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Oral cancer represents a significant challenge for public health and medicine. In Western countries, it accounts for 6% to 10% of all malignant tumors, with a particularly high incidence in Italy, where it represents approximately 6% of malignancies, more common in males than females.
Ninety percent of oral cancers are oral squamous cell carcinomas (OSCC), and most cases occur in people over the age of 40, with an average age at diagnosis of around 60.
Significant risk factors for oral cancer include: tobacco use, alcohol consumption and the combination of these two factors, which together constitute a greater risk than either factor alone.
Other significant risk factors include viral infections such as HPV, poor oral hygiene, poor dental condition, chronic trauma to the mucous membranes, and an unhealthy diet.
Despite advances in combined treatment strategies (surgery, chemotherapy, radiotherapy), the overall survival rate of oral cancer patients has remained around 50% in recent years, and no significant improvement in the stage of the disease at diagnosis has been observed.
ORAL CANCER
THINGS'
The presence of persistent swelling on the mucous membranes of the oral cavity, a reddish-white spot that does not resolve, or a wound that does not heal is a possible warning sign, as it could be the manifestation of a pre-cancerous or cancerous lesion in the mouth.
The oral cavity includes:
- The front of the tongue, the gums, the inner surface of the cheeks and lips
- The lower part of the mouth under the tongue (the floor of the mouth), the bony upper part of the mouth (the hard palate)
- The area located behind the teeth (the retromolar trigone)
CAUSE
For all oral cavity tumors, the main and most common risk factors are:
- Cigarette smoking, tobacco chewing, alcohol consumption.
- Oral transmission of the human papillomavirus (HPV) (high incidence among young people); poor oral hygiene and poor diet; genetic causes.
- Trauma to the internal surface of the mouth, such as improperly fitting dentures.
PREVENTION
Dentists should pay particular attention to oral lesions in general and any suspicious signs or symptoms of the oral cavity, particularly in individuals who use tobacco or regularly drink alcohol. Patients should follow these guidelines:
- Don't underestimate any oral lesions, even if small or painless: lumps or hardening of the mucosa, small ulcers, white, red, or reddish-white plaques, especially if bleeding, growths. Also pay attention to any impediments to proper chewing.
- Visit your dentist once or twice a year, more frequently for those over 60 and those who have led risky lifestyles.
- Adopt a healthy lifestyle, do not smoke, do not consume tobacco in any form and limit alcohol.
DIAGNOSIS
Oral cancer, if detected early, can be successfully treated, with high cure rates. Delayed diagnosis is typically due to underestimation of symptoms, often resulting from insufficient knowledge of this cancer, confusion with other more common but less serious diseases (such as dental abscesses or benign tumors), or failure to report its symptoms to a doctor in a timely manner. In the absence of symptoms, oral cancer screening should include:
- Naked visual inspection of the oral cavity and palpation of the tongue and floor of the mouth.
- Second inspection or screening of the oral cavity with Goccles and the aid of a photopolymerization light.
- Any suspicious mucosal lesions, if persistent, should be biopsied.
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