Published: Tuesday, October 14, 2008
Oral Cancer Frequently Asked Questions
What is oral cancer screening?
What are the benefits of oral cancer screening?
How long does oral cancer screening take?
Who should be screened for oral precancer and cancer?
How common is oral cancer?
What are the major screenable risk factors for oral cancer?
If my patient’s oral cancer screening was normal what should I do?
If my patient’s oral cancer screening was abnormal what should I do? What does it mean?
How do I talk to my patients about oral cancer screening?
Where can I obtain toludine blue?
What is oral cancer screening?
Oral screening involves an assessment of the patient’s risk factors, a thorough examination of the head and neck area and all the tissues of the mouth. Clinicians look and palpate for any colour or texture changes.
Top
What are the benefits of oral cancer screening?
Oral cancer screening will aid in the early identification of lesions potentially at risk for oral precancer and cancer as well as lesions that may be signs of other mucosal diseases or systemic diseases. Lesions can then be biopsied or referred for biopsy for an actual diagnosis.
Oral cancer found early has a much better prognosis than late stage oral cancer.
Lesions found while at the precancerous stage (dysplasia) may further improve survival rates.
Top
How long does oral cancer screening take?
Oral cancer screening takes less than 2 minutes.
Top
Who should be screened for oral precancer and cancer?
At present, our consensus recommendation is to offer this annually to all individuals from age 40.
There is no upper age limit. Oral cancer is a disease of the soft tissues not the teeth so all individuals regardless of whether they have their natural teeth or not should be screened regularly for oral cancer.
Top
How common is oral cancer?
Approximately 3200 Canadians will be diagnosed with oral cancer this year and many more will be diagnosed with dysplasia (precancer).
There were more oral cancer cases diagnosed in BC in 2003 than cervical, ovary, testicular, brain, Hodgkin's lymphoma, kidney and multiple myeloma to name a few.
Top
What are the major screenable risk factors for oral cancer?
- Age (the risk increases as we get older)
- Tobacco (smoked or chewed)
- Alcohol (more than 2-3 drinks/day)
- The use of tobacco AND alcohol greatly increases a person’s risk of oral cancer
- Paan, betel quid
- Previous head and neck cancer or precancer
- Immunosuppression (medications, previously diagnosed disease)
- Ultraviolet light (sun damage) (lips, perioral)
Top
If my patient’s oral cancer screening was normal what should I do?
A normal oral cancer screening requires no further follow-up.
Document that a screening was completed.
Patients with a normal screening will be followed up annually.
Top
If my patient’s oral cancer screening was abnormal what should I do? What does it mean?
If an abnormality is found it does not mean your patient has oral cancer.
Only a small number of people with abnormal screens will be found to have oral cancer.
It does mean, however, that further investigation is needed to rule out oral precancer and cancer.
Further investigation may include a biopsy of the area in question.
Top
How do I talk to my patients about oral cancer screening?
It can be difficult to introduce new procedures to our patients. Keep it as simple as possible. Tobacco and alcohol use is a risk factor for not only oral cancer and both can be contributing factors towards periodontal disease and other oral conditions.
An extraoral exam can be explained as a "quick lumps and bumps" check.
Top
Where can I obtain toludine blue?
There are two sources of toludine blue that we are aware to date. One is marketed by Zila Pharmaceuticals in Canada, and by ViZiLiteR Plus in the United States. The second is a generic version (Mashberg, 1983) prepared either in the research lab or through a local pharmacy.
Top