363PD - Community based screening for early detection of head and neck cancer among tribal community in Wayanad District, India

Date 16 December 2016
Event ESMO Asia 2016 Congress
Session Head and neck cancer
Topics Aetiology, Epidemiology, Screening and Prevention
Head and Neck Cancers
Presenter Shanavas Palliyal
Citation Annals of Oncology (2016) 27 (suppl_9): ix112-ix122. 10.1093/annonc/mdw587
Authors S. Palliyal
  • Dm Wayanad Institute Of Medical Sciences, DM Wayanad Institute of Medical Sciences, 673577 - Kalpetta/IN



Head and neck cancer ranks in the top three of all cancers in India. Wayanad district in Kerala state is a region in which 17% of the population is represented by tribal groups. These tribes generally live under severe socio-economically deprived conditions. Common risk factors include tobacco use, culturally determined practices, alcohol consumption, and nutrition deficits. Head and neck cancer, despite its high incidence and prevalence in the region, does not benefit from significant prioritization like other cancer entities. The objectives are to create awareness regarding common cancers among tribal community in Wayanad District, India; to detect pre-cancers of head and neck region by conducting screening with simple low-cost technology within the community; and to facilitate confirmation of diagnosis among screen positives and treatment and follow-up among the diagnosed cases. This is community based screening program for early detection of head and neck cancer being implemented among socio-economically disadvantaged tribal community in Wayanad District, India.


The process involves selection of clusters, household surveys, health education and screening the tribes for common cancers by primary health care workers at temporarily set-up clinics within the community. Stratification was done according to age and in consistent with W.H.O pathfinder methodology.The program will cover 142320 disadvantaged people in one year. 11670 people have been covered to date.


The compliance for screening head and neck cavity are 86.70% and the screen positivity rates is 3.01% respectively. 78 head and neck pre-cancers have been diagnosed among the screened tribes and all of them have complied to treatment. The prevalence of precancerous lesion on head and neck region was found to be 41% among the population. It was observed that 23% had leukoplakia, 18% population suffered from oral submucous fibrosis(OSMF), and 12% of them were recorded with smokers palate in their oral cavity.


Screening for head and neck cancer with simple, low cost, acceptable and effective technology is feasible at community level in developing countries and can assist detection of precancers and early stage cancers.

Clinical trial indentification


Legal entity responsible for the study

Shanavas Palliyal


DM Foundation


All authors have declared no conflicts of interest.