Visual Screening Reduces Deaths of Oral Cancer in High-Risk Individuals

Visual screening of the oral cavity detects oral cancer in individuals who use tobacco or alcohol and should be routine

Does your doctor routinely examine your mouth and gums during your physical exam? He/she should, research suggests that this simple visual screening of the oral cavity can significantly reduce deaths caused by oral cancer particularly in individuals who use tobacco and/or consume alcohol.(1)

Cancers of the oral cavity involve cancer that may originate in different areas of the oral cavity, such as the lining of the cheeks, roof of the mouth, beginning of the throat and gums. Worldwide, there are over 300,000 new cases of oral cancer each year, resulting in over 150,000 deaths.

Individuals who regularly use tobacco and/or alcohol products are at an increased risk of developing cancer of the oral cavity. Unfortunately, there is often no routine screening for cancers of the oral cavity, even in high-risk individuals.(2) Other risk factors associated with cancers of the mouth and/or pharynx include: being age 45 years or older and being infected with the human papillomavirus.(3)

Researchers from India conducted a clinical trial to evaluate the effectiveness of simple visual screening of the oral cavity. The trial included 13 population clusters in India, involving nearly 200,000 eligible individuals. A population of seven clusters underwent visual inspection of the oral cavity (three rounds of inspection at 3-year intervals) by trained healthcare workers, and a population of 6 clusters did not undergo visual inspection of the oral cavity. Individuals in the screened populations who had signs of possible cancer were then subsequently referred for a biopsy (tissue sample to determine if cancer existed), followed by treatment. Overall, individuals in the screening group had a 21% risk reduction in death, compared to those who were not screened. In alcohol and tobacco users, however, there was a 34% risk reduction in death among the screened group, compared to those who were not screened. The benefit was greater in men than women.

The researchers published their findings in Lancet and concluded that simple visual screening of the oral cavity could prevent approximately 37,000 deaths from oral cancer worldwide. Individuals who are regular users of tobacco or alcohol should speak with their healthcare provider regarding regular screening for oral cancer.

Reference:

  1. Sankaranarayanan R, Ramadas K, ThomasG, et al. Effect of screening on oral cancer mortality in Kerala, India: a cluster-randomised controlled trial. The Lancet. 2005; 9475: 1927-1933.
  2. Oral Oncology, Vol 35, No 4, pp 375-378, 1999.
  3. Freedman N, Abnet C, Leitzmann M, et al. Prospective investigation of the cigarette smoking-head and neck cancer association by sex. Cancer [early online publication]. August 10 2007. DOI: 10.1002/cncr.22957.

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