An Oral Argument About Cancer Screening

Oral cancer screenings not currently recommended for asymptomatic patients

(RxWiki News) The US Preventive Services Task Force (USPSTF) has recently tackled the issues of when to screen for prostate and breast cancers. The government-backed agency is now saying there's not enough evidence to recommend or reject oral cancer screening.

Oral cancer screening needs to be assessed on an individual case basis, according to a draft recommendation from the USPSTF.

The agency says there’s not enough evidence to show whether or not the benefits of this test outweigh its potential harms.

"If sores in your mouth don’t heal, see your doctor."

This year, nearly 41,500 Americans will be diagnosed with oral cancer that can develop anywhere in the mouth, throat, nasal passages or sinuses.

Oral cancers have traditionally been linked to smoking, with 75 percent of cases associated with some form of tobacco use. Oral cancers related to the human papillomavirus (HPV) have been increasing significantly.

Mark Ebell, MD, of Athens, Georgia, a USPSTF member and deputy editor of American Family Physician, told Matt Brown of the American Academy of Family Physicians, “As is the case for many conditions, we need more research in the primary care setting to answer this question (of whether to screen patients with no symptoms), especially since HPV (human papillomavirus) is emerging as an important risk factor for oral cancer."

The USPSTF currently recommends against routine screening in people without symptoms because the harms of both diagnosing and treating the disease may outweigh the benefits. Harms, according to the agency, include potential complications from the biopsy (removal of tissue to test for disease) and treatment which usually includes surgery, radiation and chemotherapy.

According the USPSTF, risk factors for oral cancers are highest among those who have smoked at least one pack of cigarettes a day for 20 or more years and those who have had 20 or more sexual partners.

“The incidence and mortality rate for oral cancer has been decreasing in the United States because of reduced tobacco and alcohol use; however, human papillomavirus (HPV)–related oropharyngeal (oral cavity and throat) cancer has begun to increase in incidence.

As the epidemiology of HPV-related oropharyngeal cancer continues to unfold, it could have an important effect on the identification of other high-risk populations that may benefit from screening,” the authors wrote in the draft recommendation.

This draft recommendation, which was issued April 9, is available for comment through May 6, 2013.

Review Date: 
April 10, 2013