November 2013

Oral Cancer

Oral Cancer: The Numbers Speak For Themselves

In 1984, there were 3,030 reported cases of oral cancer in the UK. That figure rose to 6,240 by 2009, and is predicted to reach 9,200 by 2030. Rates continue to rise across genders and age groups, with more young people developing the disease than ever before.(1)

  • Oral cancer makes up 2% of all new cancer cases, and is currently the 15th most common type in the UK.
  • As of 2010, the UK's lifetime risk of developing oral cancer is 1 in 84 for men, and 1 in 160 for women.(2)
  • The UK shows a great geographical divide in oral cancer occurrence, with the highest rates happening in Scotland, Northern Ireland and the north of England.(3)
  • The most common types of oral cancer in the country are tongue and mouth, which jointly accounted for 60% of the cases in 2010.(4)
  • Half of all patients diagnosed with oral cancer in the UK from 1996 to 1999 didn't survive(5), and there were 1,985 reported deaths from the disease in 2010.(6)

It's more important than ever for dental professionals to be the leaders in oral cancer screening and advocacy. As Oral Cancer Awareness Month comes to an end, it is time to make oral cancer screening and education a key focus for all patients.

  2. Oxford Cancer Intelligence Unit Profile of Head and Neck Cancers in England: Incidence, Mortality and Survival, 2010.
  3. National Cancer Intelligence Unit Head and Neck Cancer Profiles Accessed August 2013
  4. From Cancer Research UK, data provided by the following upon request: Office for National Statistics, June, 2012; ISD Scotland, April 2012; Welsh Cancer Intelligence and Surveillance Unit, April 2012; Northern Ireland Cancer Registry, October 2012
  5. Office for National Statistics (ONS). Cancer Survival: England and Wales, less common cancers by age group. London: ONS; 2005 South West Public Health Observatory.
HPV 16

The Incidence of HPV

The Human Papilloma Virus (HPV) DNA is found in 2 of 3 samples of cells tested. Not all are the type that increase the risk of cervical or oral cancer - the high risk types are 16, 18, 31 and 45. It is estimated that 80% of people will get an HPV infection but most (99%) will clear the virus with no resulting health problems.

HPV-related oral cancer seems to have a better outcome than cancer caused by tobacco or alcohol. Individuals with HPV-related cancer tend to be younger, and less likely to be smokers or drinkers. Smoking increases the risk of developing cancer along with the number of sexual partners.

A study of 5,600 men and women found the rate of oral HPV incidence was:

  • 10% for men and 4% for women
  • Highest rates are in 30 - 34 year olds and 60 - 64 year olds
  • Men are 5x more likely to be infected with HPV-16

A 2012 study in the Journal of Infectious Diseases found that older women who tested positive for an HPV infection may have a reactivation of a strain picked up years ago, not a newly acquired sexually transmitted infection. This questions the concept of clearance of the virus and also explains the increase in incidence around the age of 50.

The most recent connection of HPV to cancer was shown in a study of patients with lung cancer. Researchers found 4 of 36 tissue samples showed signs of infection from HPV-16 and HPV-18 in non-smokers with lung cancer. Earlier it was noted that people with lung cancer had an increase in high risk types of HPV regardless of smoking status or gender.

Dental professionals should educate their patients on the risk of oral cancer from smoking, alcohol and the Human Papilloma Virus. An informed public can better protect themselves from disease.

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