Oral cancer

Oral cancer
Other namesCancer of the lip, oral cavity and pharynx, mouth cancer, tongue cancer, cancer of the lips, oral cavity and pharynx[1]
Oral cancer on the side of the tongue, a common site along with the floor of the mouth
SpecialtyOncology, oral and maxillofacial surgery, ENT surgery
SymptomsPersistent rough white or red patch in the mouth lasting longer than 2 weeks, ulceration, lumps/bumps in the neck, pain, loose teeth, difficulty swallowing
Risk factorsSmoking, alcohol, HPV infection, sun exposure, chewing tobacco
Diagnostic methodTissue biopsy
Differential diagnosisNon-squamous cell carcinoma oral cancer, salivary gland tumors, benign mucosal disease
PreventionAvoiding risk factors,[2] HPV vaccination[3]
TreatmentSurgery, radiation, chemotherapy
PrognosisFive-year survival ~ 65% (US 2015)[4]
Frequency355,000 new cases (2018)[5]
Deaths177,000 (2018)[5]

Oral cancer, also known as oral cavity cancer, tongue cancer or mouth cancer, is a cancer of the lining of the lips, mouth, or upper throat.[6] In the mouth, it most commonly starts as a painless red or white patch, that thickens, gets ulcerated and continues to grow. When on the lips, it commonly looks like a persistent crusting ulcer that does not heal, and slowly grows.[7] Other symptoms may include difficult or painful swallowing, new lumps or bumps in the neck, a swelling in the mouth, or a feeling of numbness in the mouth or lips.[8]

Risk factors include tobacco and alcohol use.[9][10] Those who use both alcohol and tobacco have a 15 times greater risk of oral cancer than those who use neither.[11] Other risk factors include betel nut chewing[12] and sun exposure on the lip.[13] HPV infection may play a limited role in some oral cavity cancers.[14] Oral cancer is a subgroup of head and neck cancers.[6] Diagnosis is made by sampling (biopsy) of the lesion, followed by an imaging workup (called staging) which can include CT scan, MRI, PET scan to determine the local extension of the tumor, and if the disease has spread to distant parts of the body.

Oral cancer can be prevented by avoiding tobacco products, limiting alcohol use, sun protection on the lip, HPV vaccination, and avoidance of betel nut chewing. Treatments used for oral cancer can include a combination of surgery (to remove the tumor and regional lymph nodes), radiation therapy, chemotherapy, or targeted therapy. The types of treatments will depend on the size, locations, and spread of the cancer taken into consideration with the general health of the person.[7]

In 2018, oral cancer occurred globally in about 355,000 people, and resulted in 177,000 deaths.[5] Between 1999 and 2015 in the United States, the rate of oral cancer increased 6% (from 10.9 to 11.6 per 100,000). Deaths from oral cancer during this time decreased 7% (from 2.7 to 2.5 per 100,000).[15] Oral cancer has an overall 5 year survival rate of 65% in the United States as of 2015.[4] This varies from 84% if diagnosed when localized, compared to 66% if it has spread to the lymph nodes in the neck, and 39% if it has spread to distant parts of the body.[4] Survival rates also are dependent on the location of the disease in the mouth.[16]

  1. ^ Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. (December 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. hdl:10536/DRO/DU:30050819. PMC 10790329. PMID 23245604. S2CID 1541253.
  2. ^ "Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention". National Cancer Institute. 1 January 1980. Retrieved 5 June 2019.
  3. ^ "HPV Vaccine May Prevent Oral HPV Infection". National Cancer Institute. 5 June 2017. Retrieved 5 June 2019.
  4. ^ a b c "Cancer Stat Facts: Oral Cavity and Pharynx Cancer". NCI. Retrieved 27 June 2019.
  5. ^ a b c "Cancer today". gco.iarc.fr. Retrieved 9 June 2019.
  6. ^ a b Edge SB, et al. (American Joint Committee on Cancer) (2010). AJCC cancer staging manual (7th ed.). New York: Springer. ISBN 9780387884400. OCLC 316431417.
  7. ^ a b Marx RE, Stern D (2003). Oral and maxillofacial pathology : a rationale for diagnosis and treatment. Stern, Diane. Chicago: Quintessence Pub. Co. ISBN 978-0867153903. OCLC 49566229.
  8. ^ "Head and Neck Cancers". CDC. 2019-01-17. Retrieved 2019-03-10.
  9. ^ Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, et al. (January 2008). "Tobacco smoking and cancer: a meta-analysis". International Journal of Cancer. 122 (1): 155–64. doi:10.1002/ijc.23033. PMID 17893872. S2CID 27018547.
  10. ^ Goldstein BY, Chang SC, Hashibe M, La Vecchia C, Zhang ZF (November 2010). "Alcohol consumption and cancers of the oral cavity and pharynx from 1988 to 2009: an update". European Journal of Cancer Prevention. 19 (6): 431–65. doi:10.1097/CEJ.0b013e32833d936d. PMC 2954597. PMID 20679896.
  11. ^ "The Tobacco Connection". The Oral Cancer Foundation. 9 March 2016. Retrieved 2019-03-10.
  12. ^ Goldenberg D, Lee J, Koch WM, Kim MM, Trink B, Sidransky D, et al. (December 2004). "Habitual risk factors for head and neck cancer". Otolaryngology–Head and Neck Surgery. 131 (6): 986–93. doi:10.1016/j.otohns.2004.02.035. PMID 15577802. S2CID 34356067.
  13. ^ Kerawala C, Roques T, Jeannon JP, Bisase B (May 2016). "Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines". The Journal of Laryngology and Otology. 130 (S2): S83–S89. doi:10.1017/S0022215116000499. PMC 4873943. PMID 27841120.
  14. ^ Katirachi SK, Grønlund MP, Jakobsen KK, Grønhøj C, von Buchwald C (February 2023). "The Prevalence of HPV in Oral Cavity Squamous Cell Carcinoma". Viruses. 15 (2): 451. doi:10.3390/v15020451. PMC 9964223. PMID 36851665.
  15. ^ "USCS Data Visualizations". gis.cdc.gov. Archived from the original on 2019-01-25. Retrieved 2019-03-10.
  16. ^ "Survival Rates for Oral Cavity and Oropharyngeal Cancer". www.cancer.org. Retrieved 2019-03-10.