Description

Oral cancer is a serious and growing problem in many parts of the globe. Around 60% of all cases are estimated to arise in developing countries. In these countries oral cancer is a major public health problem. Its incidence is rising in many countries in Western Europe including the UK. Survival rates are under 50% and have not improved for decades. Screening for oral cancer (sometimes called secondary prevention) with the hope or intent of detecting small or earlier lesions and potentially malignant lesions – as with dysplasia of the uterine cervix – is in an early stage of development. Several population-based screening programmes conducted in south Asian countries with a high incidence of oral cancer often using the primary care approach have shown that the method is feasible. Though the compliance is questionable the levels of specificity and sensitivity achieved were satisfactory. Five reported invitational screening programmes in the UK have shown a low yield of precancerous lesions (up to 5.5%); one early cancer was detected in one of these five studies. While population-based screening is of unproven value in low incidence countries there is much activity in the UK at the present time to incorporate opportunistic and targeted oral screening for high-risk groups in dental and medical primary care settings.