Site Of Oral Cancer Research Articles

English and Spanish oral cancer information on the Internet: a pilot surface quality and content evaluation of oral cancer Web sites

Oral and pharyngeal cancers are responsible for over 7600 deaths each year in the United States. Given the significance of the disease and the fact that many individuals increasingly rely on health information on the Internet, it is important that patients and others can access clear and accurate oral cancer information on the Web. The objective of this study was threefold: (a) develop an initial method to evaluate surface and content quality of selected English- and Spanish-language oral cancer Web sites; (b) conduct a pilot evaluation; and (c) discuss implications of our findings for dental public health. We developed a search strategy to find oral cancer sites frequented by the public using Medline Plus, Google, and Yahoo in English and Spanish. We adapted the Information Quality Tool (IQT) to perform a surface evaluation and developed a novel tool to evaluate site content for 24 sites each in English and Spanish. English-language sites had an average IQT score of 76.6 (out of 100) and an average content score of 52.1 (out of 100). Spanish-language sites had an average IQT score of 50.3 and an average content score of 25.6. The study produced a quality assessment of oral cancer Web sites useful for clinicians and patients. Sites provided more information on clinical presentation, and etiology, and risk factors, than other aspects of oral cancer. The surface and quality of Spanish-language sites was low, possibly putting Hispanic populations at a disadvantage regarding oral cancer information on the Web.

Oral cancer over four decades: epidemiology, trends, histology, and survival by anatomical sites

Oral cancer is one of the few life-threatening oral diseases. The subtypes and different sites of oral cancer has different etiology epidemiology and survival rate. Prevalence of the various anatomical oral sites provided potential baseline for improvement of clinical approach. Incidence and survival rates were derived from the Israel National Cancer Registry and included all registered data between 1970 and 2006. Oral cancer included the lips, tongue, buccal mucosa, gums, vestibulum, floor of the mouth, and palate. Most prevalent oral cancer subtype was squamous cell carcinoma (SCC) among men above the age of 55 years. Females had a higher incidence of SCC in lateral border of tongue, gums and buccal mucosa. Lymphoma and sarcoma were the most prevalent under the age of 20. Melanomas and metastatic disease revealed the lowest survival rate, while invasive or infiltrating basal cell carcinoma in the lips had the highest rate. The highest oral survival rate was for the lip, and the lowest was for the tongue and gums. Early detection of oral cancer is important for all the medical health team. Decrease in lip carcinoma may be a result of occupational or awareness changes and should be studied. Non-epithelial tumors under the age of 20 should be considered as a differential diagnosis. A basic oral examination should be included in all routine medical examinations, with emphasis on high-risk patients and high-risk oral sites.

PS2-37: Oral Cancer Information on the Web: Assessing the Quality and Content of English and Spanish Oral Cancer Websites

Background/Aims: In the United States, about 8,000 people a year die from oral cancer and more than 30,000 new cases are diagnosed annually. A recent study showed that 80% of American adult Internet users have searched the Web for health information and 15% of those specifically searched for dental health information. Having high quality oral cancer information available via the Web is important given the significance of this health problem. The goal of this study was to evaluate the quality and content of multiple English and Spanish oral cancer websites. Methods: We developed a search strategy using the keywords: oral cancer, mouth cancer, and tongue cancer to find oral cancer sites via Medline Plus, Google, and Yahoo. We then used the translations cancer oral, cancer de la boca, and cancer de la lengua to search Medline Plus en Espanol, Google Espanol, and Yahoo Telemundo. We added sites to the datasets based on inclusion/exclusion criteria. Two native speaking raters evaluated each site within their set for quality using the modified Information Quality Tool (IQT). We then developed a survey tool to asses the content of the sites. Two native speaking oral cancer experts evaluated each site within their set using this new tool. Results: Our search strategy produced 24 English language sites and 24 Spanish language sites for evaluation. English language websites had an average IQT score of 74.7 (out of 100) and average content score of 51.5 (out of 100). Spanish-language sites had an average IQT score of 48.8 and an average content score of 25.9. Conclusions: Despite higher scores for the English language websites, our analysis showed that there was a great variation in overall quality and content with room for improvement for both language types. English sites could make the biggest improvements by providing more information about their sponsors and who controls site content as well as updated and fixing links and author credentials. The Spanish sites should focus on improving information about their agenda and overall site design. For content, both types of sites need to provide more images and information on etiology and risk factors. Both English and Spanish sites scored highest in coverage of clinical presentation, treatment and follow-up care after treatment. Overall, this study identifies several information gaps and areas for improvements for oral cancer websites. We hope our results will be used to improve online oral cancer information.

Trends of oral and pharyngeal cancer in Israel, by gender, age, ethnic group, and country of origin: 1970–2006

Oral and pharyngeal cancer is one of the few life-threatening oral diseases. Israel is recognized as a developed country, characterized by a heterogeneous population, a high level of sun exposure, and a large proportion of faired skinned inhabitants. The purpose of this study was to describe trends in incidence and survival rates of oral and pharyngeal cancer between 1970 and 2006. The incidence and survival data were derived from the Israel National Cancer Registry between 1970 and 2006. Oral and pharyngeal cancer included cancers of the lips, tongue, oral mucosa, floor of the mouth, major salivary glands and pharynx. Results indicated trends, survival rates and associations by ethnicity, country of origin, age, and gender. The average age-world-standardized incidence rate, ASR(W), per 100 000, in 2001-2006 was 5.77 and 3.75 for Jews, and 5.99 and 2.30 for Arabs (males and females, respectively). The lip was the most common oral cancer site (36.8%). Over time, the rate (per 100 total cancer cases) decreased from 3.1 to 2.0, and male:female ratio decreased from 1.7 to 1.3. Kaplan-Meier survival plots demonstrated that patients under the age of 20 years had almost half the survival rate of older groups and lip cancer had almost twice the survival rate than other sites. Israel represents a developed country with relatively low percentage of alcohol consumption and high sun exposure. Data from this region demonstrated dissimilar distributions in comparison with other 'Westernized' countries. Public health programs need to utilize the present data in order to implement preventive strategies. Potential focus on specific high-risk populations should be investigated.

Changing Trends in Oral Squamous Cell Carcinoma with Particular Reference to Young Patients: 1971–2006. The Emory University Experience

Several recent reports suggest an increasing incidence of oral squamous cell carcinoma (OSCC) among young persons in many regions of the world--a trend which is particularly concerning given the overall stabilization or even decline in incidence rates for head and neck cancer in general. The aim of this study is to determine whether there has been an increase in the number of cases of OSCC diagnosed in patients < 40 years old by our biopsy service from 1971 to 2006. A retrospective review of all OSCC cases diagnosed from 1971 to 2006 by the Emory University Hospital Oral Pathology biopsy service was performed. A comparison of demographic information, frequency, location and histologic grade was made between these cases as a whole and those occurring in a subset of patients < 40 years old. Statistical procedures included chi-square analyses. From 1971-2006, 1,919 cases of OSCC were diagnosed, and 95 (5.0%) occurred in patients < 40 years old. A total of 8 cases were diagnosed from 1971 to 1980, compared to 36 cases during the period 1981-1990, 31 during the period 1991-2000 and 21 cases from 2001 to 2006. The increase in OSCC incidence from the 1970s when compared to 1981-2000 was statistically significant (P < 0.002). A 1.7:1 male:female ratio was seen in all decades. The mobile (oral) tongue was the most common location in all decades (62.1%) in young patients. In contrast, tongue cancers accounted for 27.4% in patients > or = 40. This difference between the two groups was statistically significant (P < 0.0001). Of great surprise, however, was the significant increase in tongue cancer during the study period in patients > or = 40 which accounted for 37.1% of all OSCC diagnoses from 2001 to 2006, compared to 20.5% of OSCC cases from 1971 to 1980 (P < 0.0001). We demonstrated a greater than fourfold increase in the incidence of oral squamous cell carcinoma (OSCC) in young patients < 40 years old beginning in 1974 and peaking in the late 1980s, then remaining stable. The mobile tongue is the most common location for cancer in this age group accounting for 62.1% of cancers. However, the mobile tongue increasingly appears to be the most common site for oral cancer in all age groups.

Carcinoma of the tongue mimicking bulbar amyotrophic lateral sclerosis

presenting with bulbar-onset amyotrophic lateral sclerosis (ALS), with only minor signs of denervation at the tongue electromyography (EMG), in whom continuous follow-up led to the discovery of a carcinoma of the tongue. We recently observed a 77-year-old man affected by progressive dysarthria, dysphonia, dysphagia and sialorrhea associated with significant weight loss. Neurological examination showed paralysis of the tongue, without atrophy or fasciculations. The other cranial nerves were normal. The proximal muscles of the four limbs and the respiratory muscles were slightly weak. The deep tendon reflexes were increased. A right plantar response in extension was present. Cerebellar and sensory functions were normal. Blood examination showed normocytic–normochromic anaemia and hypoproteinaemia. The CSF was normal. The EMG study showed minor denervation signs on the left anterior tibial muscle, the other examined muscles being normal. The absence of atrophy or fasciculations in the tongue, as in other voluntary muscles, and the lack of reproducible neurophysiological evidence of denervation, prompted us to perform further diagnostic tests. A CT scan of the neck showed an extensive and inoperable tumour involving the base of the tongue and the muscles of the floor of the mouth. At biopsy, an epidermoid carcinoma was diagnosed. Percutaneous endoscopic gastrostomy, tracheotomy and radiotherapy were carried out. Two months later the patient died from severe tongue bleeding. The tongue is the most common site of oral cancer. Symptoms include dysphagia, dysarthria, neck masses, ear pain and weight loss [2]. Diagnosis is often performed in advanced disease stages, because the symptoms are common to many other conditions [3]. In conclusion, our case supports the view that a tongue carcinoma should be considered in the differential diagnosis of bulbar-onset ALS, particularly when clear denervation on EMG or atrophy of the tongue are absent.

Distinctive Features of Oral Cancer in Changhua County: High Incidence, Buccal Mucosa Preponderance, and a Close Relation to Betel Quid Chewing Habit

Oral cancer is one of the fastest increasing malignancies in Taiwan. Among the counties on the island, Changhua has been ranked in the top three in the list of oral cancer incidence. This study was performed to better characterize the epidemiology of oral cancer in Changhua county. We used the complete registered records of oral cancer from the Department of Health databank, and studied the trends in incidence rate, age of distribution, and anatomic sites of oral cancer in Taiwan. In addition, we correlated the incidence rate with known risk factors (betel quid chewing, smoking, and alcohol drinking) by regression analysis. Among neoplasms, oral cancer is one of the fastest increasing malignancies in Taiwan. In the past two decades from 1982 to 2001, Taiwan had an alarming 5.3-fold increase in the incidence of male oral cancer. Among the 23 counties, Changhua has ranked top in oral cancer incidence in recent years. The incidence of male oral cancer in Changhua is also among the highest in the world (45.07/105/year in 2001). The most common site was the buccal mucosa, while it was the tongue in other counties. Finally, Changhua was the only outlier in our regression model, indicating that possible interference factors may interact with oral cancer incidence and prevalence of betel quid chewing in Changhua. We conclude that the high incidence and buccal mucosa preponderance of oral cancer in Changhua may have an exceptionally close relation with patients' betel quid chewing habit, and other unknown etiologic factors may also be present locally.

Oral cancer at a Tasmanian tertiary referral clinic, The Royal Hobart Hospital 1996–2002

The Holman Clinic at the Royal Hobart Hospital includes a multi-disciplinary head and neck clinic which functions as a tertiary referral centre for Southern Tasmania and involves Ear Nose and Throat surgeons, Oral and Maxillofacial Surgeons, Plastic and Reconstructive Surgeons, Radiation Oncologists and Medical Oncologists. The aim of this study was to examine retrospectively the number, gender distribution, age, site of lesion, histology, mortality and treatment modalities of the oral cancers referred to the Holman clinic at the Royal Hobart Hospital. The medical histories and a database of the Holman clinic were used as the sources of data for this study. A total of 101 patients were treated for oral cancer in the Holman clinic at the Royal Hobart Hospital from 1996 to 2002. There were 64 males and 37 females. The distribution of anatomical sites of the oral cancers in this study was as follows: 36 oral tongue lesions, 17 floor of mouth, 13 lip, five retromolar trigone, five mandibular alveolus, six buccal mucosa, nine palatal and 10 minor and major salivary gland cancers. The most common site of oral cancer was the tongue (35.6 per cent), followed by the floor of mouth (16.8 per cent) and lip (12.9 per cent). The majority of oral cancers were squamous cell carcinoma, except for the salivary gland cancers. The incidence of squamous cell carcinoma was between 67 and 100 per cent, depending upon the site involved. The trends found in this study are similar to those previously documented over the past 20 years.

Assessing oral cancer knowledge among dental students in South Carolina

Because South Carolina has the fourth highest mortality rate for oral cancer among the 50 states, dental students in the state must be knowledgeable about prevention and early detection of the disease. In 2002, the authors surveyed 163 students using a written questionnaire (response rate, 79.1 percent). The questionnaire included questions about oral cancer risk and nonrisk factors as well as oral cancer diagnostic signs, symptoms and examination procedures. The authors performed univariate and bivariate analyses (alpha < or = .025). At least 93 percent of the students replied that tobacco, alcohol and previous oral cancer lesions were risk factors. One hundred six students (65 percent) knew that the most likely site for oral cancer is the ventrolateral border of the tongue. Students differed in their overall knowledge of risk factors (P = .002), nonrisk factors (P < .001) and diagnostic procedures (P < .001). Although students' level of knowledge increased with academic year, educators and policy-makers need to place greater emphasis on oral cancer education and training in dental schools. Morbidity and mortality are likely to be reduced if dentists know how to prevent and detect oral cancer.

P.68 Clinical pathological evaluation and risk factors of oral cancer cases of east coast of peninsular Malaysia

Introduction: Oral cancer is one of the common cancers m Malaysia. Tile population of east coast of Peninsular Malaysia has a different hfestyle and Malay is the predominant race. Oral cancer research in this area started since the Malaysian National Oral Cancer group was established. The am: of this study is to evaluate the clinical pathological findings and to investigate the role of tobacco smoking, alcohol consurnption and betel quid chewing as tile risk factors among oral cancer cases m east coast of peninsular Malaysia.Materials and Methods: Fifty case records of only treated/operated cases of patients with oral cancer between 1994-2003 m Hospital Umversiti Sams Malaysm were reviewed. This study is based on questio:matre developed by the Malaysian National Oral Cancer group. Tile data analysed includes personal reformation and clinical pathological findings. Results: Patients' age range was between 27-97 years old. The male to female ratio was 1.4:1. Malays ethic group has the highest incidence of oral cancer (n=46). Out of 50 cases, 80% were new cases and 66% was squamous cell carcinoma of the oral mucosa. Data revealed 12 different sites of lesions and the highest frequency was on buccal mucosa (30%) with 75% neck node involvement while 12% of the patients have two s:tes of les:oias. D:stant metastams occurred m 76.9% of the cases. Tobacco smoking was found to be the predorrm:ant risk factor (54%) wtnle 24% of pat:ents were found to be qurd chewer. Only 8% ofpafients consumed alcohol. The remaining14% patients do not admit any of the risk factors and the author would contribute their etiolo~ to viruses. Conclusion: The most common site of oral cancer was buccal mucosa with 75% neck node involvement. Presence of distant metastasis can be witnessed on most cases. More than half cases were new cases. Tobacco smokings exceed betel nut chewing as a probable risk factor among the subjects.

Carcinoma of the tongue: A case series analysis of clinical presentation, risk factors, staging, and outcome

Objective Oral cancer is primarily a disease of epithelial origin. The tongue is the most common site of oral cancer. Oropharyngeal cancer accounts for approximately 2% of all cancer deaths. The purpose of this study was to analyze a case series of patients with tongue cancer. Study design The medical records of 322 consecutive patients diagnosed with squamous cell carcinoma (SCC) of the tongue treated from 1979-1994 were reviewed. Results Patients had a mean age of 61.1 years and a 1.5:1 male to female ratio. Approximately, half of the cancers were diagnosed at an advanced stage and most involved the base of the tongue. The majority of oral tongue tumors were diagnosed at an early stage and had more well-differentiated cell types than those of the base of the tongue. Localized discomfort was the most common complaint (66.5%), present for up to 6 months in patients prior to diagnosis and were related to the oral tongue in 90% of cases. Symptoms associated with base of tongue lesions included neck masses, dysphagia, ear pain, and weight loss. Seventy-nine percent of the patients smoked, 58% consumed alcohol on a daily basis, and 43% consumed more than 4 alcoholic drinks daily. Primary radiotherapy was the treatment of 49.6% lesions, of which 57% were at an early stage at diagnosis. The mean overall survival was 3 years and 5 months, with a 5-year overall survival of 40%. Patients with stage 1 tumors had a disease-specific survival of over 80%. The 5-year survival of patients with cancer of the oral tongue was 43% and cancer of the base of the tongue was 27%. Conclusion The prognosis is poorer for patients presenting with advanced stage and with tumors involving the base of the tongue. Symptoms were more common in tumors of the oral tongue, which likely results in earlier diagnosis. Patients with SCC of the base of the tongue presented with advanced stage of disease and were typically poorly differentiated lesions.

Oral cancer at Kenyatta National Hospital, Nairobi

The epidemiology of oral cancer in the African population is still uncertain. Earlier reports suggested a relatively low incidence of oral cancer among Africans. However, there have been recent reports of an upward trend in the incidence of oral cancers in developing countries as a consequence of changes in life style and the emergence of new diseases. It is, therefore, reasonable to expect changes in the pattern of oral cancer in Kenya in view of these changes. To determine changes in the pattern of oral cancer in the past 20 years. Retrospective descriptive study. Kenyatta National Hospital, Nairobi. Pathology records of cases of oral cancer diagnosed at Kenyatta National Hospital from 1978 to 1997 were analysed for relative frequency, age, sex and site distribution. Of a total 22,788 malignancies 821 cases (3.6%) were oral cancer. Yearly relative frequency of oral cancer ranged between 1.5% of the total malignancies. There was a small male predominance (M:F = 1.3:1). The most preferred site for oral cancer was the tongue but with a significant number involving the maxilla and mandible. Comparison with a previous study did not demonstrate a dramatic change in the pattern of oral cancer in Kenya. An overall gradual decline of cancers diagnosed at Kenyatta National Hospital was noted. This decline could not be accounted for in this study. This study does not show any increase in the frequency or change in the pattern of oral cancer in this population despite changes in life style and the emergence of AIDS disease in the country.

Dental hygienists and oral cancer prevention: knowledge, attitudes and behaviors in Italy

This study explored knowledge of risk factors and diagnostic procedures for oral cancer, attitudes and behavior among dental hygienists in Italy. A random sample of 500 dental hygienists received by mail a questionnaire focusing on demographics and practice characteristics, knowledge, attitudes and behaviors regarding oral cancer assessment practices. Almost all dental hygienists correctly indicated tobacco usage and having a prior oral cancer lesion as risk factors. Although 88.8% knew that the tongue is one of the two most common sites of oral cancer, only 13.5% identified the floor of the mouth. Less than half (42.8%) recognized that an early oral lesion usually is a small, painless and red area and only 4.2% knew the examination procedures of the tongue. Results of the multiple logistic regression showed that those dental hygienists who worked a higher number of hours and treated a lower number of patients in a week were more likely to indicate tobacco and alcohol use as risk factors for oral cancer. Higher number of years in practice, scientific journals and associations as sources of information about oral cancer, and knowledge that ventral lateral border of tongue is the most common site for oral cancer, significantly predicted compliance with oral cancer examination. Dental hygienists' sex, age, and years in practice were associated with a positive attitude towards oral cancer prevention. Further educational interventions in order to early detect and prevent oral cancer are strongly needed.

口腔癌の臨床統計

Sixty-five patients with oral cancer, treated at Mie University Hospital for 7 years between 1992 and 1998, were reviewed. The average age was 63.7-years-old. Primary site of oral cancer was the tongue in 34, oral floor in 15, buccal mucosa in 8, gingiva in 5, and the hard palate in 3. The 5-year survival rate analyzed by Kaplan-Meier method was 100%, 75.0%, 61.5%, 91.7%, 21.9% and 0%, respectively for stage 0, I, II, III, IVA and IVC. The high survival rate in stage III indicates the effectiveness of therapy by superselective intraarterial chemotherapy combined with radiation. The 5-year survival rate by the site was 59.7%, 53.0%, 62.5%, 50.0%, and 100%, respectively for tongue, oral floor, buccal mucosa, gingiva, and hard palate.

Classifying cancer of the lip: an epidemiological perspective

A review of papers related to oral cancer reveals some non-uniformity in the classification of cancer of the lip. This paper examines the incidence of lip cancer in England and Wales using age-standardized and age- and sex-specific rates, and relates the results to those for other sites of oral cancer. There is a falling trend in age-adjusted incidence rates for lip cancer but not for intra-oral cancers, and the age-specific incidence shows a plateau effect for lip cancer after about 75 yr of age, whereas the incidence rate continues to rise throughout life for intra-oral cancers. These differences underline the importance of classifying cancer of the lip separately from other oral cancers.