Screening Flashcards
Define screening:
Screening is the application of a test to people who are apparently free of disease to identify those who may have the disease from those who may not
What are the types of prevention of disease?
Primary: prevent disease from developing (education of risk factors)
Secondary: to detect disease while it is localised or early (screening for OC in chair)
Tertiary: to mitigate morbidity from established disease and to improve quality of life
What is sensitivity?
What is specificity?
Sensitivity: true positive/true positive + false negative and is the proportion of the population who are correctly classified as having the disease
Specificity: true negative/true negative and false positive and shows the proportion of the population correctly classified as disease-free
Tests aim to have a sensitivity and specificity in the order of 80% or more
List some features associated with malignant progression in oral potentially malignant disorders:
- size >200mm
- texture: non homogeneous
- colour: red, speckled then white
- site: tongue and FOM
- sex: females
- age: >50 years
- habits: non-smokers
What does cancer look like?
- red patch (erythroplakia)
- white patch (leukoplakia)
- red/white speckled patches
- ulcers - malignant tend to be painless
- indurated margins - thick, rubbery margins of ulcers
- endophytic (inwards growing) and exophytic (outwards growing)
What are worrying features of cancer?
- painless
- high risk sites - FOM/lateral tongue
- duration - short but rapidly progressing
- size - bigger more concerning
- bone involvement
- spread to draining lymph nodes
- perineural spread - into nerves, can present as pain
- vascular invasion - metastasise outwith oral cavity
What should you do when you come across a lesion?
What will happen to the patient?
- photograph/document in notes
- eliminate trauma
- review
- refer using urgent pathways
Patient:
- biopsy
- imaging
- diagnosis
- treatment
When do you do an extra-oral exam?
- all new patients
- all review patients
- when the patient reports any changes
- when you notice any changes
What are you looking for in an extra-oral exam?
- symmetry
- soft, non-tender lymph nodes
- palpate all anatomical sites of lymph nodes
- skin moves freely over the nodes, they are not attached
- think about anaotmical drainage from mouth to nodes oof the neck
- symmetrical salivary glands
- symmetrical TMJ and movements
- malignant - non tender, rubbery nodes
