Early Detection Of Precancerous And Cancerous Lesions – A Review.

ABSTRACT

Oral cancer screening should be a routine part of every annual dental examination. These regular check-ups, including examination of the entire oral cavity, are essential in the early detection of precancerous and cancerous lesions. Over 90% of these tumours are squamous cell carcinomas, which arise from the oral mucosal lining. In spite of easy accessibility of the oral cavity to direct examination, these lesions are often missed and not detected until late stage. The survival rate for oral cancer has remained essentially unchanged over the past three decades. New technologies have provided an exciting new array of diagnostic tools for localizing or emphasizing abnormal mucosa in the dental office. Some of these technologies claim to identify atypical cells prior to biopsy, even before there are clinically visible mucosal changes, hence, can allow a more confident assessment of risk and localization of the most “suspicious” area to biopsy. In essence, molecular-level detection of dysplastic oral mucosal change appears to be moving into the practitioner’s office. Recently, there has been an increasing trend of optical spectroscopy methods which depends on the optical spectrum derived from any tissue that contains information about their histological and biochemical make-up of that tissue. Toluidine blue staining and cytological analysis are the main investigations for screening. Oral cancer has a tendency to be detected at a later stage which is detrimental to the patients because of its high mortality and morbidity rates. Most technologies are beneficial but must be used with intelligence and must be considered adjunctive tests rather than stand-alone diagnostic tools. The purpose of this article is to review the diagnostic aids and recent advances in early detection of precancerous and cancerous lesions.