The Silent Epidemic: Ten-Year Clinical Patterns of Oral Squamous Cell Carcinoma in Pakistan (2015–2025)

Background: Oral squamous cell carcinoma (OSCC) is a leading malignancy in Pakistan, driven by smokeless tobacco and betel quid use, with significant morbidity due to late-stage diagnoses. Objective: To analyze clinical patterns of OSCC from 2015 to 2025 across public and private hospitals in Pakistan, focusing on histological subtypes, anatomical site distribution, and demographic trends (ages 30–80, gender, and provincial variations in Punjab, Sindh, Khyber Pakhtunkhwa, Balochistan, and Islamabad). Methods: A systematic review of clinical studies (2015–2025) from PubMed, Scopus, and hospital records accessed through personal visits to public and private hospitals. Data on histological subtypes (WHO classification), tumor sites, demographics, stage at diagnosis, and survival were pooled. Statistical analyses included chi-square tests, logistic regression, and Kaplan-Meier survival estimates. Results: Of 5,200 cases, well-differentiated OSCC predominated (52%), with poorly differentiated tumors rising from 8% to 14%. Tongue (40%) and buccal mucosa (35%) were primary sites. Males (67.8%) and Punjab (50–55%) had the highest burden, with increasing incidence in younger patients (30–45 years, 15% to 22%). Advanced-stage (III/IV) diagnoses (70%) correlated with 15% 5-year survival. Conclusion: Persistent histological patterns, site-specific dominance, and rising youth incidence highlight the need for targeted screening and a national cancer registry. Significance: This study informs clinical and public health strategies to address Pakistan’s OSCC burden.