Oral Cancer Flashcards
Incidence of Oral Cancer in UK (Male & Female)
3% of all cancers
M = 20/100,000
F = 9.3/100,000
5 year survival rate of Oral Cancer in UK
58%
Percentage of pt’s that present with late stage Oral cancer
70%
Risk factors for oral cancer
Tobacco
Alcohol
Sunlight
Infections; Viruses (HPV -associated with 60% of OPSCC), Fungi (Candida), bacteria.
Recommended alcohol limits for men & women
14 units of alcohol a week
1 unit = 1 shot, 3 units = 1 pint of beer or 1 large glass of wine (175ml)
Definition of a Potentially Malignant Oral Lesion (PMOL)
A morphologically altered tissue in which cancer is more likely to occur than in its apparently normal counterpart
WHO definition of a Leukoplakia
A white patch that cannot be rubbed off and cannot be characterised clinically or histologically as any other disease and that is not associated with any physical or chemical causative agent EXCEPT the use of tobacco.
Prevalence of Leukoplakias in UK
2.8%
Types of Leuoplakia & 5 Yr Risk of Malignant Change
Homogeneous = 1-5% Non-homogeneous = 20%
WHO definition of Erythroplakia
Red patch on the oral mucosa which cannot be characterised clinically or histologically as due to any other condition.
How large can the region of field change be?
7cm away from the visible lesion (‘field’ of abnormal mucosa)
What are the architectural features of atypia in the epithelium?
Irregular epithelial stratification
Loss of basal cell polarity
Drop-shaped rete processes
What are the cytological features of atypia in the epithelium?
Increased number of mitotic figures Cellular & nuclear pleomorphism Nuclear hyperchromatism ('ploidy') Individual cell keratinisation Loss of intercellular adherence
What are the types of dysplasia?
- Mild = architectural changes in lower third, mild cytological atypia.
- Moderate = architectural changes in mid third, moderate cytological atypia.
- Severe = architectural changes into upper third, severe atypia and numerous mitosis.
- Carcinoma-in-situ = severe dysplasia/abnormal archiecture involving the full epithelium thickness, pronounced cytological atypia (mitotic abnormalities frequent), malignant but NOT invasive.
Percentage of Homogeneous Leukoplakias that show Dysplasia
20%