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
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Slide1
MJDF study group meeting 4
Oral Cancer
PBL presentation Miriam Figge
Slide2Definition
Group
of
neoplasms
affecting
the
oral
cavity
excluding
salivary gland tumours
OSCC more
than
90% of all oral neoplasms
Slide3Prevalence
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
Slide4Risk 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
Slide5Precancerous 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
Slide6Slide7Diagnosis
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
Slide8Raising awareness
Slide9When 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
Slide10What happens after the referral?
Urgent referral - written patient information
Biopsy
Staging TNM tumor nodes metastasis
Slide11Useful 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
Slide12References
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;