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Oral Cancer Screening for Today’s Population: Is Your Practice Up to Date?

April is Oral Cancer Awareness Month.  Be pro-active and prepare your practice to offer free oral cancer screenings to your community!

Connect with Jo-Anne Jones on April 16th, 2014 with a free webinar on Oral Cancer Screening for Today’s Population: The Need for ChangeRegister Here

Over 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year.  Oral cancer will claim 8,000 lives killing 1 person/hour, 24 hours per day.  Of those 42,000+ newly diagnosed individuals, only slightly more than half will be alive in 5 years.  Worldwide, the problem is much greater with 640,000 new cases being found each year.

The face of oral cancer is changing.  As the dental community and an integral part of the interdisciplinary healthcare network, we need to re-evaluate our clinical protocols related to oral cancer screening.  No longer can we be confident in identifying those of our patient population who may be at risk.  A virally and sexually transmitted etiology is fueling the escalation in oropharyngeal cancer.

Approximately 79 million Americans are infected with human papillomavirus (HPV), and approximately 14 million people will become newly infected each year. 1 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. Each year in the United States an estimated 26,000 new cancers attributable to HPV occur. 2

How can we as dental professionals combat this pandemic?  First of all recognizing that there are certain high risk anatomical areas.  For non-HPV related oral cancers the anterior segment of the tongue, the floor of the mouth and the palate are key areas to be examined closely.  For HPV-related oral and orophyaryngeal cancer, the high risk areas include the posterior segment of the tongue, the tonsillar areas and the oropharynx.

A comprehensive extraoral and intraoral examination should be conducted on an annual basis at minimum.  Magnification is critical!  If you are not wearing loupes and better still loupes and a headlamp you are going to miss the subtle changes that may be the first clinical manifestation of an abnormal lesion.

Other subtle signs we can’t afford to ignore include however are not limited to hoarseness, continual sore throat not responding to antibiotics, pain or difficulty when swallowing, unilateral ear pain, feeling of something caught in the throat, continual lymphadenopathy, slurred speech, asymmetry in the tonsillar area and a tongue that tracks to one side when stuck out.

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”. 3

Is it time to explore the offering of an adjunctive screening device that will enhance your assessment of the oral cavity for earlier discovery of an abnormal lesion?  We’re simply not making the inroads that we need to make.  Oral cancer is still claiming too many lives too soon.  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.

References:
1. http://www.cdc.gov/std/hpv/stdfact-hpv.htm
2. http://www.cdc.gov/vaccinesafety/vaccines/HPV/Index.html
3. http://jada.ada.org/content/143/12/1332.abstract

Practice Resources:
4. iTunes Podcasts:  The Thriving Dentist Podcast Show with Gary Takacs http://www.takacslearningcenter.com/thriving-dentist-show/
(Interviews with Linda Miles, Robin Morrison, Jo-Anne Jones)
5. www.velscope.com VELscope Vx Enhanced Oral Assessment System

Jo-Anne-Jones (150x150)Jo-Anne Jones is a proud supporter of the Oral Cancer Cause.  Her mission is to elevate awareness within the professional community related to the changing profile of oral and oropharyngeal cancer. Jo-Anne has shared this powerful message with dental professionals across Canada, the US, the UK and Ireland.  Jo-Anne joins the 2013 Top 25 Women in Dentistry and is a Dentistry Today CE Leader.   Jo-Anne may be reached by email at jjones@jo-annejones.com

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