Early diagnosis in primary oral cancer: is it possible?

Abstract

In this treatise oral carcinogenesis is briefly discussed, particularly with regard to the number of cell divisions that is required before cancer reaches a measurable size. At that stage, metastatic spread may have already taken place. Therefore, the term "early diagnosis" is somewhat misleading. The delay in diagnosis of oral cancer is caused both by patients' delay and doctors' delay. The total delay, including scheduling delay, work-up delay and treatment planning delay, varies in different studies, but averages some six months. The total delay is more or less evenly distributed between patients' and doctors' delay and is partly due to the unawareness of oral cancer among the public and professionals, and partly to barriers in the health care system that may prevent patients from seeking dental and medical care. Due to the relatively low incidence of oral cancer it will be difficult to increase the awareness of this cancer type among the public, thereby reducing patients' delay. However, it should be possible to considerably reduce doctors' delay by increasing the awareness of oral cancer among professionals and by improving their diagnostic ability. Population-based annual or semi-annual screening for oral cancer is not cost-effective, high-risk groups such as heavy smokers and drinkers perhaps excluded. Dentists and physicians, and also oral hygienists and nurse practitioners, may play a valuable role in such screening programs.

Oral cancer from a health promotion perspective: experience of a diagnosis network in Ceará

“…4 Unlike the associa-Braz Oral Res., (São Paulo) 2014;28(Spec Iss 1): [1][2][3][4][5][6][7][8] tion between sunlight and skin cancer, the association between sunlight and lip cancer is unknown to most, contributing to people's negligence towards their lips. 8 The dentists surveyed in this study believed that smokers are at the highest risk of oral cancer.…”

“…Approximately 90% are squamous cell carcinoma originating in the oral epithelium. 1 Etiologically, oral squamous cell carcinoma arises from potentially malignant lesions (PML), which are lesions with different malignancy potentials. The lesions that best represent this group are erythroplakias, non-homogeneous leukoplakia, and actinic cheilosis, with malignant transformation rates of 85%, 30%, and 30%, respectively.…”

“…10 Although the oral cavity can be easily explored visually and tactilely, facilitating the detection of early lesions, 5 the diagnosis of oral cancer, especially squamous cell carcinoma, during the asymptomatic stage is unusual. 1 Two aspects in particular contribute to the effective diagnosis of oral cancer. First, oral cancer is a preventable disease 10 that is directly associated with potentially malignant lesions 11 in an anatomic region that is easily accessed during physical examination.…”

Prevalence and Correlation of Oral Lesions among Tobacco Smokers, Tobacco Chewers, Areca Nut and Alcohol Users

“…(Yen et al, 2007). Hence knowing the prevalence of these precursor lesions and treating them before they progress to malignancy should be the goal of preventive oral health care workers (Van der Waal et al, 2011).…”

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

“…These findings are very valuable, given that initial examination is performed at the primary care level in various scenarios. 35,36 These findings, however, should be interpreted with caution, as many factors, such as training and 37 These factors were not considered in this study. Cancerous lip lesions are often preceded by noticeable changes in the oral or lip mucosa, also known as PMD; this process allows clinicians to detect and effectively treat lesions in the early stages of oral carcinogenesis.…”