OC: Screening Programmes Flashcards
Oral cancer screening?
There is no worldwide oral cancer screening programme as of yet. Unlike other cancers like breast and cervical.
Primary prevention
Prevents a disease developing (educating patients on risk factors etc).
Secondary prevention
Screening by a dentist - allows detection of a disease while it is localised or “early”.
Tertiary prevention
To mitigate the morbidity from established disease and to improve quality of life.
What meant that oral cancer didnt qualify for a national screening programme?
20 point criteria for what cancer requires a UK screening committee
Population screening programmes types (3)
Mass screening (everyone at all opportunities)
Selective screening (i.e women 25-74 age for cervical cancer)
Opportunistic screening (patient presenting to a dentist for a screening)
Sensitivity of a screening programme
True positives/(true positive + false negatives)
This shows the proportion of the population who are correctly classified as having the disease.
Specificity of a screening programme
True negative/(true negative + false positive)
This shows the proportion of the population correctly classified as disease-free.
What percentage of sensitivity and specificity is aimed for with tests?
80% or more.
How accurate is the screening for oral cancer?
No tests are currently accurate enough to detect oral lesions for an official screening programme.
How accurate is the screening for oral cancer?
No tests are currently accurate enough to detect oral lesions for an official screening programme.
Best way to screen for oral cancer is a oral examination by a dentist.
Oral potentially malignant disorders examples
Lichen planus
Lesion about >__cm are more likely to be malignant
> 20cm
Texture _________ more likely to be malignant
Non-homogenous (lumpy etc)
Colour of lesions most likely to be malignant
- Red lesions
- Speckled lesions
- White lesions
Site where lesions are most likely to be malignant
Tongue or FOM (lingual gutter)
Gender more predisposed to malignant lesions
male
Age more predisposed to malignant
Over 50 years old.
What does cancer look like?
Red patch, white patch, speckled patch, ulcer, indurated margins, endophytic, exophytic.
Leukoplakia
White patch
Erythroplakia
Red patch
Painless ulcer
WORRYING - potentially malignant
What should you do if you find a concerning lesion?
Taking a detailed history
Photograph the clinical appearance
Eliminate trauma (filling down rough fillings etc)
Review
If it doesn’t heal within a 2-3 week period refer using urgent pathways.
What will happen to patient after finding a lesion?
- Biopsy (refer them on to nearest maxfax urgent 2 week referral)
- Imaging (MRI, CT - to check for spread)
- Diagnosis
- Treatment (often surgery)