Mouth cancer for clinicians part 7: cancer diagnosis and pre-treatment preparation Nicholas Kalavrezos Crispian Scully Dental Update 2024 43:1, 707-709.
Authors
NicholasKalavrezos
FRCS, FFD RCSI, MD
Consultant in Head and Neck/Reconstructive Surgery, Head and Neck Centre, University College London Hospitals, London, UK
A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family.
Clinical Relevance: This article offers the dental team an overview of diagnosis, diagnostic and pre-treatment procedures.
Article
Mouth cancer theoretically should be largely preventable or detectable at an early stage. Dental training equips dentists and other dental clinicians with the best way to diagnose oral disease and the importance of the history and examination are stressed in training. The General Dental Council (GDC) recommendations for Continuing Professional Development (CPD) have long included medical emergencies, disinfection and decontamination and radiography and protection safety but, after pressure from us and others, the GDC have now added oral cancer early detection, along with legal and ethical issues, and complaints handling. There is evidence that education helps diagnostic outcomes not only of oral but also orofacial disease (Figure 1). Nevertheless, one US study showed that the diagnosis of oral lesions by dentists and dental specialists was incorrect in over 40% of cases, and over 5% of cancers were misdiagnosed.
In the UK, only 25.2% of GMPs but 54.1% of GDPs in one study felt that they had sufficient knowledge regarding detection and prevention of mouth cancer. Failure to diagnose oral cancer has led to GDC disciplinary action in the UK and already is the second highest cause of dental malpractice in the USA.
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