What is screening for oral cancer?

Oral cancer screening can take several forms. If conducted by your dentist, typically, it will involve a visual screening preceded by taking a medical history. A thorough oral, head and neck cancer examination can usually be completed in less than five minutes. Many patients see their dentist at least twice a year for check-ups and cleanings. This is typically when such an examination is performed. In the majority of cases, oral cancer screening is performed visually and using palpation of the tissues. The main issue with oral cancer screening, however, is that according to the US Department of Health and Human Services, two-thirds of the time by the time oral cancer is detected it is already in the late stages. The bad news here is that, when discovered late, a patient's five year survival rate is only 22%. If detected early, though, the survival rate jumps to well over 80%. This has led to the development of adjunctive forms of cancer screening devices. Some use a flavored rinse that causes abnormal tissue to appear a different color when viewed with a special light source. Another system (and one that I use in my office) is called a VELScope [Visually Enhanced Lesions Scope]. This is an electrical luminescent device that emits a blue light that excites oral tissue and causes it to fluoresce. Healthy tissue looks green, whereas, suspicious tissue does not fluoresce and will look dark.

What does the procedure of screening for oral cancer involve?

During an oral screening examination the doctor will typically begin by looking at the face -- checking for any asymmetry, swelling, discoloration or ulcerations. This includes an evaluation of the eyes, nose, ears, and lips. Inspection of the oral cavity is usually performed using an external light source. The doctor will then evaluate the tongue, cheeks, floor and roof of the mouth. He will inspect the hard and soft palate areas, as well as the back of the throat. A mouth mirror or tongue depressor will commonly aid the examination. The submandibular and sublingual glands are usually palpated, as well as the lymph nodes of the neck. The thyroid gland is also visually inspected and palpated during a complete inspection. There are a number of benign lesions that can mimic oral cancer. Many of these are easily diagnosed by your dentist or physician. Where there is any uncertainty, a biopsy will be recommended for a definitive diagnosis.