The ADA has provided us with a very comprehensive study on how to detect oral cancer early.
Dental health is important for many reasons, but in this article we will be taking special focus on oral cancer. Through awareness we can help educate ourselves and others in order to prevent, detect and treat oral cancer. Here are some key points to take into consideration from the ADA website:
Oral and Oropharyngeal Cancer
- Although they border each other, the oral cavity (OC) and oropharynx (OP) are separate, nonoverlapping anatomic regions.
- Squamous cell carcinoma (SCC) is the most common malignancy in the OC and OP, accounting for 90% of cancers of the head and neck.
- OC and OP cancers account for 2.9% of all cancers diagnosed in the U.S. and 1.6% of all cancer deaths.
- The 5-year relative survival rate for those with localized disease at diagnosis is 83%, compared with only 36% in patients whose cancer has metastasized.
- The major risk factors for OC-SCC and OP-SCC are tobacco use, alcohol consumption, interaction between heavy use of tobacco and alcohol together, human papillomavirus (HPV) infection, and chewing betel quid (“paan,” often practiced in Asian, migrant Asian, and other communities).
- The National Institute for Dental and Craniofacial Research (NIDCR) provides an oral cancer examination protocol for dental practitioners.
The major risk factors for OC-SCC and OP-SCC are tobacco use, alcohol consumption, interaction between heavy use of tobacco and alcohol together,10, 11 and chewing betel quid (“paan,” often practiced in Asian, migrant Asian, and other communities). Ultraviolet exposure may be the likely risk factor associated with SCC of the lip. Older age and male sex also increase the risk of OC/OP-SCC.5Smoking-associated risk appears to be dose dependent and correlates with daily or cumulative cigarette consumption. For patients who quit smoking, the risk for OC-SCC and OP-SCC declines over time and may approach that of nonsmokers after 10 or more years of cessation. Human papillomavirus (HPV) infection1 is a major risk factor for oropharyngeal cancer, rather than oral cancer (see following section “Focus on HPV”).
The increase of oral tongue SCC seen among young white women does not appear to be associated with either tobacco or alcohol use or HPV infection and has been suggested to have a different causative mechanism (e.g., genetic abnormalities such as Fanconi anemia, other oncogenic viral infections, or other environmental exposures). There is an increased risk for OC/OP-SCC in patients with certain rare heritable conditions, including Fanconi anemia, dyskeratosis congenita, and Bloom syndrome.
Signs and Symptoms
Two oral lesions that could be precursors to cancer are leukoplakia (white patches) and erythroplakia (red patches). Although there is a known potential for malignant transformation, the majority of leukoplakias will not progress to cancer. Some oral lesions will show a combination of red and white features, termed erythroleukoplakia, speckled leukoplakia, or speckled erythroplakia. Although less common than leukoplakia, erythroplakia and lesions with erythroplakic components have a much greater potential for becoming cancerous.
Because these white and/or red mucosal patches have an increased risk of becoming or already harboring invasive carcinoma, they have collectively been classified as “potentially malignant disorders.”1 Any white or red patch/lesion that does not resolve in 2 weeks should be reevaluated and considered for biopsy to obtain a definitive diagnosis.
OP-SCC develops most frequently in the tonsillar region and base of the tongue, often appearing as an ulcerated mass, fullness, or irregular erythematous mucosal change. OP-SCC tumors are thought to present at a more advanced stage than OC-SCC because of their ability to grow undetected and their propensity for metastasis. The most common chief complaints are the presence of a neck mass (from metastatic disease), sore throat, and dysphagia.
Other possible signs and symptoms of oral cancer that patients may report include:
- a lump or thickening in the oral soft tissues
- soreness or a feeling that something is caught in the throat
- difficulty chewing or swallowing
- ear pain
- difficulty moving the jaw or tongue
- numbness of the tongue or other areas of the mouth
- swelling of the jaw that causes dentures to fit poorly or become uncomfortable
Signs and symptoms that persist for 2 weeks or more merit further investigation, such as a biopsy or referral to a specialist.
Disclaimer from the ADA
Content on the Oral Health Topics section of ADA.org is for informational purposes only. Content is neither intended to nor does it establish a standard of care or the official policy or position of the ADA; and is not a substitute for professional judgment, advice, diagnosis, or treatment. ADA is not responsible for information on external websites linked to this website.