II. Epidemiology

  1. Squamous Cell represents 90% of oral cavity tumors
  2. Incidence increases with age
  3. Oral Cancer is 9th most common cancer
    1. Represents 3% of cancers in men
    2. Represents 2% of cancers in women

III. Risk Factors (account for 75% of cases)

  1. Tobacco abuse confers 6 fold risk
    1. Smokers represent 90% of Oral Cancer patients
  2. Alcohol Abuse or heavy use
  3. Combined risk of heavy Alcohol and Tobacco use
    1. Women: 100 fold risk of Oral Cancer
    2. Men: 38 fold risk of Oral Cancer
    3. Blot (1988) Cancer Res 48:3282-7 [PubMed]
  4. Other risks
    1. Viral infection (HSV, HPV)
    2. Sunlight exposure
    3. Poor Dentition

IV. Locations

  1. Lateral Tongue
  2. Floor of mouth
  3. Lower vermilion lip border
  4. Alveolar ridge

V. Symptoms

  1. Halitosis
  2. Painless Oral Ulcer
  3. Trismus may be present with deep invasion

VI. Signs

  1. Early changes
    1. Erythroplakia
    2. Leukoplakia
    3. Spotted Leukoplakia
  2. Later Changes
    1. Oral Ulcer with raised borders
  3. Spread to submandibular and cervical lymph nodes
    1. See Lymphadenopathy of the Head and Neck
    2. Perform complete Oral Examination

VII. Associated Conditions

  1. Adjacent cancer in laryn, esophagus, lungs in 15% cases

VIII. Management

  1. Surgical excision
  2. Radiation Therapy

IX. Prognosis

  1. Oral Cancers are advanced by diagnosis in 60% of cases
  2. Five year survival: 50-55%

X. Prevention

XI. References

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