II. Epidemiology
- Squamous Cell represents 90% of oral cavity tumors
- Incidence increases with age
- Oral Cancer is 9th most common cancer
- Represents 3% of cancers in men
- Represents 2% of cancers in women
III. Risk Factors (account for 75% of cases)
-
Tobacco Abuse confers 6 fold risk
- Smokers represent 90% of Oral Cancer patients
- Alcohol Abuse or heavy use
- Combined risk of heavy Alcohol and Tobacco use
- Women: 100 fold risk of Oral Cancer
- Men: 38 fold risk of Oral Cancer
- Blot (1988) Cancer Res 48:3282-7 [PubMed]
- Other risks
- Viral Infection (HSV, HPV)
- Sunlight exposure
- Poor Dentition
IV. Locations
- Lateral Tongue
- Floor of mouth
- Lower vermilion lip border
- Alveolar ridge
V. Symptoms
- Halitosis
- Painless Oral Ulcer
- Trismus may be present with deep invasion
VI. Signs
- Early changes
- Later Changes
- Oral Ulcer with raised borders
- Spread to submandibular and cervical Lymph Nodes
- See Lymphadenopathy of the Head and Neck
- Perform complete Oral Examination
VII. Associated Conditions
- Adjacent cancer in laryn, Esophagus, lungs in 15% cases
VIII. Management
- Surgical excision
- Radiation Therapy
IX. Prognosis
- Oral Cancers are advanced by diagnosis in 60% of cases
- Five year survival: 50-55%
X. Prevention
- Tobacco Cessation
- Alcohol cessation
XI. References
- Diaz in Noble (2001) Primary Care Medicine, p. 1757
- Alvi (1996) Postgrad Med 99(4):149-56 [PubMed]
- Weinberg (2002) Am Fam Physician 65(7):1379-86 [PubMed]