Oral Cancer Screening at NYU Langone

Oral cancer is a deadly and often neglected disease. Early detection can preserve a person’s ability to speak, swallow and eat while dramatically improving prognosis.

Oral cancer screening involves a visual examination of the mouth and neck for abnormalities. Healthcare professionals may also feel 강남치과 (palpate) for lumps and enlarged lymph nodes.

Risk Factors

Cancer is a disease that develops when cells in the body begin to grow out of control. We don’t know what causes all cancers, but some can be linked to certain risk factors. These include using tobacco and alcohol, being exposed to the sun’s rays (for lip cancer), and having human papillomavirus (HPV).

Our dentists are trained to look for abnormalities in your mouth. They will examine your lips, cheeks, gums, tongue, roof and floor of the mouth, and neck. They will be looking for any lumps, bumps, asymmetry, color changes or ulcers.

We don’t know if all cancers that can start in the mouth or throat are caused by these risk factors. Also, there are no studies that prove that regular screening for these cancers decreases the number of people who die from them. However, we do know that early detection allows for more treatment options. That’s why it’s important to visit your dentist on a regular basis.

Symptoms

During a screening, your healthcare professional will look for any abnormalities in the mouth and throat. They will check for asymmetries, lumps, swellings, and color changes. They will also observe how your jaws, lips, gums, tongue, cheeks and the inside of your nose feel and work.

Cancers can develop in the tissues lining the mouth and throat, but most oral cancers develop in the squamous cells (thin flat cells) of the front two-thirds of the tongue. Other places in the mouth where cancers can form include the floor of the mouth, the back of the tongue and the area behind the wisdom teeth. Cancers can also form in the pharynx, or throat, including nasopharyngeal cancer.

Some cancers never cause symptoms or become life-threatening, but they might be found by screening tests. These cancers are called overdiagnosis and can lead to unnecessary treatment, which can have serious side effects. The type of treatment you receive depends on the stage of the cancer, where it is located and whether it has spread to other parts of your body.

Screening

Many of the signs and symptoms of oral cancer can be identified by healthcare professionals during regular health checkups. A healthcare professional may also be able to take a sample of cells and send them for laboratory tests to see whether they are cancerous or precancerous.

This is called a biopsy. It is a quick and painless procedure. The healthcare professional scrapes the cells with a brush-like tool, and then a laboratory can analyze them to see whether they are cancerous or not.

Screening programs aim to detect cases of cancer at an early stage, before they can spread and become difficult to treat. This can increase survival rates and reduce the impact on quality of life.

There are several different screening models that have been used in oral cancer studies, including home visits by trained healthcare professionals, opportunistic screening at dental practices, screening with general health workers, and screening at workplaces. However, all the models need to have high attendance rates and good calibration of the index test for screening to be effective (Downer et al. 2004).

Diagnosis

To look for cancer or precancerous changes in the mouth, NYU Langone doctors may use tools such as a toothbrush or cotton swab to brush or “exfoliate” the tissue inside your mouth. They can also feel (palpate) for lumps or areas that are sore or tender. During these examinations, your healthcare professional may apply a blue dye called toluidine blue or use a device that shines a light in your mouth and highlights abnormal areas. This method, called autofluorescence imaging or a VELscope, is based on the idea that healthy tissue does not reflect light while cancerous or precancerous cells do.

In some cases, doctors can take a small sample of the suspicious area for further testing with a biopsy. They can perform a biopsy in-office with local anesthesia or, in more serious cases, use a scalpel or needle to remove a piece of the tumor under a microscope. They can also use a procedure called fine needle aspiration (FNA), which uses a thin needle to extract fluid or cells from the abnormal area and send them for analysis.