Dental Care May Improve Oral Cancer Survival

Five-year survival rates for patients with oral cavity or pharynx cancers have been steadily increasing, thanks to earlier detection and improved treatment. However, survival rates for white Americans remain higher than for many minorities, despite the fact whites and non-Hispanics have the highest incidence of these cancers.¹ Erasing this health disparity is part of the U.S. Centers for Disease Control and ­Prevention (CDC) Healthy People 2020 Oral Health Objectives. And because oral and oropharyngeal cancer screening is encouraged in dental settings, the disparity in survival rates may speak to disparities in access to dental care.

Oral cavity and pharynx cancers are most frequently diagnosed in individuals between the ages of 55 and 64. Males are the most likely to develop these cancers, with whites and non-Hispanics at greatest risk. However, white males are less likely to die from these cancers than black men, and have about the same likelihood of mortality as native American/Alaska native men, despite the fact this group has a much lower incidence rate.¹

Early detection is key to survival. When an oral cavity or pharynx cancer is localized (confined to the primary site), 83.7% of patients survive five years. When it is regional (in the primary site and also the lymph nodes), 65% of patients survive five years. However, when it has metastasized, only 39.1% of patients survive five years.¹

In 2017, the American Dental Association developed an official guideline for evaluating potentially malignant disorders in the oral cavity, and called on dentists to provide all patients with an intraoral and extraoral visual and tactile examination for potential cancers.² Yet oral health screenings to detect cancers at earlier and more treatable stages only benefit those who visit the dentist.

According to CDC data from 2015, women (67.3%) are more likely to have seen a dentist in the past year than males (60.5%), and among racial groups, whites and Asians are the most likely to have seen a dentist in the past year.³ In addition to ramping up screening efforts in dental settings, the disparity in oral cavity or pharynx cancer survival rates lends further urgency to the need to break down barriers to care that prevent some individuals from seeing the dentist on a regular basis.

REFERENCES

1. National Cancer Institute Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Oral Cavity and Pharynx Cancer. Available at: https:/ / seer.cancer.gov/ statfacts/ html/ oralcav.html. Accessed March 19, 2019.
2. Lingen MW, Abt E, Agrawal N, et al. Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity. J Am Dent Assoc. 2017;148:712–727.e10.
3. National Center for Health Statistics. National Health Interview Survey, 2015.

From Decisions in Dentistry. April 2019;5(4):46.