By Jo-Anne Jones, RDH
April is Oral Cancer Awareness Month. Is your current screening method for oral cancer serving the needs of today’s population?
Other articles on oral cancer and dentistry
- Should marijuana users be worried that smoking causes oral cancer?
- Seriously, how meticulously do you check for oral cancer?
- Human papillomavirus and oral cancer
A number of significant changes have occurred in the profile of oral and oropharyngeal cancer. This emergence is rapidly escalating and on the radar of both the medical and dental communities.
Did you know?
1. Incidence of Oral Cancer —Over 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year; three times the number of cervical cancers. Oral cancer will claim 8,000 lives killing 1 person/hour, 24 hours per day. Of those 42,000-plus newly diagnosed individuals, only slightly more than half will be alive in five years. Worldwide, the problem is much greater with 640,000 new cases being found each year.1,2
2. Smoking and alcohol etiologic factors are on the decline — While smoking and alcohol (and particularly the combination of both) are definitely risk factors for oral cancer, these etiologic factors have seen a 50% decline between 1988 and 2004 in comparison to HPV-related oropharyngeal cancers.3
3. Virally and sexually transmitted etiologic factors are escalating — During the same period of time HPV-related oropharyngeal cancers rose by 225%.3 Approximately 79 million Americans are infected with the human papillomavirus (HPV), and approximately 14 million people will become newly infected each year.4 Some HPV types can cause cervical, vaginal, and vulvar cancer among women, penile cancer among men, and anal and some oropharyngeal cancers among both men and women. Other HPV types can cause genital warts among both sexes.
4. Subtle non-traditional symptoms accompany this new profile related to HPV-oropharyngeal cancer — The following is a list of subtle symptoms however not limited to:
- Continuous sore throat; persistent infection
- Pain when swallowing or difficulty swallowing
- Pain when chewing
- Continual lymphadenopathy
- Non-healing oral lesions
- Bleeding in the mouth or throat
- Unilateral ear pain
- A lump in the throat or the feeling that something is stuck in the throat
- Unexplained weight loss
- Slurred speech
- Tongue that tracks to one side when stuck out
- Asymmetry in tonsillar area
5. The COE is not enough —The problem is that we are still discovering the majority of oral cancers or dysplastic lesions at a later stage. This greatly impedes the survival rate. The Journal of the American Dental Association published their findings regarding the limitations of the clinical oral examination in detecting dysplastic oral lesions and oral squamous cell carcinoma (OSCC).
“On the basis of the available literature, the authors determined that a COE of mucosal lesions generally is not predictive of histologic diagnosis. The fact that OSCCs often are diagnosed at an advanced stage of disease indicates the need for improving the COE and for developing adjuncts to help detect and diagnose oral mucosal lesions.”5
Has your practice looked into the integration of an adjunctive screening device to see what you may be missing with white light examination?6
Our patients deserve to live long healthy lives. Our patients deserve to be screened for early discovery of oral cancer. Our patients deserve to be treated the way we would want to be treated. Be proactive. You may just save a life.
Jo-Anne Jones, RDH, is an international lecturer. The editors of PennWell publications selected Jo-Anne’s article entitled “Sex and Oral Health: What’s the Connection?” as “The Most Important Dental Story Published in 2012” focused on the rising incidence of HPV-positive oropharyngeal cancer. Her mission through her message is to elevate awareness and promote earlier discovery of oral and oropharyngeal cancer. Jo-Anne has shared this powerful message with dental professionals across Canada, the US, UK and Ireland. She can be contacted at [email protected]. Her website can be viewed at http://www.jo-annejones.com.
1. CA: A Cancer Journal for Clinicians. Volume 64, Issue 1, pages 9–29, January/February 2014.
3. Chaturvedi A, Engels A, Pfeiffer RM et al. Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States. Jour of Clin Oncol published on October 3, 2011.