Early detection and diagnosis of oral cancer: Strategies for improvement

Aim: To discuss the broad evidence base on which strategies to enhance the early detection and diagnosis of oral cancer and potentially malignant disorders (PMD) should be designed. Methods: We reviewed the evidence for current oral mucosal screening approaches and used a theoretical model to explore behavioural influences on the early detection of oral cancer, and to outline strategies for future interventions and research. Results: While considerable advances are being made in techniques to detect oral cancer, there has been less attention paid to the patient and health care provider factors which may influence delays in detection of oral cancer. This review proposes that unless future theory based studies target these aspects of oral cancer, then efforts to improve its timely detection will have limited effectiveness. Conclusions: A primary tenet of screening programs, whether opportunistic, targeted or population based is that at -risk people present for screening. They must also present early enough in the disease process for detection to lead to a better outcome. This is particularly relevant for oral cancer. Five-year survival rates have not improved over past decades and this has mainly been attributed to delays in detection. Early detection, diagnosis and treatment significantly enhance survival rates and reduce morbidity. (C) 2013 The Authors. Published by Elsevier Ltd.