Josie Dovidio DDS

Oral Cancer: The Facts

• Almost 37,000 people will be diagnosed with oral cancer this year in the U.S.  If you add throat cancers to that number (which have the same risk factors), that number will increase to about 48,000 individuals.  Because a large number of these individuals will be diagnosed as late stage cancers (66%), only 43% of them will survive five years.  Worldwide this is a much greater problem where yearly diagnosis of new cases will reach approximately 640,000 and the associated deaths each ear will reach almost 35,000
• Each year, oral cancer kills more people in the U.S. than other more widely known forms of cancer, including skin cancer (malignant melanoma), lymphatic cancer (lymphoma), thyroid and cervical cancer.
• In the U.S., someone dies of oral cancer every hour of every day.  The death rate has remained relatively constant for almost five decades.  Approximately 100 new individuals will be diagnosed with oral cancer in the US every day of the year.
• If oral cancer is detected early (in stages one or two), the survival rate is 80% to 90%; but when found as a later stage (stages three or four), the chances of survival drop  to 20% to 30%.  Late discovery and diagnosis are major factors in the high death rate.  In the US, two-thirds of the diagnosed cases will be late stage 3 or 4 cancers this year.  Since in many cases this cancer lends itself to early visual and tactile detection, this situation is correctable without the introduction of new science.
• Historically, oral cancer has been most likely to occur after the age of 50.  However, the fastest growing segment of the oral cancer population is people in the 25-50 year old range.  Evidence from leading cancer centers shows that most of this younger group is non-smokers.  These patents represent a completely different etiology for getting the cancer from the historical tobacco and heavy alcohol users, and that is from an oncogenic virus, HPV16.  This is the same virus responsible for the vast majority of cervical cancers.  Evidence indicates that this virus can be sexually transmitted between partners, and accounts for the increase in young, non-smoking victims of oral cancer who do not fall into the historical tobacco risk factor group.
• Twenty years ago, the male to female ratio of oral cancer occurrences was ten men to one woman.  The ration now is two men to one woman.  Tobacco marketing (“You’ve come a long way baby”) and the virus are the primary reasons behind this shift to a greater number of women in the oral cancer population.
• The rates of oral cancer occurrence and death among African Americans are twice as high as they are among Caucasians.  This is related to lifestyle choices and socio-economic factors, not biology.
• Tobacco use in any form by itself, and even in more so combination with heavy alcohol consumptions, continues to be an important risk factor for oral cancer.  However, if current trends in the spread of HPV16 have now placed the virus as the primary causative factor in 63% of newly diagnosed patients in early 2011.
• Additional risk factors for oral cancer include high alcohol consumption, the use of conventional smokeless (checking/spit) tobacco, as well as prolonged exposure to the sun (for lip cancers).
• In a painless, three to five minute oral cancer screening, most of the signs and symptoms of oral cancer can be seen with the naked eye or felt with the fingers. Suspect tissues can be biopsied for a definitive diagnosis.  Unlike most other cancer detection exams, the screening for oral cancer does not require any special equipment, pain, high cost, invasive tests, or procedures.  Any dentist or primary care physician and many nurses and dental hygienists, who have been trained to do oral cancer examinations, can perform these screenings during a routine office visit.
• Regular dental checkups, when they incorporate oral cancer examinations, as well as an increased public awareness of oral cancer’s risk factors, can reduce the death rate of this disease.  The importance of early detection, and the need for an annual screening, are the most crucial factors in reducing treatment related quality of life issues, and the ultimate survival of oral cancer patients.

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