“A major problem is that more than half of all oral cancer cases have already metastasized to regional or distant structures at the time of detection which decreases the 5 year survival rate to less than 50% for tongue and floor of mouth cancers”(BDA, 2000).

Dentists and other dental clinicians play a key role in the early detection of mouth cancer. They have a professional and ethical duty of care to screen every patient during a dental exam. If this is the case and every dentist is screening and educating their patients as they should, then why are oral cancer incidence rates and subsequent death rates still increasing?

The answer is four-fold:-

• There is currently no Government initiative to tackle the problem of mouth cancer. The Human Papilloma Virus immunization for girls aged 12-13 is incidentally safeguarding them against mouth as well as cervical cancer. However, boys are twice as likely to develop mouth cancer and are presently not included in the immunization programme.
• Awareness of oral cancer is internalized within the dental world. External knowledge is very poor. Change will only occur if driven by increased public knowledge and a public demand for robust oral cancer screening in general practice.
• The public has little awareness of risk factors and symptoms for oral cancer so often present in general practice very late.
• Young people are not educated in secondary schools with regard to oral cancer risks as they engage and experiment with lifestyle choices.

How do the Statistics Stack Up?

Since the 1970’s, the incidence rates for mouth cancer have increased dramatically. Current statistics show the following:-

• 60% increase in incidence between 1999 and 2007.
• 7,700 new cases in 2011. Predicted to be more than 9,000 in 2030.
• The ratio is 2:1 men to women.
• 87% cases occur in the over 40 age group but becoming more common in younger people.
• Mortality rate is around 50% despite treatment.
• Oral cancer is now 3 times more common than cervical cancer.
• ORAL CANCER KILLS 5 PEOPLE IN THE UK EVERY DAY!

Why is This?

Well, the answer lies mainly in the lifestyle choices we make. The following are the significant causative factors:-

• Smoking/chewing tobacco — WHO states that up to half of current smokers will die from tobacco related illness, including mouth cancer.
• Drinking alcohol — increases risk of mouth cancer by 4 times. Smoking and drinking together increases risk by 30 times.
• Human Papilloma Virus — Strains HPV 16 and HPV 18 cause cervical cancer as well as oral cancer. The virus is sexually transmitted particularly during oral sex.
• Poor diet — a diet low in beta-carotene, vitamin C and vitamin E is linked to a third of all cancer cases.
• Exposure of the lips to the sun.
• Genetic factors – familial clusters of oral squamous cell cancer has been reported  which also demonstrated cases occurring at younger ages.

Read our next newsletter to learn more about these predisposing factors.