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MJDF study group meeting 4

MJDF study group meeting 4. Oral Cancer PBL presentation Miriam Figge. Definition. Group of neoplasms affecting the oral cavity excluding salivary gland tumours OSCC more than 90% of all oral neoplasms. Prevalence. Approx 7000 new cases per annum—20 diagnoses per day

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MJDF study group meeting 4

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  1. MJDF study group meeting 4 Oral Cancer PBL presentation Miriam Figge

  2. Definition • Group ofneoplasmsaffectingthe oral cavityexcluding salivary gland tumours • OSCC more than 90% of all oral neoplasms

  3. Prevalence • Approx 7000 new cases per annum—20 diagnoses per day • Among 10 most common cancers among men in the UK • Most common: oldermales, lowersocioeconomicstatus • Increasing incidence in young female patients 18-44 years

  4. Risk factors • Tobacco use  Smoking of tobacco – assocwith 75% of oral cancercases, 6x riskcomparedto non-smokers (DBOH says 7-10x) Betel, chewing tobacco, cannabis, areca • Alcohol 6x increased risk compared to non drinkers 14 units/week, no safe amount Synergistic effect of tobacco and alcohol: 15x increased risk • Viral: HPV 16, 18 (oropharyngealcancer), Epstein Barr, Hepatitis C  • Contributing factors: diet poor in nutrients, immune defects

  5. Precancerous disorders • Erythroplakia • Leukoplakias, particularly: • Erythroleukoplakia (nodular or verrucous) • Proliferative verrucous leukoplakia • Actinic cheilitis • Lichen planus (mainly the erosive and atrophic type) • Sideropenic dysphagia (Plummer-Vinson syndrome) • Submucous fibrosis • Dyskeratosis congenita • Discoid lupus erythematosus

  6. Diagnosis • usually painless • Tongue, FOM, Lips • Non healing ulcers +/-raised margins • Lumps • Erythroplakia, leukoplakia, mixed lesions • Cervical lymph node enlargement • Non healing extraction socket • Tooth mobility w/o identifiable cause

  7. Raising awareness

  8. When to refer urgently • 2 week national target • Unexplained ulceration lasting for more than 3 weeks • Persistent/unexplained neck lump • Lump on lipor in oral cavityconsistentwith oral cancer • Red or whitepatchconsistentwitherythroplakiaorerythroleukoplakia

  9. What happens after the referral? • Urgent referral - written patient information • Biopsy • Staging TNM tumor nodes metastasis

  10. Useful links and documents • BDA oral cancer tool kit • https://www.myhealth.london.nhs.uk/healthy-london/cancer/pan-london-suspected-cancer-referrals/patient-leaflets • Leonardo da Vinci Programme: Free e-learning module for European dentists www.oralcancerldv.com

  11. References • ORAL CANCER DIAGNOSIS IN PRIMARY CARE NIKOLAOS FANARAS, SAMAN WARNAKULASURIYA Prim Dent J. 2016;5(1):64-68 • Current Aspects on Oral Squamous Cell Carcinoma Anastasios K Markopoulos* Open Dent J. 2012; 6: 126–130. Published online 2012 Aug 10. doi:  10.2174/1874210601206010126 • https://cks.nice.org.uk/head-and-neck-cancers-recognition-and-referral#!scenario • https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/head-and-neck-cancers/incidence • Detection of Early-Stage Oral Cancer Lesions: A Survey of California Dental HygienistsDayna M. Hashimoto Barao, Gwen Essex, Ann A. Lazar and Dorothy J. RoweAmerican Dental Hygienists' Association December 2016, 90 (6) 346-353;

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