Bhurgri Y (2005) have studied the time trends in the site specific oral cancer incidence in the Karachi South, a sample population of Pakistan with a representation of all ethnic and socio-economic groups of the country. Oral cancer ranks 6th world-wide. However, 58% of the cases are concentrated in South and Southeast Asia (Nair et al; 2004). In Karachi, it ranks 2nd in all malignancies among both males and females, with the highest reported incidence in the world. In the absence of alcohol use, chewing of products of betel, areca and tobacco remain the main etiological risk factors. These products include paan, chaalia, gutka and naswar. Because of the ancient history of these products, their use is socially acceptable in all sections of South Asian society.
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