Study Shows Dentists Are Detecting More Oral Cancers

Oral health professionals in Ontario, Canada are detecting more cases of oral cancer and pre-cancer than ever before, according to an 11-year study led by University of Toronto researchers. The findings show an increase in overall numbers of carcinomas and dysplasia detected by dentists, indicating the important role clinicians play in screening. The study, “Increase in Detection of Oral Cancer and Precursor Lesions by Dentists,” appears in the Journal of the American Dental Association.

“Our study highlights the fundamental role of dentists in the diagnosis of oral cancer, and particularly premalignant oral lesions. These premalignant lesions have the potential of transforming to cancer and early detection can improve patient survival,” says Marco A. O. Magalhaes, DDS, MSc, PhD, Dip, ABOMP, FRCD(C), an assistant professor at the University of Toronto
 Faculty of Dentistry. Magalhaes, who led the study, also serves as an oral pathologist at the Toronto Oral Pathology Service (TOPS).

The team analyzed 63,483 biopsies submitted to TOPS from 2005 to 2015. The data was compared to biopsy data collected by the Ontario Cancer Registry and Cancer Center Ontario.

Researchers report the percentage of oral cancer detected through the biopsy service rose significantly in that timeframe. While only 56 cases of oral cancer and 99 cases of oral epithelial dysplasia were detected through biopsy in 2005, by 2015, the number of cancers detected through the service increased to 103 cases of oral cancer, with dysplasia cases rising to 374 cases. TOPS diagnosed a total of 828 cases of oral cancer and 2,679 premalignant lesions between 2005 and 2015.

Using 2015 data, biopsies for 99.95% of cases received by TOPS were performed by oral health professionals, with 52.7% submitted by oral and maxillofacial surgeons, 16.1% submitted by periodontists, and 12.1% submitted by endodontists.

The number of diagnosed cases outpaced the increase of oral cancers diagnosed in the region, the increased number of licensed dentists in Ontario, and the rise in population in Ontario.

Oral health professionals play a unique role in early oral cancer detection by providing oral cancer screenings and educating patients about self-examination techniques and risk factors. In their role, clinicians should follow a suggested examination sequence that consists of extraoral and intraoral exams.

“We believe there is a combination of increased awareness from patients and dentists regarding oral cancer and premalignant lesions. We also believe that continued education for dentists and better training has improved detection,” says Magalhaes.

Featured Image: Marco A. O. Magalhaes, DDS, MSc, PhD, Dip, ABOMP, FRCD(C), assistant professor at the University of Toronto
 Faculty of Dentistry; and Denise Lopes Eymael, University of Toronto Faculty. Credit: Jeff Comber, University of Toronto Faculty of Dentistry

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