Over 50,00 people in the U.S. will be newly diagnosed with oral cancer this year—and one person every hour will die from it. Despite those chilling numbers, oral cancer awareness is relatively low, and HPV- related cases are on the rise among young people. Dentists and all oral healthcare practitioners are on the front-lines of education and prevention.
Regular visits to your office that include oral cancer screening are the most effective strategy for keeping your patient population protected, and not only against oral cancer. Poor oral health can complicate pregnancy, worsen diabetes and result in costly emergency rooms visits for dental issues that could have been more easily handled in your office if caught earlier. The Dental Trade Alliance estimates that if just 20% more oral cancers were detected early, the annual healthcare savings could be as much as $495 million, and survival rates would increase. So, it’s important to communicate with patients exactly why those two checkups each year aren’t merely ‘cleanings’…they’re vital to whole-body health.
HPV infection is behind about 70 percent of oropharyngeal cancers and growing. Most young people don’t think they can get oral cancer, if they think about it at all. Worse, HPV16, which is most commonly associated with cervical cancer, can lay dormant for years before resurfacing as oropharyngeal cancer, most often in the tonsils or the base of the tongue. That’s a problem since oral cancer is generally viewed as a disease affecting heavy smokers and drinkers over 50. Cases of HPV-related cancers in the young are generally in nonsmokers, and overwhelmingly in men, which tends to surprise many.
Not only are early-stage cases more likely to be curable, the treatment is generally easier and less invasive, with fewer lasting effects. The five-year survival rate for stage 1 and 2 is 70 to 90 percent, but plummets to 30 to 50 percent for cancer that has spread to other parts of the body. Patients may be more comfortable seeing their friendly neighborhood dentist first if they sense there may be a problem, which means you could be the primary or only person who can begin medical intervention that could ultimately save lives.
Dentists typically have a special rapport with patients, so it may be easier for you to begin a conversation about oral cancer prevention and detection. A patient’s family history, relationship with tobacco and alcohol and general health can be part of your back-and-forth. Certainly, sexual health and HPV can be uncomfortable discussions, but they’re increasingly necessary given the alarming rate at which HPV-related oral cancers are occurring. Avoiding excess alcohol consumption, never using tobacco products and being safe are important, but so too is talk about the role of healthy diet and lifestyle in preventing cancer in the first place.
While patients aren’t trained to identify dangerous lesions, you can give them some general advice about when they need to see you for screening. Bad breath, sore throat, ear pain on one or both sides, lumps or bumps in the neck and asymmetry should all be considered suspicious. So should pain, loose teeth, bleeding, sores that don’t heal, white or read patches or anything out of the ordinary. Other symptoms include sores/irritation that does not go away in a few weeks; numbness in mouth or lips; rough spots or thickening, difficulty speaking, chewing or swallowing; discoloration; any growth, hard spot, or raised tissue; and sores under dentures that do not heal after denture is adjusted. When patients understand that oral cancer is curable if caught early, and that HPV-related oral cancer is highly treatable, they’ll be less hesitant to see you with these concerns.
Patients with any of the following symptoms that do not resolve after two or three weeks should see a healthcare professional: hoarseness or sore throat; lumps on the outside of the neck; coughing; difficulty swallowing or a feeling food gets stuck; and earache.
1) Host a free screening event at your practice this April. Let the media know your plans. Not only is it a great way to give back, it brings new people into your practice for a visit
2) Offer to do a screening event at a local drugstore and partner with them for help with publicity and marketing
3) Consider adding an effective screening tool like GOCCLES to your practice