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To compare the treatment outcomes of squamous cell carcinoma (SCC) of buccal mucosa in India and Canada.We compared the outcome of 169 patients with SCC of buccal mucosa treated at Tata Memorial Hospital (TMH), India with 64 matched patients from Cancer Care Manitoba (CCMB), Canada. Overall and cause specific survivals for the two geographical groups were calculated by Kaplan-Meir method and compared using log rank test. Cox regression analysis was used to see impact of independent variables.At 5 years, CCMB patients had lower over all survival (57.4% vs. 67.1%; P = 0.002) than TMH ones but similar cause specific survival (76.4% vs. 74.2%; P = 0.690). Age had an independent influence on both over all and cause specific survival. After adjusting for the age confounding in the Cox proportional hazard model there was no difference in the overall survival of the two groups (HR = 0.84; 95% CI = 0.51, 1.40; P = 0.509). Radiated patients had three times higher risk of dying of disease than surgically treated ones (HR = 3.03; 95% CI= 1.64, 5.60; P< 0.001).There was no difference in the cause specific survival between the two groups. Apparent difference in the overall survival was due to the difference in the age of presentation.