Are we able to reduce the mortality and morbidity of oral cancer; some considerations

Abstract

Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral cancer present with advanced disease. There are several ways of trying to diagnose oral cancer in a lower tumor stage, being 1) mass screening or screening in selected patients, 2) reduction of patients’ delay, and 3) reduction of doctors’ delay. Oral cancer population-based screening (“mass screening”) programs do not meet the guidelines for a successful outcome. There may be some benefit when focusing on high-risk groups, such as heavy smokers and heavy drinkers. Reported reasons for patients’ delay range from fear of a diagnosis of cancer, limited accessibility of primary health care, to unawareness of the possibility of malignant oral diseases. Apparently, information campaigns in news programs and TV have little effect on patients’ delay. Mouth self-examination may have some value in reducing patients’ delay. Doctors’ delay includes dentists’ delay and diagnostic delay caused by other medical and dental health care professionals. Doctors’ delay may vary from almost zero days up to more than six months. Usually, morbidity of cancer treatment is measured by quality of life (QoL) questionnaires. In the past decades this topic has drawn a lot of attention worldwide. It is a challenge to decrease the morbidity that is associated with the various treatment modalities that are used in oral cancer without substantially compromising the survival rate. Smoking cessation contributes to reducing the risk of oral cancers, with a 50% reduction in risk within five years. Indeed, risk factor reduction seems to be the most effective tool in an attempt to decrease the morbidity and mortality of oral cancer. Key words:Oral cancer, early diagnosis, quality of life.

Oral Lesions Diagnosed during Oral Cancer Prevention Campaign in Fernandópolis, Brazil, 2015

“…9,10 Therefore, attitudes aiming to early diagnosing and rising awareness regarding oral cancer early detection and prevention among general population are required, once high rates of oral cancer cases associated to harmful habits, such as tobacco smoking and alcohol drinking suggests this is a preventable malignance. 16,17 Delayed OSCC diagnosis is clearly associated to general population awareness regarding this malignancy. 18 Agrawal et al 19 (2012) reported the unsatisfactory awareness of the general public regarding oral cancer, commenting the need for further dissemination of infor mation on this issue and its associated risk factors.…”

Oral diseases diagnosis rate during an oral cancer prevention campaign in Fernandópolis, Brazil, 2014

“…Nevertheless, in most of cases, oral cancer is diagnosed on advanced stages, and, for this reason, oral cancer represents a public health problem worldwide, requiring attitudes aiming to raise awareness regarding the importance of early diagnosing and preventing this disease among general population and oral health caregivers, since, apparently oral cancer is preventable, being, nowadays, clearly associated to harmful habits such as abusive tobacco smoking and alcohol drinking [2,17,28].…”

“…Furthermore, this campaign aimed to educate population regarding the importance of preventing and early diagnosing oral cancer. OSCC is a potentially preventable malignant disease, being associated to harmful habits, which, if avoided, OSCC development chances might decrease [17,28] therefore, the importance of performing campaigns like this is to disseminate information regarding oral cancer among general population, once knowing the disease and etiologic factors associated to oral cancer, as much as the importance of early detecting this disease, preventive work becomes easier and more effective [24,26].…”

“…Several studies have been performed aiming to evaluate the capacity of dentists to detect oral cancer and educate general population about the risk factors for oral cancer development and the importance of oral self-examination and early diagnosis of oral cancer, and although in some studies dentists have demonstrated satisfactory knowledge regarding oral cancer, some lacks on this knowledge have been reported [4,27] and furthermore, there is a general agreement regarding the need for continued education programs for these professionals aiming to improve their capacities on adequately diagnosing and preventing oral cancer [10,27,28].…”

Assessment of relationship between tobacco consumption and laryngopharyngeal cancers

“…It is widely accepted that tobacco usage is directly related to oropharyngeal and laryngeal cancers, because of their direct exposure while tobacco consumption. [3] A study reported 96.5% of patients with squamous cell carcinoma of the larynx to be smokers, with a relative risk of 5.6. [4] There are many smokeless tobacco products which include dissolvable nicotine.…”