Dr Deepak Gupta, Consultant, Radiation Oncology, Cancer Institute, Medanta – The Medicity
The term “Cancer” is derived from the Greek word “Karkinos” (for crab) which refers to a generic non-communicable disease (NCD). It is characterized by malignant growth (cancerous or neo-plasms) of abnormal cells in any part of the human body. Cancer is one of the leading causes of adult deaths worldwide accounts for 8.7 million deaths per year.
According to WHO, India accounts for over 6 per cent of cancer-related death out of total deaths. By end of the decade, cancer mortality in India is projected to increase to over 900,000 deaths.
The absolute number of cancer deaths in India is projected to increase because of population growth and increasing life expectancy. The number of people diagnosed with mouth and throat cancers has been rising over the last several years.
Screening
Screening, in medicine, is a strategy used to look for as-yet-unrecognised conditions or risk markers. Screening by definition is a presumptive identification of unrecognized disease in an apparently healthy, asymptomatic population by means of tests, examinations or other procedures that can be applied rapidly and easily.
Oral Cancer Screening
The oral cavity is easily accessible for a routine examination, and even nonmedical personnel can readily detect lesions that are the precursors of carcinoma. In general, oral cancer screening is an examination performed by a doctor to look for signs of cancer or precancerous (means changes before cancer) conditions in your mouth. The purpose of oral cancer screening is to identify mouth cancer early, and when detected early, there is a higher chance for a cure. The screening is useful for the general population but the benefit is higher in person who is at higher risk of getting cancer.
High-risk individual for oral cancer include:
- Tobacco in any form:- cigarettes, cigars, pipes, chewing tobacco and snuff, among others
- Alcohol use
- A previous oral cancer diagnosis
- History of significant sun exposure, which increases the risk of lip cancer
During the screening exam, your doctor looks inside of your mouth to check for red or white patches or sores. The doctor also feels the tissues in your mouth to check for lumps or other abnormalities. The doctor will also examine your neck to see for any swelling.
In case your doctor finds any abnormal lesion he or she may recommend:
- A doctor can suggest follow up visit to see whether it has grown or changed over time.
- In case the doctor finds lesion suspicious he may suggest a biopsy. A biopsy in which a small tissue is taken from the abnormal area and send it to laboratory examination under the microscope to rule out cancer.
One should understand there are some limitations for screening such as:
- A large number of sore are non-cancerous. But in screening, it is difficult to rule out whether it is cancerous or non-cancerous. You might need to undergo the additional test.
- It can be difficult to detect areas of abnormal cells just by looking at your mouth.
- Small cancer or precancerous lesion could go undetected.
A study done by Sankaranarayanan R in Kerala showed that with visual repeated screening during a 15-year follow-up of oral cancer result in 24% reduction in oral cancer mortality (95% CI 3–40%) especially in users of tobacco/or alcohol.
Because of prevention efforts – such as smoking and tobacco cessation – and continued advancements in early detection cancer mortality rates have dropped over the past two decades. Research is going on to discover more early indicators that can be in cooperated in screening to improve outcomes for all types of cancer.
