Oral Cancer Screening

If oral cancer is detected early, treatment can be successful. Many people have questions about what the screening process entails, and this article will explore it in detail.


Oral cancer case-finding programs are based on visual examination (VOE). Commercially available adjunctive techniques enhance VOE with optical or other means, such as vital staining and fluorescence, or cytopathologic analysis following the detection of OPMDs by VOE.

Oral Cancer Symptoms

As part of your oral cancer screening, the healthcare provider will look for red and white patches inside your mouth, as well as any lumps or sores. They will also check the roof of your mouth (palate), hard and soft palate, sinuses and pharynx (throat). They may use special lights to help see more clearly any areas that look abnormal. They will also rinse your mouth with a special dye that turns the cells in your gums and throat blue, so they can better spot any areas that might be cancerous.

If they find anything suspicious, they will take a small tissue sample from the area and send it off to be tested for cancerous cells. This is called a biopsy. If it’s found to be cancerous, treatment can begin. Early detection is key to successfully treating this disease.

In most cases, oral cancer is a squamous cell carcinoma, which means that it starts in the upper layer of cells in the mouth or on the lips. Squamous cell carcinomas tend to grow and spread quickly if not treated, but they can be easily removed if caught and diagnosed in the early stages.

While most squamous cell carcinomas are associated with tobacco or heavy alcohol use, there are now more cases that occur in people who have never smoked and have been exposed to the human papilloma virus (HPV). This type of cancer is growing in younger men and women who might not be at high risk, so regular screenings and self-reporting of any changes can make a difference.

Oral, head and neck cancers are common but preventable, especially if caught early. You can reduce your risk by avoiding tobacco and excessive alcohol consumption, using sunscreen with UVA and UVB protection and getting an HPV vaccine. You can also get an oral cancer screening by visiting your dentist regularly.

Despite the high number of people who die from oral cancer each year, it is relatively easy to detect and treat in the early stages. This is because most oral cancers are preceded by clinical pre-malignant lesions that can be seen with the naked eye. The challenge is to improve the ability of the healthcare professional to recognize these early lesions during routine visual examination, thus enabling them to be referred for expert examination and potentially early diagnosis and treatment. This is the purpose of oral cancer screening and case-finding programs.

Oral Cancer Risk Factors

During your oral cancer screening, your dental professional will examine the inside of your mouth, including your lips, cheeks, tongue and gums, for any abnormalities. They will also feel around your jaw and neck for any lumps or bumps. Your healthcare professional may use a brush-like tool to scrape some cells from your oral cavity and send them away for further examination, or they may perform a biopsy on one or more areas of concern. The results of a biopsy will determine whether or not you have oral cancer, as well as the type and stage of your cancer.

There are several risk factors for developing oral cancer, including age (your chance of getting it increases with age), tobacco and alcohol use, chronic inflammation, genetic predisposition, lifestyle, cigarette smoking or alcohol consumption, and human papillomavirus (HPV) status. The most common type of oral cancer is squamous cell carcinoma, or SCC. Other types include oat cell cancer, adenoid cysts, lymphoma, granulomas, sarcomas and leukemias.

The majority of cases of oral cancer develop in people over the age of 55, and it is twice as likely to occur in men than women. It is also more prevalent in those of African descent.

It is important to note that not all cases of oral cancer are diagnosed at early stages, and that the overall survival rate is quite low. This is largely due to the fact that most of the time, oral cancers are not detected until they are in an advanced stage and have spread to other parts of the body, where they are usually more difficult to treat.

In order to improve the diagnosis and treatment of oral cancer, it is important that people who are at high risk for developing this disease attend regular screenings with their dentist or healthcare professional. Those who are not at risk should consider starting a habit of performing self-exams at home on a weekly basis, using the same techniques that your healthcare professional will be able to show you during your screening.

Many studies have investigated the feasibility of visual screening to detect OSCCs and OPMDs, with some evidence that it is effective. However, a number of challenges remain, including lead time bias and overdiagnosis. These are illustrated in the figures below, which depict 4 scenarios. “Aggressive” oral squamous cell carcinomas progress rapidly and are unlikely to be detected as asymptomatic by screening, while “less aggressive” and “indolent” OSCCs have longer potential screening windows and are more likely to be detected. The latter are associated with favorable stage shifts and improved survival, but this result needs to be interpreted cautiously given our imprecise understanding of natural history.