Low-resource screening of Pre-Cancerous Lesions and its reversal by Triphala

Objective: India has seen an alarming rise in the number of substance abusers and increased risk of oral cancer among adolescents. Around 55,000 children get addicted to tobacco every day. This astounding increase seen in number of children addicted to tobacco and at growing risk of oral cancer, calls for a preventive program to stop usage of tobacco. Screening pre-cancerous lesions and reversing them is the main weapon for early detection and treatment at pre-invasive stage; however cost-effective methods need to be evaluated for low socio-economic strata, which is the hub of this widespread disease. This study aimed to evaluate a low resource screening method for oral precancerous lesions and thereby tested the efficacy of an indigenous mouth rinse (Triphala) in reversing these lesions.

Method: This study was conducted in teenage (13-19 year old) Indian population in two phases. In first phase, screening for pre-cancerous lesions was carried out by a new method- visual inspection with acetic acid. The positive subjects were further investigated by pap smear and biopsy for confirmation. In second phase positive cases were advised indigenous triphala mouth rinse for reversal and effects were evaluated at 6 and 9 months.

Results: Using a low cost screening method for oral pre-cancerous lesions we found out that 10.9% of tobacco users showed white lesions in oral mucosa in contrast to only 0.4 % of non-tobacco users. Use of different forms of tobacco showed convincing relationship between development of lesions. Triphala was found to have a great potential for reversal of these lesions.

Conclusions: It can be concluded that low resource screening and indigenous methods for reversal of oral pre-cancerous lesions is an effective tool for prevention of fast spreading risk of oral cancer due to tobacco usage among teenage population.