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MJDF study group meeting 4 MJDF study group meeting 4

MJDF study group meeting 4 - PowerPoint Presentation

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MJDF study group meeting 4 - PPT Presentation

Oral Cancer PBL presentation Miriam Figge Definition Group of neoplasms affecting the oral cavity excluding salivary gland tumours OSCC more than 90 of all oral neoplasms ID: 779895

oral cancer tobacco risk cancer oral risk tobacco london neck cancers referral erythroplakia https www unexplained increased alcohol factors

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Slide1

MJDF study group meeting 4

Oral Cancer

PBL presentation Miriam Figge

Slide2

Definition

Group

of

neoplasms

affecting

the

oral

cavity

excluding

salivary gland tumours

OSCC more

than

90% of all oral neoplasms

Slide3

Prevalence

Approx 7000 new cases per annum—20 diagnoses per day

Among 10 most common cancers among men in the UK

Most

common

:

older

males

,

lower

socioeconomic

status

Increasing incidence in young female patients 18-44 years

Slide4

Risk factors

Tobacco use

 Smoking of tobacco –

assoc

with

75%

of

oral

cancer

cases

, 6x

risk

compared

to

non-

smokers

(DBOH

says

7-10x)

Betel, chewing tobacco, cannabis, areca

Alcohol 6x increased risk compared to non drinkers

14 units/week, no safe amount

Synergistic effect of tobacco and alcohol: 15x increased risk

Viral: HPV 16, 18 (

oropharyngeal

cancer

), Epstein Barr, Hepatitis C 

Contributing factors: diet poor in nutrients, immune defects

Slide5

Precancerous disorders

Erythroplakia

Leukoplakias, particularly:

Erythroleukoplakia (nodular or verrucous)

Proliferative verrucous leukoplakia

Actinic cheilitis

Lichen planus (mainly the erosive and atrophic type)

Sideropenic dysphagia (Plummer-Vinson syndrome)

Submucous fibrosis

Dyskeratosis congenita

Discoid lupus erythematosus

Slide6

Slide7

Diagnosis

usually painless

Tongue, FOM, Lips

Non healing ulcers +/-raised margins

Lumps

Erythroplakia, leukoplakia, mixed lesions

Cervical lymph node enlargement

Non healing extraction socket

Tooth mobility w/o identifiable cause

Slide8

Raising awareness

Slide9

When to refer urgently

2 week national target

Unexplained ulceration lasting for more than 3 weeks

Persistent/

unexplained

 neck lump

Lump on

lip

or

in oral

cavity

consistent

with

oral

cancer

Red or

white

patch

consistent

with

erythroplakia

or

erythroleukoplakia

Slide10

What happens after the referral?

Urgent referral - written patient information

Biopsy

Staging TNM tumor nodes metastasis

Slide11

Useful links and documents

BDA oral cancer tool kit

https://www.myhealth.london.nhs.uk/healthy-london/cancer/pan-london-suspected-cancer-referrals/patient-leaflets

Leonardo da Vinci Programme:

Free e-learning module for European dentists

www.oralcancerldv.com

Slide12

References

ORAL CANCER DIAGNOSIS IN PRIMARY CARE NIKOLAOS FANARAS, SAMAN WARNAKULASURIYA Prim Dent J. 2016;

5

(1):64-68

Current Aspects on Oral Squamous Cell Carcinoma Anastasios K Markopoulos

*

Open Dent J. 2012; 6: 126–130. Published online 2012 Aug 10. doi:  10.2174/1874210601206010126

https://cks.nice.org.uk/head-and-neck-cancers-recognition-and-referral#!scenario

https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/head-and-neck-cancers/incidence

Detection of Early-Stage Oral Cancer Lesions: A Survey of California Dental Hygienists

Dayna M. Hashimoto Barao, Gwen Essex, Ann A. Lazar and Dorothy J. Rowe

American Dental Hygienists' Association December 2016, 90 (6) 346-353;