Oral Cancer Screening

By MaryAnn DePietro, CRT. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Developing a small sore in your mouth is usually not a cause for great concern.

You wait for it to go away or think to yourself that you can have it checked out later, whenever you have time. You might chalk it up to accidentally biting the inside of your cheek or thinking it’s a canker sore. Most of the time, these conclusions may actually be correct. But in some instances, a small bump or raised patch in the mouth could indicate something far more serious.

For many people, oral cancer is not something they think about. But for adults under age 50, there has been a rise in HPV-associated oral cancer rates within the past three decades. When discovered in advanced stages, oral cancer can be deadly. The fact that most of these cancers are detected late, after metastasis, underlines the importance of early screening, as early detection of oral cancer may result in a better prognosis.

When and Why Should You be Screened?

Oral cancer symptoms, such as a chronic sore throat, difficulty swallowing and a persistent earache, may prompt you to see your doctor. But in some cases, the only symptom of oral cancer may be a small sore or tissue changes in the mouth, which may go unnoticed. In other cases, people don’t notice symptoms until the cancer has spread to the lymph nodes and they have a lump in their neck.

According to the Oral Cancer Foundation, oral cancer found in advanced stages has less than a 60 percent five-year survival rate. Unfortunately, the majority of oral cancers are found when they have already advanced beyond the initial tumor site. 

That is why people are optimistic and enthusiastic about oral cancer screening. “All adults, especially those with risk factors for oral cancer, may benefit from annual screening during their regular dental evaluation,” says Lanceford Chong, MD, medical director of radiation oncology at the Western Regional Medical Center, Cancer Treatment Centers of America.

Unfortunately, there is not yet a standard or routine screening test for oral cancer, and studies have yet to show that a screening test would decrease the risk of dying from this disease, according to the National Cancer Institute.

But yearly screening can detect small sores or tissue abnormalities you may not be aware you have. “In addition to an annual screening, if you have a sore [that] bleeds easily or does not go away in a couple of weeks, you should see your dentist or doctor for screening,” says Oliver Wong, DDS, owner of Johnson Ranch Dental in Roseville, Calif.

Screening Techniques

Oral cancer screening can be performed by your doctor or your dentist. Most screening will start with the doctor or dentist examining your mouth, which includes checking the tongue, gums, cheeks and roof of the mouth. Clinicians also examine and touch the neck area to check for swelling of the lymph nodes.

“In the past, oral cancer screening mainly involved palpation and visual inspection of a person’s mouth,” says Wong. “Both methods are still important, but using specialized tools allows for a more comprehensive screening.”

There are different types of handheld devices used to examine the oral cavity. For example, one device uses light and fluorescence technology to detect abnormal tissue changes that an inspection with the naked eye may miss.

The Need for Self-Exams

It’s important to understand that oral cancer screening starts with you. According to the American Association of Oral and Maxillofacial Surgeons, monthly oral cancer self-exams should be performed by all adults regardless of risk factors.

Lasting only a few minutes, the easy self-exam involves using a mirror and a bright light and checking all areas of the mouth including the tongue, lips, inside of the cheeks, gums and roof of the mouth. It’s important to take notice of the following:

  • Sores that have been present for a couple of weeks;
  • Patches of red or white tissue in the mouth;
  • A lump in the neck; or
  • Unusual thickening of tissues in the mouth.

Abnormalities do not necessarily imply cancer, but to be on the safe side, you should see your dentist or doctor.

“It may turn out to be nothing serious. But similar to most types of cancer, if oral cancer is found early, it greatly improves the prognosis,” says Wong.

Next Steps

  • Lower your risks. Smoking, heavy alcohol use and infection with oral HPV are all risk factor for oral cancer.
  • Don’t ignore suspicious growths in the month. If you spot unusual changes in your mouth, see a doctor or dentist immediately. 
  • Have precancerous lesions treated. Some tissue changes in the mouth, such as erythroplakia and leukoplakia, are often considered precancerous lesions. Speak to your doctor about treatment. 

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