Oral Cancer: Diagnostic Considerations

Abstract

Globally, oral cancer is among the top 10 most common cancers, and despite being largely preventable, the global incidence is still on the rise. The major risk factors for oral cancer in the Western world are tobacco and alcohol consumption, but in Nigeria, other risk factors like poverty, malnutrition, poor oral hygiene, kolanuts, immune suppression and chronic malaria may play a greater role. The overall prognosis for oral cancer is poor, with a 5-year survival rate of about 50%, although this is due to late presentation and delays in diagnosis. When diagnosed early, oral cancer is potentially curable, and the 5-year survival rate increases to over 80%. So, efforts should be geared towards prevention and early diagnosis. Biopsy for histopathologic examination is the gold standard for the diagnosis of oral cancer, but other methods that have been used for oral cancer screening include visual oral examination, vital staining, cytology, and light-based methods e.g. autofluorescence. In recent times, artificial intelligence and use of salivary biomarkers have shown promise in improving the early diagnosis of oral cancer.

Patient related factors play the major role in delaying the diagnosis of oral cancer, as patients often delay seeking professional advice for up to 6 months or more from when they first notice any oral symptom that may be linked to oral cancer. Public education, improvement in health-seeking behaviour, better healthcare facilities and use of adjunctive screening methods will help in reducing incidence of oral cancer as well as the associated morbidity and mortality