Screening programmes for the early detection and prevention of oral cancer

Abstract

Background: Screening programmes for major cancers, such as breast and cervical cancer have effectively decreased the mortality rate and helped to reduce the incidence of these cancers. Although oral cancer is a global health problem with increasing incidence and mortality rates, no national population-based screening programmes for oral cancer have been implemented. To date there is debate on whether to employ screening methods for oral cancer in the daily routine work of health providers. Objectives: To assess the effectiveness of current screening methods in decreasing oral cancer mortality. Search strategy: Electronic databases (MEDLINE, CANCERLIT, EMBASE (1966 to July 2005 and CENTRAL (The Cochrane Library 2005, Issue 3), bibliographies, handsearching of specific journals and contact authors were used to identify published and unpublished data. Selection criteria: Randomized controlled trials of screening for oral cancer or precursor oral lesions using visual examination, toluidine blue, fluorescence imaging or brush biopsy. Data collection and analysis: The search found 112 citations and these have been reviewed. One randomized controlled trial of screening strategies for oral

The Changing Aetiology of Oral Cancer and the Role of Novel Biomarkers to Aid in Early Diagnosis

“…The initial study evaluating LBC for oral cytology assessed 150 specimens from 50 healthy volunteers and found that this technique distributed cells evenly, optimized fixation, improved and unbiased sampling, enhanced nuclear detail and eliminated airdrying artifacts. These researchers also reported that the specimens showed cells from two populations, superficial and intermediate cells with only six (4%) of specimens containing parabasal or basal cells (Kujan and et al 2006). This latter finding has significant impact as these superficial cells represent keratinocytes that are terminally differentiating and thus nuclei have become non-functional with condensed and fragmented chromatin.…”

“…Over recent years there has been increased use of liquid-based cytology (LBC) for cervical smears and this method has been analyzed for utility with oral cytology (Kujan and et al 2006). The initial study evaluating LBC for oral cytology assessed 150 specimens from 50 healthy volunteers and found that this technique distributed cells evenly, optimized fixation, improved and unbiased sampling, enhanced nuclear detail and eliminated airdrying artifacts.…”

Utilization of Saliva as a Diagnostic Fluid in Determination of Oral Cancer

“…17 It has been shown that identical mutations can be identifi ed in bodily fl uids draining a tumor, 18 but also lately in bodily fl uids secreted away from the initial point where a solid tumor is developing. 19,20 Nucleic acids and proteins related to cancer cells have been detected in plasma/serum, 21,22 urine, 23,24 saliva, 25,26 broncho-alveolar lavage fl uid, cerebrospinal fl uid 27 and other bodily fl uids.…”

Timing of Oral Cancer Diagnosis: Implications for Prognosis and Survival

“…The equivocal relationship between diagnostic delay and certain outcomes of interest, like tumour stage and survival to the disease, suggest the need to prioritise the early diagnosis of oral cancer through screening programmes aimed at detecting the disease during its asymptomatic phases, as there is evidence demonstrating that oral visual inspection is satisfactorily sensitive to detect oral precancers and that can improve oral cancer stage at diagnosis. Moreover, communitybased screening on these bases may thus decrease oral cancer specific mortality amongst people who use tobacco, alcohol or both (Kujan, 2006).…”