Overview of Screening

What is screening? Purposes of this summary

Oral Cancer Screening

Risk of oral cancer Screening tests for oral cancer

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Changes to This Summary (07/23/2007)
Questions or Comments About This Summary
About PDQ

Overview of Screening

What is screening?

Screening for cancer is examination (or testing) of people for early stages in the development of cancer even though they have no symptoms. Scientists have studied patterns of cancer in the population to learn which people are more likely to get certain types of cancer. They have also studied what things around us and what things we do in our lives may cause cancer. This information sometimes helps doctors recommend who should be screened for certain types of cancer, what types of screening tests people should have, and how often these tests should be done. Not all screening tests are helpful, and most have risks such as bleeding or infection due to a biopsy for an abnormal screening test. For this reason, scientists at the National Cancer Institute are studying many screening tests to find out how useful they are and to determine the relative benefits and harms.

If your doctor suggests certain cancer screening tests as part of your health care plan, this does not mean he or she thinks you have cancer. Screening tests are done when you have no symptoms. Since decisions about screening can be difficult, you may want to discuss them with your doctor and ask questions about the potential benefits and risks of screening tests and whether they have been proven to decrease the risk of dying from cancer.

If your doctor suspects that you may have cancer, he or she will order certain tests to see whether you do. These are called diagnostic tests. Some tests are used for diagnostic purposes, but are not suitable for screening people who have no symptoms.

The purposes of this summary on oral cancer screening are to:

• Give information on oral cancer and what makes it more likely to occur (risk factors).
• Describe oral cancer screening methods and what is known about their effectiveness.

You can talk to your doctor or health care professional about cancer screening and whether it would be likely to help you.

Oral Cancer Screening

Oral cancer may develop in any of the following areas:

• Lips.
• Oral cavity, which includes:
  • The front two thirds of the tongue.
  • The gingiva (gums).
  • The buccal mucosa (the lining of the inside of the cheeks).
  • The floor (bottom) of the mouth under the tongue.
  • The hard palate (the roof of the mouth).
  • The retromolar trigone (the small area behind the wisdom teeth).
• Oropharynx, which includes:
  • The middle part of the pharynx (throat) behind the mouth.
  • The back one-third of the tongue.
  • The soft palate.
  • The side and back walls of the throat.
  • The tonsils.

Salivary glands are located throughout the oral cavity and oropharynx.

This summary will describe the risk factors and screening tests associated with oral cancer.

The number of new cases of oral cancer, as well as the number of deaths from oral cancer, has been decreasing.

Anything that increases a person’s chance of developing a disease is called a risk factor. Some of these risk factors for oral cancer are as follows:

Sex: Men have a slightly higher risk of developing oral cancer than women.

Race: The risk of developing oral cancer is higher in blacks than in whites.

Age: The risk of developing oral cancer increases after age 45 years.

Tobacco and Alcohol Use: The use of tobacco (including smokeless tobacco) and alcohol increases the risk of developing oral cancer.

HPV Infection: Infection with human papillomavirus (HPV) increases the risk of developing cancer of the oropharynx.

Screening for oral cancer may be done during a physical examination by the dentist or doctor. High-risk areas of the mouth that can be checked for early detection are the floor of the mouth, the front and sides of the tongue, and the soft palate. The exam will include looking for lesions on the mucous membranes, including leukoplakia (white patches) and erythroplakia (red patches). Oral cancer sometimes develops in areas with these lesions. It is not known, however, if screening decreases the risk of dying from oral cancer. Early- stage oral cancer can be cured, but most oral cancers have spread by the time they are found.

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Changes to This Summary (07/23/2007)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Changes were made to this summary to match those made to the health professional version.

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If you have questions or comments about this summary, please send them to Cancer.gov through the Web site’s Contact Form ⁴. We can respond only to email messages written in English.

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ². PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether a method of finding cancer earlier can help people to live longer. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients and those who are at risk for cancer. During screening clinical trials, information is collected about the effects of a new screening method and how well it works. If a clinical trial shows that a new method is better than one currently being used, the new method may become "standard." People who are at high risk for a certain type of cancer may want to think about taking part in a clinical trial.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ⁵. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Glossary Terms

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

The inner lining of the cheeks.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

To heal or restore health; a treatment to restore health.

A health professional who specializes in caring for the teeth, gums, and other tissues in the mouth.

A method used to identify a disease.

An abnormal patch of red tissue that forms on mucous membranes in the mouth and may become cancerous. Tobacco (smoking and chewing) and alcohol may increase the risk of erythroplakia.

The tissue of the upper and lower jaws that surrounds the base of the teeth. Also called gums.

The front, bony part of the roof of the mouth.

A member of a family of viruses that can cause abnormal tissue growth (for example, genital warts) and other changes to cells. Infection with certain types of human papillomavirus increases the risk of developing cervical cancer. Also called HPV.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

An area of abnormal tissue. A lesion may be benign (noncancerous) or malignant (cancerous).

An abnormal patch of white tissue that forms on mucous membranes in the mouth and other areas of the body. It may become cancerous. Tobacco (smoking and chewing) and alcohol may increase the risk of leukoplakia in the mouth.

The moist, inner lining of some organs and body cavities (such as the nose, mouth, lungs, and stomach). Glands in the mucous membrane make mucus (a thick, slippery fluid). Also called mucosa.

The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. The National Cancer Institute conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the National Cancer Institute Web site at http://www.cancer.gov. Also called NCI.

Cancer that forms in tissues of the lip or mouth. This includes the front two thirds of the tongue, the upper and lower gums, the lining inside the cheeks and lips, the bottom of the mouth under the tongue, the bony top of the mouth, and the small area behind the wisdom teeth.

The mouth.

The part of the throat at the back of the mouth. It includes the soft palate, the base of the tongue, and the tonsils.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

The hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The pharynx is about 5 inches long, depending on body size. Also called the throat.

An exam of the body to check for general signs of disease.

The small area behind the wisdom teeth.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

A gland in the mouth that produces saliva.

Checking for disease when there are no symptoms.

The back, muscular (not bony) part of the roof of the mouth.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

One of two small masses of lymphoid tissue on either side of the throat.