scholarly journals Oral Cancer and Precancer: A Narrative Review on the Relevance of Early Diagnosis

Author(s):  
Silvio Abati ◽  
Chiara Bramati ◽  
Stefano Bondi ◽  
Alessandra Lissoni ◽  
Matteo Trimarchi

Oral cancer (OC) is an uncommon malignancy in Western countries, being one of the most common cancers in some high-risk areas of the world. It is a largely preventable cancer, since most of the different risk factors identified, such as tobacco use, alcohol consumption, and betel nut chewing, are behaviors that increase the likelihood of the disease. Given its high mortality, early diagnosis is of utmost importance. Prevention and the anticipation of diagnosis begin with identification of potentially malignant lesions of the oral mucosa and with local conditions promoting chronic inflammation. Therefore, every lesion must be recognized promptly and treated adequately. The clinical recognition and evaluation of oral mucosal lesions can detect up to 99% of oral cancers/premalignancies. As stated by the World Health Organization, any suspicious lesion that does not subside within two weeks from detection and removal of local causes of irritation must be biopsied. Surgical biopsy remains the gold standard for diagnosis of oral cancer. Adjunctive tools have been developed and studied to help clinicians in the diagnostic pathway, such as toluidine blue vital staining and autofluorescence imaging. In the near future other methods, i.e., identification of salivary markers of progression may help in reducing mortality due to oral cancer.

2015 ◽  
Vol 16 (9) ◽  
pp. 744-749 ◽  
Author(s):  
Kamran Habib Awan

ABSTRACT Background Oral cancer is a serious global issue and early diagnosis of oral cancer is the key in reducing the high mortality rate. Autofluorescence properties of oral mucosa have been gaining interest in the field of early diagnosis of oral premalignant lesions. Objective The aim of the study was to evaluate the clinical usefulness of an autofluorescence based imaging system to detect oral premalignant and malignant lesions. Materials and methods A systematic review of the Englishlanguage literature to evaluate the effectiveness of visually enhanced lesion scope (VELscope) published between 1966 and March, 2014 was undertaken. Data relating to study design, sampling and characteristics of the study group, interventions, and reported outcomes and diagnostic value of VELscope were abstracted from articles meeting inclusion and exclusion criteria. Results Eleven articles that met the inclusion criteria were included. In nine studies, all the lesions underwent histological assessment, whereas the remaining four studies only performed histological assessment on suspicious lesions. Visually enhanced lesion scope showed high sensitivity values in detecting oral premalignant and malignant lesions. However, most of the studies reported it inability in discriminating dysplasia cases from nondysplasia cases. Conclusion There is insufficient evidence to support the use of VELscope in primary care setting, however, they may be useful in hands of a specialist. How to cite this article Awan KH, Patil S. Efficacy of Autofluorescence Imaging as an Adjunctive Technique for Examination and Detection of Oral Potentially Malignant Disorders: A Systematic Review. J Contemp Dent Pract 2015;16(9):744-749.


2021 ◽  
Vol 10 (28) ◽  
pp. 2122-2127
Author(s):  
Rakhi Chandak ◽  
Manoj Chandak ◽  
Pranali Thakare ◽  
Ramhari Sathawane ◽  
Swapnil Mohod ◽  
...  

Oral cancer is the sixth most common malignant tumour, and it is the leading cause of morbidity and mortality due to its capacity to spread and invade. Oral cancer occurs at a different rate in different areas of the world, ranging from 2 to 10 per 100,000 people each year. Oral cancer is prevalent in South Asian nations such as Sri Lanka, India, Pakistan, and Bangladesh. In India, the frequency is 7-17 per 100,000 people each year, with 75,000 - 80,000 new cases per year. Identifying oral cancer in its early stages has a significant impact on survival rates when compared to detecting it later. Despite this, almost half of all diagnosed patients die within five years. A variety of well-established cancer screening programmes have been demonstrated to lower the patient morbidity and mortality dramatically. Regular check-ups, which include a thorough inspection of the whole mouth, are critical for detecting malignant and pre-cancerous problems early on. Unfortunately, early detection of oral precancerous and cancerous lesions has proved difficult due to the lesions' asymptomatic nature, doctors' casual approach to benign lesions, and the fact that 50 % of patients had regional or distant metastases at the time of diagnosis. Oral cancer is one of the most common cancers that leads to defacement and death. Despite recent advancements in therapeutic modalities, the prognosis has not improved. Patient’s mortality rates are positively associated with the point of presentation, with 60 % of people diagnosed with late-stage illness. Early diagnosis is important for oral cancer patient’s survival rate, as it decreases morbidity and mortality. According to the World Health Organization, the bulk of oral cancer patients are diagnosed late in the disease's progression, with a mediocre 5 - year survival rate of 50 %. As a result, careful treatment of oral cancer necessitates early diagnosis and intervention. Surgical biopsy is the gold standard for medical purposes, but it requires clinical assistance. Other screening methods that are simple to use, non-invasive, and expensive are the norms for any test to be accepted as a histopathology choice. The older cancer diagnosis modalities took longer, had more inter-observer bias, and were less descriptive. A standard oral examination with digital palpation is used in traditional techniques of screening for oral possibly malignant illnesses and oral cancers. Conventional inspection has been shown to be a poor discriminator of oral mucosal lesions. A variety of visual aids have been developed to help clinicians spot anomalies in the oral mucosa and in recent years, scientific and clinical developments have aided in the early detection and treatment of this disease. This review reflects on some of the older diagnostic modalities and screening methods for oral cancer diagnosis, as well as some of the recent more sophisticated techniques. KEY WORDS Diagnostic Aids, Oral Cancer, Premalignant Lesions


Author(s):  
Paresh Kumar Behera ◽  
Diksha Mohapatra

World Health Organization (WHO) defined the terminology ‘Oral Potentially malignant disorders’ (OPMD) as the presence of risk of malignancy in a lesion or condition either during the time of initial diagnosis or at a future date with the commonly accepted prevalence of 1–5%. All OPMDs may not transform into malignancy, many factors have been explored which effectively assess the risk of malignant transformation in OPMDs including many clinical, pathological and molecular factors. Qualitative & experimental factors of different cells in cytological preparations and/or biopsy specimens are reliable parameters for pathologists. The analysis and assessment of histological units can be enhanced by image analysis assisted by a computer that can be used for statistical comparisons. Fractal geometry is considered to be an ideal method of image analysis in quantitative microscopy & histopathology. Fractal dimension analysis is not only limited to determining cell and tumour types but can also be used for determining cellular behaviours in vitro such as cell migration, apoptosis and cellular differentiation, which can be a useful characterization of oral cancer lines and further help in the treatment planning. Keywords: Oral Cancer, Oral Potentially Malignant Disorders (OPMDs), Conventional morphometry, Fractal Dimension, Photomicrograph


Author(s):  
DANIELA BRITO BASTOS ◽  
VITOR BONETTI VALENTE ◽  
BRUNA AMÉLIA MOREIRA SARAFIM DA SILVA ◽  
SUZY ELAINE NOBRE DE FREITAS ◽  
ANA RITA ALBUQUERQUE ZITO ◽  
...  

2021 ◽  
Author(s):  
Xue Xiao ◽  
Zhou Wang

Oral cancer is a frequent head and neck cancer in developing countries and some developed world. According to the World Health Organization classification 2017, oral cancer influences the anatomical subsites including buccal mucosa, the anterior two-third of the tongue, lip, palate, vestibule, alveolus, floor of the mouth, and gingivae. A variety of premalignant lesions are related with the development of oral cancer, such as leukoplakia, erythroplakia, et al. The predominant histological type of oral cancer is squamous cell carcinoma (SCC). Tobacco and alcohol consumption are regarded as critical etiological factors. Due to the unspecific symptoms in early stage, the majority are diagnosed in advanced stages. Despite the development of medicine over decades, the mortality rate of oral cancer remains high, indicating the importance of optimized treatment and screening strategies.


2021 ◽  
pp. 35-39
Author(s):  
Hanna Sahhar ◽  
Karly Derwitz ◽  
Erica Rubin

Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in March 2020 by the World Health Organization (WHO), there has been an emergence of a new syndrome termed multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. MIS-C is defined by the presence of fever, systemic inflammation and multiorgan dysfunction in association with SARS-CoV-2 infection or COVID-19 exposure. Knowledge of this syndrome’s presentation and pathophysiology is constantly evolving as more cases are reported in the literature. This case identifies a 3-month-old patient who tested negative for SARS-CoV-2 antigen, reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies but qualified for MIS-C diagnosis. To the best of our knowledge and through extensive research at the time of diagnosing and reporting this condition to the healthcare authorities, we report the youngest pediatric patient with MIS-C diagnosis. We document this case to contribute to further understanding the variable manifestations of MIS-C and the importance of early diagnosis and treatment with intravenous immunoglobulin (IVIG).


Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4408
Author(s):  
Angélique Virgone ◽  
Sara Badreh

The early diagnosis and management of oral potentially malignant disorders (OPMD) represent a unique opportunity to develop strategies that will prevent malignant transformation. Despite a high prevalence, awareness remains low, patient outcomes poor, and quality of life highly affected. How can patient advocacy groups (PAGs) bring more awareness to preneoplasia preceding oral cancers and help patients after the identification of a suspicious oral leukoplakia presented as white patches in the mouth? PAGs are today involved with awareness campaigns, lobbying, and education of both health care systems as well as the survivor and the newly diagnosed. PAGs are a link between the clinician and the patient, making sure that the medical terminology used is explained in layman language and that psychological support is available during and after treatment. This review outlines the actions that could be deployed by PAGs to successfully complete OPMD prevention challenge. The added value of researchers and patient representatives working together is the increased awareness of the problem. To know at which angle to best approach it for encouraging early diagnosis, improved education of disease signs and symptoms will condition effective prevention from the beginning.


2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A5.3-A6
Author(s):  
Agnes Saint-Raymond ◽  
Martin Harvey ◽  
Maria Cavaller

BackgroundThe European legislation introduced in 2004 (under article 58) a collaboration tool to increase access to high quality and effective medicines in low- and middle-income countries. The European Medicines Agency (EMA) can provide scientific opinions on medicines intended for significant public health needs, in partnership with the World Health Organisation (WHO) and the relevant ‘target’ non-EU regulatory authorities. This EU-Medicines4all (EU-M4all) initiative contributes to the broader Global Health Mandate of the EU.MethodsWe contacted the pharmaceutical companies holding ‘article 58’ scientific opinions and compiled the number of actual approvals based on these opinions.ResultsNine medicines have been assessed so far, most of them for HIV/AIDS, tuberculosis, malaria and maternal/new-born health. Although this figure may appear low, the impact of the corresponding scientific opinions is much wider. Approvals were granted in 66 different countries worldwide, 38 of which are in Africa, based on these opinions.DiscussionSuch scientific opinions on the quality, safety and efficacy of the medicines are provided by the EMA’s Committee for Medicinal Products for Human Use (CHMP). Prior to this, it is recommended to agree on the data to be generated through scientific advice. The opinions are based on the same standards as used for those approved for Europe, with considerations for local conditions of use. To promote reliance on EMA scientific outputs and awareness of the procedure, two training events with regulators from Southern and from Western Africa are organised in partnership with WHO, NEPAD and local regulators in June 2018.ConclusionWe have shown that this ‘article 58’ procedure has a true impact and we encourage applications by companies developing medicines, aimed to prevent or treat diseases of significant public health interest, to be marketed outside the EU. This will ensure timely access of medicines by patients in target countries all over the world.


2013 ◽  
Vol 7 (3) ◽  
pp. 161-165 ◽  
Author(s):  
S Saxena ◽  
M Kaur ◽  
YP Samantha ◽  
G Chawla ◽  
G Yadav

ABSTRACT Early detection of oral cancers is not easy, because oral precancerous lesions and early oral cancers can mimic many benign conditions in the mouth, leading to delays in diagnosis and treatment. There is a need to emphasize the early diagnosis of oral cancers in order to reduce the unacceptably high morbidity and mortality. Oral exfoliative cytology can be a powerful tool for early detection of malignant and premalignant lesions as well as for some viral and fungal infections. The use of oral exfoliative cytology in clinical practice declined due to the subjective nature of its interpretation and because there may be only a small number of abnormal cells identifiable in a smear. The more recent application of quantitative techniques, together with advances in immunocytochemistry, has refined the potential role of cytology, stimulating a reappraisal of its value in the diagnosis of oral cancer. The limitations of the method should be thoroughly understood and appreciated by the dental clinician. The aim of the publication is to encourage maximum participation of dental professional in early detection and control of oral cancer by means of early diagnosis through use of cytological smear.


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