Oral mucosal malignancy and potentially malignant lesions: an update on the epidemiology, risk factors, diagnosis and management

McCullough, MJ; Prasad, Gareema; Farah, CS

doi:10.1111/j.1834-7819.2010.01200.x

Cited by 127 publications

(149 citation statements)

References 33 publications

(43 reference statements)

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“…1 Potentially malignant lesions of oral cavity are relatively common occurring in about 2.5% of the population with a malignant transformation rate of 0.6 to 20% as reported in various studies and locations. 3 Identification of molecular markers in blood would predict the development of cancer in its earliest stage or in precancerous stage. Literature scan reveals very few studies on RBC indices and role of WBC count in the diagnosis of malignancies of the head and neck.…”

Section: Blood Urea and Creatininementioning

confidence: 99%

Evaluation of Hematological Parameters as a Possible Marker for Head - And - Neck Cancer and Precancerous Conditions

Bhattacharjee¹,

Borah²,

Giri³

et al. 2015

jemds

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BACKGROUNDHead neck cancer (HNCA) is a major health problem, accounting for 30-40% cancers at all sites with the incidence in North-East India, where this study has been conducted is highest in the country (54.48%). As various substances alter quantitatively in the serum during tumor development, we intended to explore the changes in the haematological profile in cases of head neck squamous cell carcinoma and epithelial precursor lesions. Moreover, such study will be the first on HNCA patients in this North East region of India.

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Section: Blood Urea and Creatininementioning

confidence: 99%

Evaluation of Hematological Parameters as a Possible Marker for Head - And - Neck Cancer and Precancerous Conditions

Bhattacharjee¹,

Borah²,

Giri³

et al. 2015

jemds

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“…13,14 The reported five-year survival rate of stage III or IV oral cancer ranges between 15% and 55%. [15][16][17][18] In contrast, oral cancers diagnosed at a smaller size and without lymph node involvement in stage I or II report a five-year survival rate ranging between 66% and 85%. 11,15,19 A recent analysis of 22,204 pathologically verified oral cancers followed up over ten years concluded that early diagnosis and intervention before stage II can significantly improve life expectancy and decrease expected years of life lost to oral cancer.…”

Section: Chapter One: Introductionmentioning

confidence: 99%

“…[15][16][17][18] In contrast, oral cancers diagnosed at a smaller size and without lymph node involvement in stage I or II report a five-year survival rate ranging between 66% and 85%. 11,15,19 A recent analysis of 22,204 pathologically verified oral cancers followed up over ten years concluded that early diagnosis and intervention before stage II can significantly improve life expectancy and decrease expected years of life lost to oral cancer. 18 This is ideally when the patient is likely asymptomatic with a tumour less than 2cm in diameter and with less than 4mm of invasion.…”

Section: Chapter One: Introductionmentioning

confidence: 99%

“…18,20 Therefore, early detection of malignant lesions and oral potentially malignant lesions (OPMLs) is an important goal for reducing morbidity and mortality. 14,15,21,22 The Cochrane collaboration and other expert consortia agree that whilst population-based annual or semi-annual screening for oral cancer is not cost-effective, targeting high-risk populations to be opportunistically screened using a visual and tactile examination should be encouraged in the primary care setting. [23][24][25][26] Opportunistic oral cancer screening by general medical practitioners (GMPs) and general dental practitioners (GDPs) should remain an integral part of the routine daily work of these groups, and particular attention should be paid to high-risk individuals.…”

Section: Chapter One: Introductionmentioning

confidence: 99%

“…13,14 The reported five-year survival rate for stage III or IV oral cancer ranges between 15 and 55%. [15][16][17][18] The most important prognostic marker for oral cancer remains the tumour stage at diagnosis. 6,12 Survival rates are significantly improved if the disease is treated at an early stage, ideally when the patient is likely to be asymptomatic with a tumour less than 2cm in diameter and with less than 4mm of invasion.…”

Section: Introductionmentioning

confidence: 99%

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Opportunities for achieving early diagnosis of oral cancer within the medical profession in Australia

Webster¹

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Most oral cancers lack early symptoms that would prompt a patient to seek diagnosis; hence at presentation more than 60% of patients are diagnosed with stage III or IV advanced disease. Survival rates and morbidity are dramatically improved if the disease is treated at an early stage, preferably asymptomatic in stage one. Therefore, early detection of oral cancer and oral potentially malignant lesions in the asymptomatic phase via an oral cancer screening examination is important.The core objective of this thesis is to determine whether asymptomatic diagnosis of oral cancer at an early stage of disease is achievable in Australia. We achieve this by evaluating the awareness of, and attitudes toward, oral cancer and opportunistic screening held by recently-diagnosed oral cancer patients, experienced general medical practitioners, and recentlygraduated medical students. From these studies we found that participants with oral cancer had poor awareness of oral cancer and poor knowledge of risk factors prior to diagnosis. Nearly all were over 40 years of age and most consumed tobacco or alcohol or both, suggesting a target population for opportunistic screening in the primary healthcare setting. Patient, professional, and total diagnostic ii delay were better than in many other countries. In the asymptomatic phase before diagnosis, participants with oral cancer were more likely to visit a GMP over a General Dental Practitioner (GDP), and likely to do so multiple times each year, identifying significant opportunities for GMPs to perform opportunistic oral cancer screening.We also found that Australian GMPs and GMSs have an inadequate level of knowledge of oral cancer, OPMLs, risk factors, and inadequate skill in performing opportunistic oral cancer screening examinations. At the present level of knowledge and confidence, it would be unlikely for a GMP to conduct a thorough visual and tactile oral cancer screening examination even if a highrisk individual presented to his or her clinic. Only 7% of participants with oral cancer were diagnosed in the asymptomatic phase, and all were diagnosed by health practitioners with a dental qualification.We conclude that asymptomatic diagnosis of oral cancer at an early stage of disease is achievable in the primary medical healthcare setting in Australia via opportunistic oral cancer screening. Initiating a consultation with a GMP or GDP for an oral cancer screening examination would require a patient to have an improved awareness of oral cancer and knowledge of his or her personal risk factors for developing it. To increase opportunistic oral cancer screening activity from Australian GMPs, interventions need to ensure that GMPs and GMSs reach competence in risk factors for oral cancer, identifying high-risk populations, diagnostic confidence, and skill in performing the nine-step visual and tactile opportunistic oral cancer screening examination.iii

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Expression of ABCG2 and Bmi‐1 in oral potentially malignant lesions and oral squamous cell carcinoma

et al. 2014

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Early diagnosis is vital for effective treatment of oral squamous cell carcinoma (OSCC). The optimal time for clinical intervention is prior to malignancy when patients present with oral potentially malignant lesions such as leukoplakia or erythroplakia. Transformation rates for oral dysplasia vary greatly and more rigorous methods are needed to predict the malignant potential of oral lesions. We hypothesized that the expression of two putative stem cell markers, ABCG2 and Bmi-1, would correlate with disease severity for non diseased, potentially malignant and OSCC specimens and cell lines derived from an equivalent range of tissues. We compared immunoreactive protein and relative gene expression of ABCG2 and Bmi-1 in eight cell lines derived from source tissues ranging in disease severity from normal (OKF6-TERT2) through mild and moderate/severe dysplasia (DOK, POE-9n) to OSCC (PE/CA-PJ15, SCC04, SCC25, SCC09, SCC15). We also analyzed immunoreactive protein expression of ABCG2 and Bmi-1 in 189 tissue samples with the same range of disease severity. A trend between oral lesion severity to ABCG2 and Bmi-1 immunostain intensity was observed. Flow cytometry of oral cell lines confirmed this trend and gave good correlation with RT-PCR results for ABCG2 (r = 0.919, P = 0.001; Pearson) but not Bmi-1 (r = −0.311). The results provide evidence of increased density of ABCG2 and Bmi-1-positive populations in malignant and oral potentially malignant lesions and derived cell lines, but that intragroup variability within IHC, flow cytometry, and RT-PCR results compromise the diagnostic potential of these techniques for discriminating oral dysplasia from normal tissue or OSCC.

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Oral mucosal malignancy and potentially malignant lesions: an update on the epidemiology, risk factors, diagnosis and management

Cited by 127 publications

References 33 publications

Evaluation of Hematological Parameters as a Possible Marker for Head - And - Neck Cancer and Precancerous Conditions

Evaluation of Hematological Parameters as a Possible Marker for Head - And - Neck Cancer and Precancerous Conditions

Opportunities for achieving early diagnosis of oral cancer within the medical profession in Australia

Expression of ABCG2 and Bmi‐1 in oral potentially malignant lesions and oral squamous cell carcinoma

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