Clinical tip: the days of prescreening for oral cancer are long gone

April 19, 2011
Prescreening still occurs in many dental offices, because dental professionals are unaware of the new risk factor — HPV. Dr. Kevin Huff gives readers the skinny on HPV and oral cancer risk.

By Kevin D. Huff, DDS, MAGD

Classically, the risk factors for oral cancer have been:

  • Age (over the age of 45)
  • Gender (males more prevalent)
  • Ethnicity
  • Tobacco use
  • Heavy use of alcohol
  • Heredity

In the past, it was common practice for dental professionals to decide on which patients to perform oral cancer screening exams based on whether or not they have these risk factors. Unfortunately, prescreening still occurs in many dental offices, because dental professionals are unaware of the new risk factor — HPV.

The skinny on HPV:

  • There are more than 120 identified strains of HPV, and only a few have been found to cause cancer.
  • Type 16, which is one of the strains that causes cervical cancer, is a risk factor for oropharyngeal cancer.
  • Lesions typically are not easily visible.
  • HPV is a virus and can be cleared naturally by the body over 60 to 90 days.
  • HPV is spread through sexual contact and is an STD.
  • HPV-related squamous cell cancers have a better prognosis than non-HPV cancers.
  • HPV cancers are more prevalent in nonsmokers of both sexes under the age of 40.

Although it was reasonable in the past to prescreen based on common risk factors, HPV debunks this concept. Since HPV causes cancer in individuals who do not have the classical risk factors, everyone is at risk. Social studies done by Merck during the development of its HPV vaccine suggest that adolescents begin sexual activity with partners as early as age 11 or 12. Therefore, it makes sense that oral cancer screening should be performed on all adolescents and adults at least once a year, regardless of known risk factors.

Author bio
Dr. Kevin Huff is a practicing general dentist in Dover, Ohio. He is a sought-after lecturer and author on the topic of oral cancer screening by general dentists and serves as the coordinator of oral mucosal screening for the Mercy Medical Center Dental GPR program in Canton, Ohio. Dr. Huff is also visiting faculty for Spear Education in Scottsdale, Ariz., and is a clinical instructor at the Case School of Dental Medicine in Cleveland, Ohio. You may reach him by email at [email protected].