What Should I Know About Oral Cancer?

In the United States, nearly 50,000 people will be diagnosed with oral cancer each year. The survival rate varies greatly depending upon the stage of the disease. For example, according to the National 

Cancer Institute (NCI), if oral cancer is detected in one localized area on the tongue, and has not spread, the five-year relative survival rate is 81 percent*. However, if cancer has spread from the tongue to distant regions of the body, the survival rate drops to 39 percent. 

Early detection is critical to aid survival rates. Every adult should be screened for oral cancer annually by a dental professional. Getting screened is a simple, quick, and painless process and is an effective way to find cancer (or pre-cancer) at an early, more curable stage. 

  

Videos

Healthcare Provider Exam Tips

How to do an Oral Cancer Self-Exam:

Public

Do I really need to be screened?

Yes! It is common knowledge that dentists are on the lookout for issues such as cavities and gum disease during dental checkups. However, many do not realize that dentists are also checking for signs of oral cancer. 
 
Some people mistakenly think that if they have no teeth or wear dentures, they do not need to go to the dentist. Oral cancer could be hiding in various areas of the mouth or under a denture, so it is still vital to get an annual oral cancer screening. 
 

Oral Cancer Concerns During COVID-19

Should you notice or experience any of the oral cancer signs and symptoms listed below, contact a health care professional for guidance. UK Dentistry can review oral cancer signs and symptoms with you. Contact our office by calling 859-323-6080. 

Oral Cancer Self-Exam

The American Association of Oral and Maxillofacial Surgeons (AAOMS) recommends monthly oral cancer self-exams for adults 18 years and older. Watch the below video to learn how to perform an oral cancer self-exam. 

Risk Factors

Drinking excessive alcohol and tobacco use (smoking, dipping, chewing, etc.) are known risk factors for oral cancer. Excessive exposure to sun or tanning bed use are risk factors for lip cancer. Exposure to the human papillomavirus (HPV) is another potential risk factor. Oropharyngeal (mouth/throat) cancer is now the most common HPV related cancer in the U.S. Men are three to four times more likely to be diagnosed with oropharyngeal cancer than women. Kentucky has the highest rates of HPV related cancers in the U.S. The CDC estimates that 92% of HPV cancers could be prevented by the HPV vaccine. Over 270,000,000 million doses of the HPV vaccine have been given since 2006 with no serious safety issues found.

Signs & Symptoms

Signs and symptoms of oral cancer include a sore in the mouth or on the lip that doesn't heal within 14 days, red or white patches in the mouth, or hoarseness of the voice that lingers for a prolonged period. Additional signs and symptoms to mention to a healthcare provider include: Feeling like something is stuck in your throat; Numbness in the area of the mouth; Difficulty swallowing or moving the jaw or tongue; Pain in only one ear; A sore under a denture, that doesn't heal, even after a denture adjustment; or A lump or swelling that develops in the mouth or on the neck. 

Providers

Why should providers conduct oral cancer screenings?

Kentucky has the highest rate of oral cancer in the nation. Most cases are found late when survival rates are low. Providers can help by conducting oral cancer screenings to find pre-cancerous lesions and diagnose oral cancers early. 

Steps to Conduct an Oral Cancer Screening

  • Use a light source and gloved hands.
  • Looking for ulcerations, red or white patches, lumps, and exophytic growths.
  • Pull the lips and cheeks out to examine the mucosa.
  • Examine the hard palate and use a tongue depressor to examine the soft palate, pharynx, tonsils, and uvula.
  • Ask the patient to raise their tongue and look at the floor of the mouth.
  • Palpate for lumps with your fingers under the chin.
  • Use a gauze to grasp the tongue and pull right and left to examine all surfaces.
  • Check the floor of the mouth for lesions and palpate for lumps.
  • Palpate the neck for lumps.
  • If you find something suspicious, call your local oral surgeon or UK Oral Surgery at 859-323-6080.

Other Ways to Help

Encourage HPV vaccination. Kentucky has the highest rates of HPV related cancers in the U.S. Oropharyngeal cancer is now the most common HPV related cancer in the U.S. Men are three to four times more likely to be diagnosed with oropharyngeal cancer than women, making it very important to vaccinate males as well as females. The CDC estimates that 92% of HPV cancers could be prevented by the HPV vaccine. Over 270,000,000 million doses of the HPV vaccine have been given since 2006 with no serious safety issues found. 

Encourage patients to get a professional oral cancer screening at a dental office once per year, even if they have no teeth.

Encourage patients to check their own mouth once a month for signs of oral cancer, such as unhealed sores, white/red areas or swellings. 

Oral Cancer Awareness

Spread the word: Oral cancer screenings critical

On warm summer weekends, a group of health care professionals stand under a tailgate tent in the Harlan County Food City parking lot, waving shoppers over. The team has an important mission: encouraging Eastern Kentuckians to take a brief detour from their grocery lists to stop in for an oral cancer screening.

The screenings are fast, easy, and efficient – and they’re saving lives.

April happens to be Oral Cancer Awareness Month, a time to highlight the dangers of oral cancers and the importance of screenings. Eastern Kentucky, as it turns out, can serve as a roadmap for successful strategies to engage more people in oral cancer screenings and prevention.

According to the National Institute of Health, Kentucky has one of the nation’s highest incidences of oral cancer. A project launched in 2019 by the University of Kentucky College of Dentistry is working to reverse that trend.

The Eradicate Oral Cancer in Eastern Kentucky project, funded through a $1 million grant from the United Health Foundation, is focused on improving outcomes in Harlan, Letcher, and Pike counties, places where oral cancer is as much as 54% higher than the state’s already above the norm average.

While oral cancer can strike anyone, leading risk factors include smoking, chewing tobacco, excessive alcohol consumption, and infection with certain strains of the Human Papilloma Virus (HPV). Several troubling health trends put Kentuckians at a higher risk. According to the United Health Foundation’s America’s Health Rankings report, almost a quarter of Kentucky adults smoke (23.6%) and 17% report excessive drinking. Additionally, Kentucky has the highest rates of HPV-related cancers in the U.S.

Early detection and getting patients into treatment is key to improving survival rates. According to the American Dental Association, the five-year survival rate for people with localized oral cancer is 83%. The survival rate drops to 36% when the cancer has metastasized, or spread, to other areas.

To support better health outcomes in Eastern Kentucky, we’re focused on community education, bolstered through outreach events and partnerships that extend our impact. It’s an all-hands-on-deck approach.

Local partnerships are essential. We’ve met with mayors and local government officials to encourage more conversations about oral cancer in the community. We’re also training health care providers on how to screen oral cancers and equipping them with literature and resources.

Our efforts are working. When we originally launched the Eradicate Oral Cancer in Eastern Kentucky project, we had a goal of screening 1,000 patients. Through pop-up events at grocery stores to setting up sessions at local festivals, farmers’ markets, churches, and health care clinics, we quickly surpassed our original goal to reach almost 2,000 screenings and have increased our goal to completing 3,000 screenings.

Like many of our day-to-day activities, the COVID-19 pandemic has forced us to rethink outreach efforts. We’ve traded parking lot tents for pre-arranged appointments at local pharmacies, health care clinics and hospitals, with safety precautions in place. Despite the challenges of the pandemic, our work and commitment continue. In fact, because of the initiative’s success, we have expanded to include nearby Perry, Floyd, and Johnson counties.

The Eradicate Oral Cancer project is making a tangible difference in Eastern Kentucky by raising awareness about the importance of early detection and peoples’ risk factors for oral cancer. It’s a message that needs to be spread far and wide.

While April happens to be Oral Cancer Awareness Month, oral cancer is something we should all be vigilant about year-round. All adults should have a professional oral cancer screening at least once per year, even if they have no teeth. For helpful information on signs and symptoms to be aware of in between dental visits, visit ukdentistry.org/oral-cancer.

Let’s all continue the conversation about oral cancer so more people know how to access screenings and why early detection is critical. Together, we can eradicate oral cancer in Eastern Kentucky and beyond.

Pamela A. Van Arsdall, DMD, MPH, is a professor at the University of Kentucky College of Dentistry and is the grant education director for the Eradicate Oral Cancer in Eastern Kentucky project. She can be reached at pam.stein@uky.edu.

Melvyn Yeoh, DMD, MD, is a professor at the University of Kentucky College of Dentistry and the Director for the Eradicate Oral Cancer in Eastern Kentucky project. He can be reached at melvyn.yeoh@uky.edu.

"Eradicate Oral Cancer in Eastern Kentucky" Project

Oral Cancer Screening Team

Kentucky has one of the nation's highest incidences of oral cancer, according to the National Institutes of Health. As part of the UK College of Dentistry's "Eradicate Oral Cancer in Eastern Kentucky" project, the college is working with local healthcare departments and others to offer free oral cancer screenings in Floyd, Harlan, Johnson, Perry, Pike, and Letcher Counties, as the prevalence of oral cancer is high in these areas. Project efforts are made possible by grant funding from the United Health Foundation (UHF). 
 
This project seeks to raise public awareness of the symptoms of oral cancer and its links to heavy alcohol and tobacco use, provide free oral cancer screenings in partnership with local health departments, and help connect patients who need additional care to cancer specialists in Lexington. Almost 2,000 free oral cancer screenings have been provided. 
 
Following COVID-19 public health concerns, the UK College of Dentistry looks forward to scheduling additional free oral cancer screenings and educational oppourtunties in Pike, Harlan, and Letcher Counties. 
 
About the United Health Foundation
Through collaboration with community partners, grants and outreach efforts, the United Health Foundation works to improve our health system, build a diverse and dynamic health workforce and enhance the well-being of local communities. The United Health Foundation was established by UnitedHealth Group (NYSE: UNH) in 1999 as a not-for-profit, private foundation dedicated to improving health and health care. To date, the United Health Foundation has committed $430 million to programs and communities around the world. We invite you to learn more at www.unitedhealthgroup.com/SocialResponsibility.
 
 
*National Cancer Institute (NCI), Surveillance, Epidemiology, and End Results (SEER) Database
Based on people diagnosed with oral cavity or oropharyngeal cancer between 2009 and 2015.
 
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