The project for prevention and early detection of oral cancer was undertaken in Ratlam district, Madhya Pradesh, India. The World Health Organization through the Ministry of Health & Family Welfare, Government of India, provided the funding for this project.

The project was implemented in association with the Basic Dental Research Unit, Tata Institute of Fundamental Research, Mumbai, and the Ratlam district administration.

The work on the project started on 10.02.1993 and six training programmes were conducted on awareness, mouth self-examination, detection of pre-cancerous conditions and identification of high-risk population.

• A 3-day programme for government doctors, private practitioners and medical field health workers was held at Ratlam. Drs. PC Gupta & PR Murthy of the Tata Institute of Fundamental Research conducted it.
• The nodal officer of this project, Dr. S N Mehra, a retired civil surgeon, conducted a programme for rural health workers.
• A programme for urban workers was held in the civil hospital.
• Training seminar in a rural village of the district.
• A refresher programme.
• A final training and refresher course held on 22.02.1993
• 3 cancer detection camps were held in which 51 cases were identified. A sample survey of 2 schools was carried out in which it was found that 75 students out of 386 were using tobacco in some form or the other. As a part of a publicity program, hoardings against the use of tobacco were set up at different places, handbills were distributed through newspapers, advertisements were published in the newspapers, slides were shown in cinema halls.
• As a part of this project 69 000 individuals were interviewed and examined within a period of one year. This warranted regular field visits, which started from 09.03.1992. Survey work was completed in November 1992.
• 99% of those interviewed were tobacco users. The ratio of men to women was 3.3 to 1. 92% of the women were tobacco chewers while 75% of the men were smokers. 61% of the smokers smoked bidis.

Amongst the chewers, the most common combination was tobacco and lime followed by betel leaf and tobacco. A small percentage of chewers (4.5%) but a larger percentage of smokers (8%) started their habits before 15 years of age.

In his comments on the study, Dr. Helmut Sell, Regional Advisor on Health and Behaviour for Regional Director of the WHO, has focused on the striking finding of the report, namely the reluctance of those in whom some lesion was detected to come for examination. He felt that there is little chance of improving compliance and thereby reducing cancer mortality substantially, unless some information on the motivational patterns in compliance and non-compliance is available.

137 health workers carried out the survey. About 16 doctors worked actively by guiding and helping the health workers.

The Scientific Committee of the 16th International Cancer Congress (UICC) approved the findings of the survey for presentation.