## Epidemiology of Oral Cavity Carcinoma in India **High-Yield:** Buccal mucosa is the most common site of oral cavity squamous cell carcinoma in India, accounting for approximately 40–50% of all oral cancers. This differs from Western populations where the tongue and floor of mouth are more frequently affected. ### Geographic and Aetiological Variation **Key Point:** The high incidence of buccal mucosa carcinoma in India is directly linked to the widespread use of betel quid (paan) and tobacco products, which are held in the buccal vestibule during chewing. ### Site-Specific Incidence in India | Site | Frequency (%) | Key Features | |------|---------------|---------------| | Buccal mucosa | 40–50 | Most common; associated with paan/tobacco | | Alveolar ridge | 15–20 | Second most common | | Hard palate | 10–15 | Often associated with reverse smoking | | Tongue | 10–15 | More common in Western populations | | Floor of mouth | 5–10 | Least common in India | **Clinical Pearl:** Reverse smoking (holding the burning end of the cigarette inside the mouth) is a risk factor specific to certain regions of India and increases the risk of hard palate carcinoma. ### Why Other Sites Are Less Common - **Hard palate:** While associated with reverse smoking, it accounts for only 10–15% of cases. - **Dorsum of tongue:** Relatively protected from direct contact with carcinogens; more common in Western populations. - **Floor of mouth:** Least common site in India despite being a high-risk area in Western countries. 
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