Oral Cancer Essay

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Almost 263,020 oral cavity cancers, and 127,654 oral cancer deaths occur worldwide each year1. On January 1, 2010, in the US there were approximately 275,193 women and men alive who had a history of cancer of the oral cavity and pharynx (181,084 men and 94,109 women)2. The 5-year survival rate of patients with oral cancer remains almost unchanged despite various treatment improvements in the last three decades3. Individuals at high risk of developing oral cancer (OC) are mainly older, males, heavy users of alcohol and tobacco, and have a poor diet and low socioeconomic status4, 5. Recent studies have implicated HPV infection as an independent risk factor for oro-pharyngeal cancers6, 7. For oral squamous cell carcinoma (OSCC), the role of HPV remains controversial8.
OSCC initiates in a multi-step process in which normal cells are transformed into preneoplastic cells and then to cancer9. During this process a sequential accumulation of genetic and molecular changes occur10. The majority of oral cancers are preceded by visible changes of the oral mucosa. Within the oral cavity lesions such as leukoplakia, erythroplakia, lichen planus and submucous fibrosis have a propensity for malignancy11. Oral potentially malignant disorders (OPMD) transform to oral cancers through various histopathological stages from hyperkeratosis/hyperplasia, to various degrees of dysplasia (categorized by mild, moderate, or severe according to the presence and severity of cell atypia and other structural aspects of the epithelium), to carcinoma in situ (CIS), and finally to invasive cancer12. Histopathological assessment for the grade of epithelial dysplasia is the most common method to determine malignant potential of patients with oral pre-cancerous lesion...

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...ociation between smoking tobacco, alcohol consumption and OPMDs. Second, our results may not be generalizable to the population at large, as only dental patients were included. Randomized-controlled trials may be useful to further investigate the sensibility and specificity of the oral visual examination in the context of OPMDs.
Optimal oral visual screening for OC remains a simple and essential tool to identify any suspicious lesions and potentially increase survival. A thorough visual and tactile examination in dental patients, particularly those with a history of smoking and elderly is warranted. Dentists should stay alert for signs of oral potential malignancy and counsel their patients about risk factors for oral cancer. Although OPMDs were rare, our results confirm the importance of a thorough chairside screening by dentists to detect any mucosal changes.

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