New oral cancer tests: crucial or wasteful?
Source: nytimes.com Author: Laurie Tarkan Though relatively rare, it is one of the easiest cancers to spot and diagnose. And if treated early, it is usually curable. So why do experts find oral cancer so vexing? Despite the many advances against cancer in recent decades, the statistics on this form of it remain discouraging: more than 60 percent of cases are diagnosed in the late stages, and the five-year survival rate is a disappointing 59 percent. Moreover, oral cancer is increasing in people traditionally at low risk, a phenomenon partly attributed to the rise of the cancer-causing human papillomavirus, or HPV, which can be transmitted through oral sex. Now some dentists — whose visual examinations have long been a first line of defense against oral cancer — are using screening devices that they say may help identify cancers and premalignant lesions. But these new tests have set off a debate over cost and effectiveness. Experts are divided on whether they will reduce mortality from oral cancer or simply lead to a wave of expensive and unnecessary biopsies. An estimated 35,300 Americans learned they had oral cancer last year, and about 7,600 died from the disease. For survivors, oral cancer can be painful and disfiguring, and can destroy the ability to taste and enjoy food. Smokers and heavy drinkers are considered at highest risk for the disease, but 25 percent of those who receive a diagnosis are neither. Still, the lifetime risk of oral cancer — about 1 in 99 — [...]