Oral Cancer Screening Updates

Oral cancer screenings by primary care physician recommendations updated

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Because tobacco use has been declining in the US over recent years, cancers found in the mouth have also been on the decline.

The US Preventive Services Task Force (USPSTF) has updated its 2004 recommendation on primary care physicians screening for oral cancers.

The task force did not find enough evidence to recommend for or against oral cancer screenings by primary care physicians in adults with no symptoms of the disease.

"See your dentist if you have a mouth sore that doesn’t heal after a couple of weeks."

Virginia A. Moyer, MD, MPH, Chair of the USPSTF, wrote this updated recommendation.

Oral and oropharyngeal (back of the mouth and top of the throat) cancers are the two primary types of cancer seen in the head and neck.

These two types of cancer often are considered to be the same, but they’re not.

The American Society of Clinical Oncology (ASCO) defines oral cancers as those that appear in the oral cavity, which consists of the lips, the lining of the lips and cheeks, gums, front parts of the tongue, roof of the mouth (palate) and the floor of the mouth under the tongue, along with the area behind the wisdom teeth.

The oropharynx starts where the oral cavity stops, ASCO explains, and includes the soft palate at the back of the mouth, the tonsils, the very back of the tongue and the part of the tongue behind the mouth.

Risk factors for both types of cancer are tobacco and alcohol use. However, oropharyngeal cancer is also caused by the human papillomavirus (HPV), a sexually transmitted virus.

Oral cancers are declining, while oropharyngeal cancers are on the rise.

According to the USPSTF, “In the United States, the prevalence of oropharyngeal cancer due to oral HPV infection is probably as high as 80 percent to 95 percent.”

In updating its recommendation, the Task Force reviewed the latest published studies to determine if primary care physician screenings reduced the incidence of or deaths caused by oral cancers.

“The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening for oral cancer in asymptomatic adults by primary care providers,” the statement read.

The recommendation does not apply to oropharyngeal cancers, which can’t be adequately seen in the primary care setting.

This recommendation applies to visual inspection and palpation (feeling) performed by primary physicians and does not apply to dental professionals or otolaryngologists (ear, nose and throat specialists).

The USPSTF does have recommendations for lowering oral cancer risk factors like tobacco and alcohol use.

The Task Force recommends that clinicians screen all adults for tobacco use, urge patients not to use tobacco products and provide methods that can help patients stop using any form of tobacco product.

The USPSTF also recommends that primary care professionals screen for and offer recommendations for behavioral therapy interventions to help patients reduce alcohol misuse.

This updated recommendation was published November 25 in the Annals of Internal Medicine.

Review Date: 
November 25, 2013
Last Updated:
December 31, 2013