Molecular Pathological Epidemiology of Oral Cancer in Rural India

Abstract

Background: Oral squamous cell carcinoma (OSCC) remains a leading malignancy
in India, with a significant burden in rural populations. While tobacco and areca nut
use are well-established risk factors, the molecular characteristics of OSCC in rural
patients remain underexplored. This study integrates traditional epidemiology with
molecular pathology to identify key risk patterns and biological behaviour in rural
Indian OSCC cases.
Methods: A cross-sectional observational study was conducted on 100 histologically
confirmed OSCC patients from rural northern India. Epidemiological data were
collected via structured interviews. Tissue samples underwent immunohistochemical
(IHC) analysis for p53, Ki-67, and Cyclin D1 expression. HPV status was assessed
using p16 IHC. Associations between risk factors, molecular markers, and
clinicopathological parameters were analysed.
Results: The majority (83%) had a history of tobacco or areca nut use. HPV
positivity (p16+) was found in 20% of cases, predominantly among younger, nonsmoking patients. p53 overexpression was noted in 57% of cases and correlated with
high-grade tumours and nodal metastasis (p < 0.05). Cyclin D1 and Ki-67 were
significantly associated with tumor stage and depth of invasion.
Conclusion: OSCC in rural India demonstrates high p53 mutation prevalence and
moderate HPV association. Integration of molecular markers with epidemiologic
data could enable risk stratification and tailored treatment in resource-limited
settings.