Oral cancer includes cancer in the areas like cheek lining, floor and roof of the mouth, gums, lips, tongue and tonsils. More often patients are likely to present themselves to either dentists or general physicians if they have swellings, inflammation, lesions or as part of a routine exam. What are various methods and oral cancer screening devices used by healthcare providers?
Background – Oral Cancer in India
Oral cancer poses a significant and growing threat to our population. It ranks as the sixth most prevalent cancer worldwide and the third most common in India. As per Global Cancer Observatory, the incidence of oral cancer in India in 2022 was about 143759 and 5-year prevalence was 370106. The incidence of oral cancer in India and South Asia is said to be high probably due to the practice of tobacco chewing. The median age of oral cancer cases was found to be 41.5 and indicated a huge loss of productivity due to incidence being in younger age.
The fatality from Oral cancer is high. Squamous Cell Carcinoma accounts for 90% of all oral cancers, with a 5-year survival rate around 60%. However, if diagnosed early, the survival rate could be better than 90%. Early screening of oral cancer can be extremely helpful. Unfortunately, the mortality rate has seen no improvement over the past three decades, making it the most costly cancer to treat.
Why is oral cancer screening important?
Oral cancer has a five-year survival rate of 57%. This means that just a little more than half of the people diagnosed with oral cancer would be alive five years after their diagnosis. Oral cancer isn’t very difficult to diagnose. But fatality rates are high because oral cancer is too often detected late in its development. Oral cancer screening devices are the best tool available for early diagnosis and treatment.
While many different specialists can perform oral cancer screenings, routine dental examinations can be most helpful.
Oral cancer screenings help dentists look for signs of cancer in your mouth. They’ll examine the lining of your cheeks, gums, lips, tongue, and floor and roof of your mouth to check for lesions and abnormalities. If anything suspicious is found, consultation by an oncologist followed by further testing, diagnosis and treatment can be done.
Common Oral cancer screening methods
Oral cancer screening includes examination of several oral structures, including gums, tongue, lips, cheek lining, tonsils, floor and the roof of the mouth. The following or a combination of oral cancer screening methods could be used as appropriate:
- Visual exam – A doctor could do a visual examination of the mouth and throat to look for lesions and other abnormalities. The abnormalities may include thick white patches and abnormally red areas etc.
- Palpation – Over and above visual examination, the doctor could use their fingers to feel for lumps or bumps around the face, neck and jaw.
- Oral cancer screening dye – Many healthcare providers use oral cancer screening tools — like toluidine blue dye — to look for signs of oral cancer. The dye changes colour in abnormal cells as compared to normal cells and this can help identify potentially abnormal cells for further investigation.
Oral Cancer Screening devices using fluorescence
Dentists could use fluorescence visualization devices such as Vel-scope Oral assessment system, Vizilight PRO, OralScan etc. These are special lights that can which makes healthy tissue look different from abnormal tissues and hence help identify abnormal tissues in your mouth.
Cell tissues when excited by light of an appropriate wavelength (e.g. blue) will emit their own light at a longer wavelength (e.g. green). This resulting fluorescence reveals information about cellular structure and/or metabolic activity, potentially indicating any abnormality.
Unlike other adjunctive devices used by dentists, the fluorescence-based oral assessment system does not require any dyes or prolonged testing procedures. These examinations can be quickly done in the dentist’s office during routine hygiene exams.
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