Oral Cancer Screening

During health checkups, dentists or hygienists may examine your mouth for signs of pre-cancer and cancer. Using their fingers, they feel (palpate) for lumps or bumps in your mouth and throat.

The four scenarios depict length-time bias: Aggressive oral squamous cell carcinomas (OSCCs) have a short potential screening 韓国ホワイトニング window and are unlikely to be detected in an asymptomatic population. “Less aggressive” OSCCs are detected by screening and are associated with improved survival.

Examination of the Oral Cavity

The oral cavity includes the lips, cheeks, gums, tongue, and the inside of the mouth and throat. Cancers of the mouth and throat often start in these areas. During regular checkups, dentists and medical doctors examine the mouth for areas of abnormal cells that could be cancer or precancerous.

The most common premalignant lesion in the oral cavity is called leukoplakia, a white or red patch of cells that cannot be scraped off and can lead to cancer if it isn’t treated. Another way to look for cancer is to use a toluidine blue stain, which coats the mouth with a blue dye. Areas that stain darker are more likely to be cancer or precancerous.

In low- and middle-income countries where trained dental professionals are unavailable, PHCWs have been used to perform oral cancer screening (Kaye et al. 2020). They need to be adequately trained and provided with consistent, ongoing support and supervision. They also need reliable systems to track patient data and supplies and compensation commensurate with their roles.

Examination of the Tongue

Many healthcare providers will gently use their fingers to feel (palpate) for lumps and bumps around the mouth and throat. They may also coat the tongue with a blue dye that highlights any areas that are sore or tender.

Ask the patient to open wide, relax and say “Ahhh”. This may allow a better view of the posterior pharyngeal wall for examination for ulcerations, asymmetry or enlargement.

If they find anything unusual, a healthcare professional may want to take cells for testing in a laboratory. A biopsy is when they remove a small piece of tissue from the abnormal area and send it to a lab to see if it’s cancerous or precancerous. It’s important to know that some cancers never cause symptoms and are only found by screening tests. This is called overdiagnosis. It’s also important to remember that not all cancers are treated with drugs and other therapies. Some are removed surgically and left untreated.

Examination of the Throat

During this exam, your doctor will shine a light in your mouth and throat, looking for areas that may look or feel abnormal. Your doctor will also gently press the sides of your cheeks and the back of your neck to see if there are any lumps or bumps in those areas. This is a simple examination that can be done in 5 to 10 minutes in your doctor’s office. Your doctor might spray numbing medicine on the back of your throat to help you tolerate the examination.

Your healthcare professional may use a tool to coat any areas that seem abnormal with toluidine blue dye to help them spot cancer cells more easily. They will also examine your neck for enlarged lymph nodes, which may be a sign that the cancer has spread to the throat or surrounding tissues. If there is a concern, your doctor will use a special tool to remove a small sample of the area (a biopsy).

Examination of the Soft Tissues

The examination of the soft tissues is vital in detecting early cancers. Any red, white or swollen lesion, sore, induration, indentation or enlarged lymph node in the neck should be evaluated as these are all signs of potentially serious disease which can spread quickly. It is important to examine the entire tongue including both sides and underneath, the soft palate, tonsils and posterior throat areas for any changes. Any numbness, pain or discomfort should be investigated as well as complaints of difficulty swallowing and unilateral earaches.

PHCWs can perform effective oral cancer screening in resource poor settings with the proper training and supervision. Several studies have shown that mobile phone applications can allow PHCWs to send images of oral lesions deemed as screen positive to a remote specialist (Birur et al, 2019).

Various diagnostic adjunctive techniques have been developed which improve the diagnostic ability of the visual examination of the mouth (VOE). These include vital staining, exfoliative cytology, fine needle aspiration biopsy, routine dental radiographs and CT scans of the neck. The use of a new diagnostic tool called the VELscope, which uses fluorescence visualization, also helps detect abnormalities which can’t be detected by the naked eye.