageous conversations about critical health information. When I first started sharing information about HPV with my patients 12 years ago, I would bring it up when I was palpating the occipital nodes behind them so I wouldn’t have to look at them. I was very uncomfortable with this conversation at first; however, I knew it was vital information to my patients’ oral and systemic health and it needed to be shared. During your clinical appointments, find the time and place that is most comfortable for you.

Our job doesn’t end when we take off our scrubs. Be open to spontaneous conversations regarding essential information about HPV and oral cancer. In a recent conversation with Katrina Sanders, MEd, she eloquently said, “Irene Newman, the first dental hygienist—her job was not to improve production and close more cases. Her job was to be a patient advocate and educate the community.” I’m encouraging you to be like Irene Newman: be an advocate and educate the community, share the tremendous amount of knowledge, expertise, and lifesaving information you possess about “our cancer,” not only with patients, but the general public as well.

Call to action

If you are uncomfortable or lack confidence in sharing information about HPV or feel you need more knowledge, find a mentor, do some research, and be your own advocate to gain the knowledge you need. Recruit your entire dental team or dental service organization (DSO) to establish a positive, informative culture around HPV and oral cancer. Make it your mission to save lives through sharing critical information with patients and the public. Perform a thorough EOIO evaluation on every patient, tell them what you’re doing, and use that time to efficiently share information and raise awareness about what we now know concerning HPV and oral cancer.

Get yourself started with a practitioner HPV fact sheet and patient HPV fact sheet.


  1. HPV/oral cancer facts. The Oral Cancer Foundation. understanding/hpv/hpv-oral-cancer-facts/
  2. Cancers associated with human papillomavirus, United States—2014–2018. U.S. Cancer Statistics Data Briefs, No. 26. Centers for Disease Control and Prevention. December 2021. UnitedStates-2014-2018.htm
  3. FDA adds prevention of oropharyngeal cancer to HPV vaccine’s indication. AAP News. May 2021.

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The Dickinson Press VELscope

A southwestern North Dakota dental practice has started using VELscope, a revolutionary device using LED light sources to identify abnormalities down to the bone. That deep look can help detect problems much earlier than just a glance.

Using a specialized light — blue light causes stimulation of the epithelial cells with areas of abnormality appearing darker in color — Robinson said the VELscope is able to identify a variety of abnormalities.

“So what it can do is when I do a regular oral cancer screening, I just visually look at someone’s mouth. I pull out their tongue; I look all around. Well, the VELscope light can actually penetrate all the way down to the bone,” Robinson said. “So instead of just seeing the surface, it can go all the way down to the bone and things will show up a different color. So that’s why it can detect things early.

Dr. April Robinson, of Robinson Family Dental in Dickinson, North Dakota, demonstrates how the VELscope works on an individual to detect cancer two years earlier than normal oral screenings.

Jackie Jahfetson / The Dickinson Press

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The VELscope, pictured above, is a revolutionary device using chemiluminescent and autofluorescent LED light sources that can detect cancer two years sooner.
Jackie Jahfetson / The Dickinson Press
A VELscope, pictured above, uses an iPhone to capture images of oral screenings for cancer.
Jackie Jahfetson / The Dickinson Press

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Oral cancer found in those below 30

Original Article


Symptoms mimic regular mouth blisters so be careful

Cigarette smoking is the most common form of tobacco usage, causing about 90 per cent of all lung cancers.

This cancer starts in the mouth cavity, either on the tongue, lower lip, gum, and jaw or on the floor of the mouth.

Cigars can trigger tumours related to oral cavity, throat or voice box, oesophagus and lungs.

Smoking, chewing or snuffing tobacco and nicotine-based products may be perceived as ‘cool’ for some, but it is not. These leaves in any form, be it cigarettes, cigars, or snuff can play havoc with one’s health, at any age! Tobacco is a widespread epidemic costing millions of lives worldwide annually and it may be astonishing that even those exposed to passive smoke bear the equal brunt as direct, active users. 

Despite many awareness campaigns and advertisements worldwide and that mandatory reel before starting a movie in the theatres in our country, tobacco usage is rampant. It is, unfortunately, picking up among the youth.

Triggers cardiovascular diseases, diabetes, vision and hearing loss Tobacco usage is the primary reason behind many types of cancer, including lung and oral cancer. It is also a major trigger behind cardiovascular diseases, diabetes, chronic lung infections, vision and hearing loss, and dental issues. That is because tobacco is chock-a-block with poisonous toxic substances, cancer-causing agents-carcinogens, and nicotine – an addictive substance, a crucial component in all these products.

Cigarette smoking is the most common form of tobacco usage, causing about 90 per cent of all lung cancers. It increases the risk of oral cancer by ten times compared to non-smokers. Cigars and pipes are no good either, as they can trigger the tumours related to the oral cavity, throat or voice box, oesophagus and of course, lungs. Chewing tobacco and snuff in the form of leaves packed into pouches, expedite the chances of getting affected by cancers of lips, cheek and gums multi-fold besides oesophageal and pancreatic cancers.

Oral cancer starts in the mouth cavity

Oral cancer is a type of head and neck cancer that starts in the mouth cavity, either on the tongue, lower lip, gum, and jaw or on the floor of the mouth when abnormal cells begin growing out of control. Squamous cell carcinoma is the most common oral cancer. While it is often found on the floor of the mouth and tongue for men, it is detected on the tongue and gums for women. Oral cancer is of various types and can affect all genders. 

Though mostly detected among the age group 45 and above, doctors these days are unfortunately witnessing a growing number of cases in those below 30 years. There are various types of oral cancer and like in any other type of cancer, early diagnosis is the key to eliminating it.

Tobacco is loaded with carcinogens, make genetic changes in mouth cavity

Symptoms of oral cancer initially mimic some regular blisters in red and white colours but can spread to other parts of the oral cavity if not addressed on time. Ever wondered about the role of tobacco in causing oral cancer, one should understand these products are loaded with carcinogens. When they enter the body, these chemicals trigger genetic changes in the mouth cavity leading to oral cancer. Besides genetic differences, the smoke that is emitted out of burnt tobacco releases radioactive materials, when inhaled, can cause cancer to both active and passive smokers. 

And if one thinks, cigars, chewing tobacco and getting used to smokeless tobacco products like snuff may not be cancerous, think again! The combination of nitrate and nitrite, notoriously known as cancer-causing substances along with tobacco-specific nitrosamines cost the same peril caused by cigarettes and in the same breath! 

The only way possible to prevent oral cancer is to quit tobacco and adopt a healthy lifestyle right now. If you are addicted, seek help from counsellors and join rehabilitation.

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Oral Cancer Awareness Month

View our media kit and share this information on your social media channels!

April is Oral Cancer Awareness Month, a time when dental professionals join with surgeons and other medical professionals to highlight the dangers oral cancer brings, and to call attention to the progress made in fighting this disease.


Oral cancer refers to cancer of the mouth, while pharyngeal cancer refers to cancer of the pharynx, or back of the throat. Your dental professionals are a first line of defense and diagnosis for oral and pharyngeal cancer. Be sure to discuss this with your dentist and hygienist at every checkup.


Sadly, the death rate from oral and pharyngeal cancers remains frustratingly high, at around 43 percent five years after diagnosis. This, according to the Oral Cancer Foundation, is because so few cases are diagnosed early enough to allow doctors to treat the disease. This year:

  • More than 45,000 Americans will hear the diagnosis from their doctors
  • More than 8,000 Americans will die from oral cancer

Word of Mouth

Because this treatable cancer causes needless deaths due to late diagnosis, a number of professional organizations are coming together to spread the word on prevention, early diagnosis, and the search for cures:

  • Academy of General Dentistry
  • American Academy of Oral and Maxillofacial Pathology
  • American Academy of Oral Medicine
  • Academy of Periodontology
  • American Association of Oral and Maxillofacial Surgeons
  • American Dental Association
  • Dental Hygienists’ Association


Doctors and surgeons are constantly striving to understand oral cancer’s origins, though the issue is complex. Some behaviors, according to the Mayo Clinic, place you at greater risk of contracting oral and pharyngeal cancers:

  • Human papillomavirus (HPV)—HPV 16 is the leading cause of oropharyngeal cancer
  • Tobacco—smoked or smokeless tobacco causes cancer; smokeless tobacco causes cancers of the mouth, throat and esophagus
  • Alcohol—combining tobacco with alcohol greatly increases your risk of contracting oral cancer
  • Sun exposure—you risk lip cancer
  • Diet—not eating enough fruits and vegetables can increase your risk

Age, too, is a factor—most oral cancer victims are aged 40 and over.


The causes themselves provide ample direction on helping to lower your risks of developing oral cancer:

  • Cut out tobacco in all forms
  • Drink moderately, and never combine alcohol and tobacco use
  • Limit exposure to the sun, using a high Sun Protection Formula (SPF) sunscreen and lip balm
  • Eat plenty of natural foods, including more fruits and vegetables

Additionally, brush and floss regularly, exercise to maintain a healthy immune system, and see your dentist regularly.

Early Detection

Your dental professional is best equipped to detect early signs of oral and pharyngeal cancer, but you can monitor your own body for symptoms:

VELscope Oral Cancer Awareness Month
  • Difficulty chewing or swallowing, or difficulty moving your jaw or tongue
  • Numbness of the tongue or other areas in your mouth
  • Pain in only one ear, unaccompanied by hearing loss
  • A sore, lump or other irritation in your mouth, on your lip, or in your throat
  • A white or red spot in your mouth, especially on the mucosal membrane (inside cheek)


If detected early, oral cancer can be treated effectively. The best course is a team approach, combining the skills of your dentist, surgeons, oncologists, nutritionists and others. Choices of therapies to fight oral cancer include:

  • surgery, radiation and additional surgery
  • radiation, surgery, and chemotherapy


No cancer is minor. The emotional aspects of receiving a diagnosis and fighting a cancer can be as important for a good prognosis as the finest team of medical professionals. Early detection is still the best way to lower the risk of oral and pharyngeal cancer. This April, make detection and prevention of oral cancer a priority in your life.


What is Oral, Head and Neck Pathology?

Oral and maxillofacial surgeons (OMS) are the experts for diagnosing and surgically treating pathology of the head, neck and mouth.

What Does Pathology Mean?

Pathology represents any deviation from a healthy, normal condition. Pathology can mean a lot of different things, from tumors to cysts. Tumors can be benign or malignant (cancerous). It’s important to know that while oral cancer is an oral pathology, NOT all oral pathology is cancer. A biopsy will help determine the nature of the condition.

Some of the signs and symptoms of oral, head and neck pathology appear early on – when treatments are most effective. These signs include:

• White patches on oral tissue (leukoplakia)
• Red patches on oral tissue (erythroplakia)
• Mixed white and red patches on oral tissue (erythroleukoplakia)
• Sores (ulcerations), particularly those that bleed easily and have failed to heal
• Abnormal thickening of oral tissue
• Masses or lumps
• Enlarged lymph nodes in the neck
• Unexplained numbness
• Other symptoms to watch for include chronic sore throat, hoarseness, or difficulty swallowing or chewing.

Many types of oral, head and neck pathology are benign. However, it may increase the risk of cancer if left untreated. In some cases, the presence of leukoplakia can increase the risk of transforming into a cancerous lesion. These lesions may need ongoing management.

While it might be alarming to find a lump or sore, please remember that it does not automatically indicate the presence of cancer. Your OMS can help diagnose your condition – often through a biopsy of the tissue – and determine your treatment plan.

How to Perform a Monthly Self-exam

Make it a regular routine to perform a self-exam each month. Using a bright light and a mirror, follow these steps:

• Remove any dentures.

• Look and feel inside the lips and the front of the gums.

• Tilt head back to inspect and feel the roof of the mouth.

• Pull the cheek out to see its inside surface as well as the back of the gums.

Check out our Oral Cancer Awareness Month media kit and share this content on your social channels!

Original Article


Early Detection Saves Lives

Newswise — Chulalongkorn University’s researchers have developed a cervical cancer test kit that uses urine samples. A simple, accurate, and fast method of early detection is guaranteed for its quality by the 2021 Outstanding Inventions Award from the National Research Council of Thailand. Early detection is the key to saving lives.

Cervical cancer can be cured if detected in its early stages.  Many women are, however, deterred by the rather high cost of the screening procedure, and the pap smear testing method.  This leads to late detection that can cause cancer to spread making it harder to treat.

Today, there is a new invention that makes cervical cancer treatment a simpler and pain-free procedure that can be done frequently.  The HPV paper-based DNA sensor testing kits for cervical cancer developed by the Department of Chemistry, Faculty of Science, Chulalongkorn University’s research team comprising Prof. Dr. Orawan Chailapakul, Dr. Prinjaporn Tee-ngam, Sarida Naorungroj, Dr. Somrak Petchcomchai along with Prof. Dr. Tirayut Vilaivan.

Dr. Prinjaporn, one of the main researchers on the team discussed how this innovation was conceived, “The government has consistently urged women to get tested for cervical cancer.  One of the limitations of the original form of testing which requires taking a sample of cells from the cervix on stirrups invokes fear in many women who would rather avoid the test altogether.  For this reason, we have tried to find an easier way that most women would feel more comfortable with.  This could help to increase the number of those being tested as well as the frequency of their tests so that if any anomalies are found, then treatment can be immediately provided.”

Getting to know cervical cancer and early detection methods

Cervical cancer is the second most common cancer of women in Thailand after breast cancer with an incidence rate of 10,000 new cases per year affecting women between the ages of 30-60 and claiming as many as 5,000 deaths each year.  The Ministry of Public Health recommends that from the age of 25 women should receive regular screening for cervical cancer every five years.

Prof. Dr. Orawan explains that cervical cancer is a sexually transmitted disease, mainly caused by the human papillomavirus (HPV).  The use of condoms as protection cannot prevent such transmission, and the HPV vaccine is not yet prevalent or provides 100% protection against cervical cancer.

She also stressed that “Most of those who have been affected are asymptomatic which makes it necessary for us to still be tested regularly since that is a crucial way to prevent us from the disease and death.”

The HPV paper-based DNA sensor testing kits

The cervical cancer testing kits are easier and much faster than the Pap Smear or Pap Tests currently in use.  It eliminates the need to insert a tool and hold the vaginal walls open as well as swabbing over the cervix to take cell samples that are sent to the lab for testing.

“HPV paper-based sensor testing is a way to test the DNA of the HPV virus by using PNA (Peptide Nucleic Acid) which is a synthetic substance that imitates our DNA designed to be specific according to the cells being tested which can be specified since HPV comes in many different strains and not all strains cause cervical cancer.  When designing the substance, we needed to determine which strains there were when it comes to HPV infection,” said Prof. Dr. Orawan.

The HPV paper-based sensor testing kit is something that a lot of us are already familiar with from the ATK tests we have undergone for COVID-19.

“The urine is mixed in a solution then dropped onto the paper after which we notice the change in color of the solution.  Normally the color of the solution is bright red but if the urine is contaminated by the virus the color appears lighter. The brightness of the color varies according to the amount of the virus.  We have an additional tool, used with the colorimeter application on smartphones that helps make the color more visible.”

Prof. Dr. Orawan assured us that the HPV paper-based sensor testing kit has been tested and shows a high level of accuracy with a sensitivity of 85%, specificity of 78%, and reproducibility rate of 100%.”

The HPV Testing Kits have not been produced for home use.  They are, however, being used in health centers and community hospitals.

“In the urine, there are fewer DNA materials than in tissues, which means we need to have a device that increases the DNA level so that the change of color is more visible and the device is already in use in the clinics and community hospitals.”

How to watch over our health to stay away from cervical cancer

Prof. Dr. Orawan left us with some tips on how to help women stay safe from cervical cancer.  “First, women should make sure they always keep their vaginal areas clean.  Vaccinations are good but the prevention they offer isn’t a hundred percent.  The best way is to have regular cervical cancer checkups for early detection and treatment.”

The research team hopes that this innovation will motivate women to get themselves tested regularly, with a simple and painless process, at an affordable price.  Each test kit should not exceed 500 baht.

Prof. Dr. Orawan left us with these words.   “We’d like to see women getting cervical cancer tests regularly as advised by the Ministry of Public Health.  Therefore, we have tried to make the cost of these kits as low as possible to make them easily accessible.  It would be ideal if women can be tested regularly, for example once a month at a health center nearby.”

Nursing facilities or agencies interested in these HPV paper-based DNA sensor testing kits may contact Prof. Dr. Orawan Chailapakul at the Department of Chemistry, Faculty of Science, Chulalongkorn University, email address for more information.

Original Article

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Increases in HPV-linked cancers in parts of US with high smoking rates

A new paper in JNCI Cancer Spectrum, published by Oxford University Press, finds increases in both men and women for several HPV-related cancers in low-income counties or those with high smoking rates. Increases were slower in the highest-income US counties or those with low smoking rates.

In the era of collective decline in cancer rates, human papillomavirus (HPV)-associated anal, oropharyngeal, and vulvar cancer is still rising. Risk factors for HPV-associated cancers include smoking and risky sexual activities, both behaviors likely more common in poorer parts of the United States.

Researchers here used the Surveillance, Epidemiology, and End Results database, a National Cancer Institute database that provides nationwide information on cancer statistics, to investigate HPV-associated cancers by US county-level income and smoking prevalence between 2000 and 2018.

They found that anal and vulvar cancer among women and anal cancer incidence among men increased significantly in the lowest-income counties and counties with high smoking rates, while the increases were slower in their counterparts.

Cervical cancer incidence plateaued, rising not at all in the highest income counties, but increasing 1.6% a year in the lowest income counties. Oropharyngeal cancer rates among women increased by 1.3% a year in low-income counties and only by .1% in high-income areas. Anal cancer rates among women increased by 3.2% in low-income counties but by only 2.6% in high-income areas. For vulvar cancer, rates increased 1.9% a year in the lowest-income counties but only vs. 0.8% a year in the highest-income counties. Vaginal cancer rates increased by 2% a year in low-income counties and declined by .3% in wealthier areas.

Among men, oropharyngeal cancer rates increased by 2.1% a year in low-income counties and by 1.7% per year in high-income counties. Anal cancer rates increased by 3.9% in low-income areas but increased by only 1.5% in high-income counties.

Counties with high smoking prevalence, which are also often low-income counties, had marked increases in cancer rates compared to their counterparts. Anal cancer among women increased by 5% a year for those living in high-smoking counties and only 1.9% a year for those living in lower smoking-rate counties. Vulvar cancer increased by 3.8% a year a year for those living in high-smoking counties and only .6% for those living in lower smoking-rate counties.

Oropharyngeal cancer rates among men increased by 2.7% a year in high-smoking areas, but only by 1.5% in low-smoking counties. Anal cancer incidence rates among men increased by 4.4% in high smoking-rate counties, but only by 1.2% in lower smoking-rate counties.

“HPV vaccination and cervical cancer screening are the cornerstone interventions to prevent avoidable suffering caused by six cancers,” said the study’s senior investigator, Ashish Deshmukh. “Unfortunately, cervical cancer screening rates declined in recent years and HPV vaccination rates remains 15% points lower in rural low-income counties. The COVID-19 pandemic has further disrupted the delivery of preventative care. Urgent and collective efforts are needed to prevent growing disparities from worsening.”

The paper, “Trends in the Incidence of Human Papillomavirus-Associated Cancers by County-Level Income and Smoking Prevalence in the United States, 2000-2018,” is available (at midnight on March 3, 2022) at

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How Bad Is It Really to Never Clean Your Yoga Mat?

Your yoga mat is like your water bottle — you know you should clean it every now and then, but you probably rarely do. However, if you examined your mat under a microscope, what you’d find lurking about might change your mind (and give you the heebie-jeebies). Yep, an unwashed mat is a breeding ground for all kinds of creepy crawlies including bacteria, fungi and viruses. This includes the risk of HPV. Which makes it an especially fertile incubator for many infections (more on this later).

We spoke to Kelly Reynolds, PhD, director of the Environment, Exposure Science and Risk Assessment Center at the University of Arizona, to find out what happens if you let your mat accumulate muck, plus tips on how to clean a yoga mat

3 Reasons to Clean Your Yoga Mat Regularly

1. It Can Cause a Skin Infection

Your yoga mat may be harboring harmful germs — including viruses, bacteria and fungi — which can produce nasty skin infections. “These microbes can live on surfaces for days to months and spread from person to person via surfaces like exercise mats,” Reynolds says. Common pathogens that can be transmitted by a dirty yoga mat include:

  • Fungi that cause athlete’s foot and other types of ringworm:​ These pathogens multiply in warm, moist environments (like gym showers or around swimming pools). They are especially well adapted to thrive for long periods of time on yoga mats, Reynolds says, which is why fungal infections flourish so easily.
  • Staphylococcus or staph bacteria:​ It’s a pathogen commonly found on the skin that’s usually harmless but can cause infection when it gets into a cut. Staph infections can cause red, swollen and painful skin infections that look like pimples or boils, and can even leak pus or become crusty, according to the National Library of Medicine. They can also lead to bone infections, which can cause flu-like symptoms such as fever and chills.
  • Human papillomavirus (HPV):​ Some strains of HPV can cause warts on the skin. Plantar warts are warts on the bottom of the feet.
And while bringing your own yoga mat to the gym (versus borrowing a rarely cleaned communal mat) can help mitigate your risk of infection, it doesn’t eliminate it completely. You can still become infected by someone simply stepping on your mat on their way to the water fountain. Or you could pick up germs from the gym floor and transfer them to your mat.

“Either way, add sweat and a warm environment, like a hot yoga studio, and you may have your own fungal colony established,” Reynolds says.

2. It Can Make You Break Out

Your filthy yoga mat might be bringing on bouts of breakouts. Excess oil, dirt, dead skin cells and bacteria –— which can block your pores and produce pimples — can easily spread from an unclean exercise mat and promote acne, Reynolds says. To make matters worse, acne typically appears on areas of your body that boast the most oil glands such as your chest, upper back and shoulders, per the Mayo Clinic. And these oilier body parts are often the ones exposed to your yoga mat.

3. It Can Make You Sick

A dirty yoga mat can also ramp up your risk for catching the common cold, a respiratory infection or the stomach flu. This happens when cold and flu viruses are released into the air through a sick person’s coughs or sneezes, Reynolds says.

And someone doesn’t have to be particularly close for their germs to reach you. The spray from a sneeze or cough can travel up to 6 feet, per the Centers for Disease Control and Prevention (CDC). In fact, an April 2014 study in the Journal of Fluid Mechanics found that smaller droplets can cover even longer distances (as far as 2.5 meters or more than 8 feet).

These meddling microbes rapidly settle on surfaces — like your yoga mat — where they can survive for days and spread to others, Reynolds says. Usually, an infection occurs when you touch your germy mat and unknowingly transfer the virus to your eyes, nose or mouth from your hand.

And while the common cold or flu may be a temporary inconvenience (read: mostly harmless) for healthy individuals, those with compromised immune systems may become sicker.

For instance, people with certain medical conditions such as asthma, diabetes and heart disease, and older adults and pregnant people all have a higher risk for serious flu complications, per the CDC.

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How to Clean a Yoga Mat

So, how often do you need to clean your yoga mat? More often than you think.

“Given that exercise mats are placed on dirty floors, often shared among users and come into direct skin and face contact, I recommend cleaning ​and​ disinfecting them before every use,” Reynolds says. “Cleaning alone will not kill most of the germs, but it will reduce dirt, sweat and oils that bacteria and fungi feed on.”

If you’re sticking to solo at-home workouts (i.e., you’re the only one coming into contact with the mat), you have a little more leeway. In this case, cleaning and disinfecting it once a week should suffice. That said, if you sweat profusely, or you’re prone to acne, you might want to wipe down your mat more often.

Here are Reynold’s tips for how to clean a yoga mat and keep it microbe-free.

If Your Mat Is Machine Washable

Toss it in the wash (by itself) and follow the manufacturer’s instructions. To properly disinfect your mat, also use a laundry sanitizer, Reynolds says. A product like Lysol Laundry Sanitizer will kill bacteria and viruses that a regular detergent might miss.

If Your Mat Isn’t Machine Washable

First, scrub it with soap and water to remove any dirt, then use a disinfecting spray or wipe, which is your best defense against germs. “Alcohol-based wipes are safe for use with most surfaces,” says Reynolds, who recommends throwing a travel pack in your gym bag.

After you clean and disinfect your mat, pat it down to dry it thoroughly. “Be sure your mat is fully dry before rolling it up to store as trapped moisture can promote more germ growth,” Reynolds says.

So, How Bad Is It Really to Never Clean Your Yoga Mat?

Doing downward dog on a dirty mat may impact each of us differently — for some it’s NBD, but for others, it can be potentially harmful. If you have a weakened immune system and are more susceptible to infection, a clean yoga mat is more important, especially if you lug it to the gym or a hot yoga studio where germs love to gestate.

But a group class isn’t the only place where you can pick up pathogens. At home, your roommate or your partner can also pass on infections if they use your mat or inadvertently cough or sneeze on it. So if your immune system isn’t robust and you live with someone, stick to separate mats and stow yours away (out of reach of random sneeze sprays) when you’re not using it.

If you’re a generally healthy person who lives alone and only uses your mat at home (i.e., never shares it with another soul or carries it to the gym), you’re probably in the clear even if you don’t clean it as often. But if you’re noticing recurring body acne or an unexplained skin infection, you may want to scrub and disinfect your mat more often.

To extend the time between washings, you can even lay a towel on top to keep sweat and body oils off the surface of your mat. Keep in mind: This strategy only works if you launder the towel with each use.

Original Article

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