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Early Detection of Oral Cancer : A Perspective View
Authors: Dr. Krishna Deo Prasad Dr. Basavraj T. Bhagawati
Number of views: 497
Oral cancer is a disease in which malignant cells form in the lips, oral cavity &oropharynx. traditionally known as squamous cell carcinoma of the lips,oral cavity & oropharynx. Head&neck cancer account for 5% of all tumours & about 50%of head &neck cancer occur in the oral cavity. In the year 2000, about 300,000 out of the 615000 new cases of oral cavity reported world wide were primary oral cavity squamous cell carcinoma.1Recent data from surveillance, epidemiology end result program suggested that 28,900 new cases of oral cancer will be identified&7400 death attributed to oral cancer each year in the U S.2 The sixth leading cause of cancer related morbidity, oral cancer account for 1 death every hour in U S. Despite numerous advances in treatment the 5 year survival has remained approximately 50% for the last 50 years.3 This poor prognosis is likely due to several factors. First, oral cancer is frequently associated with the development of multiple primary tumors. The rate of second primary tumors in these patients, 37% per year, is higher than for any other malignancy.4This characteristic led Slaughter to propose a theory known as ''field cancerization''. To underscore the significance of this complication, the most common cause of treatment failure and death in oral cancer patients is their second primary tumor.5 Second, poor survival among oral cancer patients can also be attributed to the advanced extent of the disease at the time of diagnosis, with over 60% of patients presenting in stages III and IV. Such dismal statistics seem perverse since the disease primarily arises in the surface oral epithelium that is readily accessible to direct visual and tactile examination. The conclusion that at least some lesions are ignored or missed by patients,health care professionals or both, is inescapable. In part, this may be due to an incomplete understanding or awareness that even, small asymptomatic lesions can have significant malignant potential. One approach to this problem wold be to improve the ability of oral health care professionals to detect relevent potentially malignant lesions or cancerous lesions at their earliest or most incipient stage. Such a goal could be achieved by increasing public awareness about the importance of regular oral screening or case finding examinations to identify small, otherwise asymptomatic cancers and precancers (secondary prevention). Another strategy would be the development and use of diagnostic aids that could help the general dentist or dental specialist more readily identify or assess persistent oral lesions of uncertain biologic significance. This paper will examine the role of screening examinations in oral cancer and evaluate the literature regarding currently available diagnostic tests or techniques that are purported to aid in the detection and diagnosis of cancerous and precancerous lesions.