Impact of cancer screening in California over past 15 years

Author: University of California – Davis Health System

A new report from the UC Davis Institute for Population Health Improvement (IPHI) shows the impact of cancer screening over the past 15 years, identifying areas where increased screening and other cancer-control efforts would save lives and significantly benefit population health.

heatmapThe CalCARES report uses heat maps to show areas with higher proportions of particular cancers diagnosed at a late stage, pointing to a need for increased screening. The CalCARES report uses heat maps to show areas with higher proportions of particular cancers diagnosed at a late stage, pointing to a need for increased screening.

“We have effective screening tests for several cancers, which allow physicians and other health-care providers to identify the disease at an earlier stage — often before symptoms surface — when treatment is more likely to result in a cure,” said senior author of the report and IPHI Director Kenneth W. Kizer. “However, too many Californians are not getting screened and, as a result, many persons are not being diagnosed until their cancers have progressed to an advanced stage.

“With cancer now surpassing heart disease as the leading cause of death in California and 22 other states, we need to increase cancer screening efforts to save lives,” he said.

IPHI’s California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program works in partnership with the California Department of Public Health to manage the day-to-day operations of the California Cancer Registry (CCR), the state mandated population-based cancer surveillance system. CalCARES researchers routinely review cancer registry data to monitor cancer incidence and mortality trends and identify opportunities to improve cancer-control efforts and reduce the occurrence of cancer.

For their latest report, CalCARES researchers reviewed statewide data from 1999 through 2013 to identify trends in the diagnosis of advanced cancers of the breast, colon and rectum, cervix, prostate, skin, and oral cavity and pharynx — six sites of cancer for which effective screening methods exist. Some of these screening methods include visual inspection or procedures such as mammography, Pap smears, colonoscopy, fecal occult blood tests and prostate-specific antigen testing.

“Showing where in California cancer is being diagnosed after it has spread beyond a localized site shows where lives can be saved through improved screening,” Kizer said.

The report found that in California overall, late-stage diagnoses for cervical, prostate and oropharyngeal cancers significantly increased, but significantly decreased for breast cancer. Diagnosis of late-stage colorectal cancer and melanoma (a form of skin cancer) remained relatively constant. For each of these cancer sites, the researchers calculated important regional and county differences in advanced stage of diagnosis, which takes into account the growth and size of the tumor and whether it has spread to the lymph nodes or other organs.

Trends in advanced cancer diagnoses by cancer type
Cervical cancer: Advanced cancer diagnoses increased statewide, with the highest percentage of late-stage diagnoses in the Central Valley region, followed by the Sacramento and Northern California regions. In the most populated regions of the state, Los Angeles-Orange, San Francisco Bay Area and Scan Diego-Imperial, late-stage diagnoses remained relatively steady. In the San Francisco Bay Area, for example, nearly 50 percent of cases were diagnosed at a late stage in 2013. Only El Dorado county and the High Sierra region saw a significant decrease.

Prostate cancer: Advanced cancer diagnoses increased statewide, especially in Los Angeles-Orange, Central Valley and Sacramento regions, and in Kern, Imperial, Del Norte-Humboldt, Lake and Siskiyou-Trinity counties, where incidence has been persistently high in recent years. Only Napa and Monterey counties saw significantly decreasing percentages of advanced prostate cancer diagnoses in the study period. Since the late 1990s, San Francisco Bay Area has consistently had the lowest percentage of advanced-stage diagnoses for prostate cancer.

Oropharyngeal cancers (cancers of the lip, tongue, floor of mouth, gingiva (gums), mucosa, throat and tonsils): Advanced cancer diagnoses increased in Los Angeles-Orange, San Francisco Bay Area, Central Valley, San Diego-Imperial and Sacramento regions. No counties had decreasing trends.

Female breast cancer: There has been a progression towards early diagnosis of breast cancer statewide, especially in San Francisco Bay Area, Sacramento, San Diego and the High Sierra regions, but pockets of late-stage diagnoses persist in Del Norte-Humboldt and in San Bernardino, Kern, Merced and Kings counties, which had the highest proportion of advanced breast cancers diagnoses in the state.

Colorectal cancers: Advanced cancer diagnoses increased in San Diego-Imperial and Northern California counties, decreased in the San Francisco Bay Area, Inland Empire and Central Valley regions, and remained unchanged and persistently high in Sacramento, Placer, Mendocino, Lake, Lassen-Modoc-Plumas and Santa Cruz counties over time. Counties with worsening trends include Santa Barbara, Sonoma, Butte and Sutter.

Melanoma: Advanced cancer diagnoses decreased in San Francisco Bay Area and Central Coast Counties and increased in Sacramento, the High Sierra and Los Angeles County regions.

IPHI researchers calculated the percent of cases diagnosed at an advanced stage for each cancer type and each county or region by dividing the number of advanced stage cases by the total number of cases for each year. The range of percentages were divided into eight color-coded categories, or heat maps, to indicate a decreasing trend (green tones) an increasing trend (red tones). Counties with fewer than 15 cases were excluded from the county analysis but were included in the regional and state calculations.

Two other recent studies by CalCARES investigators have shown a particularly large need for increased screening for colorectal cancer among Hispanic men in California and a need for greater use of gene expression profile testing for women with early stage breast cancer, especially among women with Medi-Cal health insurance.

The above post is reprinted from materials provided by University of California – Davis Health System. Note: Content may be edited for style and length.

September, 2016|Oral Cancer News|

Shedding light on oral cancer

Author: staff

A team of Indian cancer researchers led by Dr Narayanan Subhash has developed a simple, non-invasive spectral imaging system that holds the possibility of rapid, inexpensive mass screening. Even in the hands of non-clinical staff, it is capable of real-time discrimination of healthy oral tissue from pre-malignant and malignant tissues with accuracy comparable to the gold standard histopathology of a biopsy sample.

The core of the novel Diffuse Reflectance Imaging System (DRIS) is an Andor Luca-R EMCCD camera, which captures monochrome images of the patient’s mouth at 545 and 575 nm.

Andor’s SOLIS software computes a ratio image (R545/R575) of the area under investigation and generates a Pseudo Colour Map (PCM) where blue designates healthy tissue, red denotes dysplastic/pre-malignant tissue and yellow identifies malignant tissue.


This allows rapid visual differentiation of oral lesions and identification of regions with pre-malignant characteristics.


“Since mortality from oral cancer is particularly high, early detection, diagnosis and treatment is vital in increasing the survival rate of those with the disease,” says Dr Subhash. “Our imaging method has the great advantage of non-invasively scanning entire lesions and their surrounding areas and automatically categorising these oral lesions into normal/clinically healthy, pre-malignant, and malignant tissue in real-time.

“It also delineates the boundaries of neoplastic changes and locates sites with the most malignant potential for biopsy, thereby avoiding unnecessary repeated biopsies and delay in diagnosis. What’s more, imaging the entire region may also help the surgeons to identify the margins of the lesion that cannot be easily visualised by the naked eye during surgical interventions.”

Orla Hanrahan of Andor added: “The Luca-R EMCCD camera is well-equipped to handle this demanding role. It is built around a monochrome, megapixel frame transfer EMCCD sensor to deliver single photon detection sensitivity and unrestrained QE (65% max) in a TE cooled, USB 2.0 camera platform.”

February, 2014|Oral Cancer News|

What the ‘rinse-and-spit’ oral cancer test could mean for dental professionals and their patients

Author: Vicki Cheeseman, Associate Editor

A new oral cancer “rinse-and-spit” test for the early detection of tumors could mean great things for dental professionals and their patients when the test becomes available for use in dental practices nationwide possibly as early as late 2014 or into 2015.

The test, developed at the University of Miami Miller School of Medicine and exclusively licensed to Vigilant Biosciences, Inc., will be available as a low-cost, point-of-care screening test for the early detection of oral cancer, and is envisioned as a kit with a special oral rinse and test strip. The test strip detects proteins that are markers of oral cancer and are captured by the rinse. The markers may be present before a lesion is easily visible. Early detection tests are critical because the majority of patients present in late stage when cure rates reach only 40%.

I asked Dr. Franzmann to explain how the test strip works.
“The beauty of the test strip approach is that it is so simple for the patient and health-care professional to use. The technology behind the test strips has been around for many years and is used for many medical applications. The key is to know what to test for. Through our research, we discovered certain proteins, or markers, are present in the saliva in the early stages of squamous cell carcinoma, the most common head and neck cancer.”

How early can tumors be detected with the test strip?
Dr. Franzmann said, “The tumors can be detected in some instances before they become noticeable to the patient or the dentist. This is so important because today only about 40% of oral cancers are caught early enough to be cured.”

Does the cancer test strip distinguish among various types of tumors, or simply whether a tumor is cancerous or not?
Dr. Franzmann explained, “This test is for detecting squamous cell carcinoma, the most common head and neck cancer. The main risk factors for squamous cell carcinoma are tobacco and alcohol use and human papillomavirus infection.”

Once a test is performed, how long does it take for a patient to receive the results?
She continued, “This is a point-of-care test, meaning that the patient receives results in just a few minutes during the office visit.”

So, the big question is, when the product becomes available for dental offices, will it become part of the standard oral cancer screening process for patients?
Matthew H.J. Kim, JD, CEO of Vigilant Biosciences, said, “We believe that there is a tremendous unmet need for a test that not only detects cancer early when there is a better chance for a cure, but also rules out the disease. Current products generate many false positives that lead to unnecessary biopsies and cause undue stress on the patient and their family while they wait for results.”

Much has been in the news lately about the link between human papillomavirus and oral cancer. Dr. Franzmann weighed in:
“HPV has been linked to oral cancer and cervical cancer. In both cases not all HPV infections lead to cancer. Other risk factors for oral cancer include smoking and alcohol use. Although our test is recommended for high-risk individuals including HPV infection, the number one cause of oral cancer, our test is designed to detect markers specific for oral cancer regardless of etiology.”

Vigilant’s new test product has the potential to play an enormous role in mass screening initiatives as it eventually becomes an integral part of routine oral cancer exams.

Mr. Kim firmly believes: “With health-care costs on the rise, it is important that new technology not only help find disease earlier when it costs less to treat but that it does a good job of ruling out disease to reduce unnecessary testing and patient anxiety.”

April, 2013|Oral Cancer News|

April: Oral Cancer Awareness Month

Source: Aspen Dental

April is Oral Cancer Awareness Month. According to Brian Hill, founder and executive director of the Oral Cancer Foundation, as many as 40,000 people in the United States will be told they have oral or pharyngeal cancer in 2012. Some of them may be sitting in your dental chair today. With one person dying of oral cancer every hour of every day, and more than 50% of those diagnosed not living more than 5 years, this is a reminder to screen every patient yourself, and encourage your dental hygiene staff to do the same.

The Statistics

About 100 people are diagnosed with oral cancer every day in the United States. Few people are aware that the death rate for oral cancer is higher than for many other types of cancers, which is because oral cancer often is not discovered until it has reached later stages. This is particularly true for human papilloma virus number 16 (HPV16)-related oral cancer, which occurs most frequently in the posterior areas of the mouth—at the base of the tongue, around the tonsils, and in the oropharynx—where it’s harder to spot without a very thorough exam. To further complicate things, HPV16-related cancer does not always present the tell-tale physical characteristics, including lesions, that are easily distinguished from healthy oral tissues. This is not good news, because HPV16 has reached epidemic levels in the United States: of the 37,000 incidences of oral cancer, about 20,000 (up to 60%) can be linked to HPV, according to Hill.

Oral cancer accounts for 85% of the cancers grouped under “head and neck” cancers. If the number of larynx cancer cases (for which the historic risk factors; tobacco and alcohol are the same) is added to the oral cancer category, we’re now talking 50,000 people diagnosed yearly and 13,500 deaths per year in this country. More than 640,000 new cases occur worldwide annually. These stats do not include brain cancer, which is its own category.

“Late discovery and misdiagnosis are the biggest problems,” Hill says. “I’m a very typical example of this.” Hill was misdiagnosed with an infection by a physician when a painless lump appeared on the side of his neck. When it had not resolved after a course of antibiotics, Hill, who had a background in dentistry, insisted on having a needle aspiration biopsy. Testing resulted in a diagnosis of HPV16-related squamous cell carcinoma, a very deadly cancer. Fourteen years after extensive surgery, and both radiation and chemotherapy, he has since heard from literally thousands of people that they were misdiagnosed more than once, told not to worry about it, or were merely given antibiotics. “Why are so many people diagnosed late?” Hill asks. “Because, according to one study,probably under 20% of dentists are performing oral screenings.” 1 Another problem is that public awareness about oral cancer, its early signs and symptoms, and its changing etiology, is low. Additionally, oral cancer has historically been linked to long-term tobacco use and high alcohol consumption (or a combination of both), with associated lesions usually seen in the anterior areas of the oral cavity. With the prevalence of HPV16-related oral cancer increasing at an alarming rate, and tobacco-related cancers on the decline, it is critical that dental and medical professionals re-educate the public to understand the current risk factors and the need for an annual professional screening.

The Impact of HPV16

It was reported in 2009, before the advent of HPV-related cancers, that oral cancer incidence rates were more than twice as high in men as in women, and both were on the decline.2 That was before HPV-infected individuals became the fastest growing segment of the oral cancer population. HPV16 is a human papillomavirus related to more than 150 other HPV versions, over 40 of which can be easily sexually transmitted.3 Nine of these are known to be cancer causing. HPV’s were directly linked to cervical cancer, also squamous cell carcinoma, which was the number one killer of women in 1948. “Using the cervical cancer model, once ‘opportunistic’ screening and PAP testing became routine, the cervical cancer death rate dropped 71% in 10 years,” Hill notes. “We have no ‘viruscide’. But we do have an HPV vaccine that can be administered before young people become sexually active.” This is important information to share with patients, because 50%-80% of Americans will have HPV in their lifetime according to the Center for Disease Control and Prevention (CDC). About half of all men and more than 3 out of 4 women will be diagnosed with it at some point.4

Detection vs Diagnosis

Signs and symptoms or oral cancer, if there are any, range from a sore area or lesion that bleeds easily, a lump or thickening of tissues in the mouth or neck, ear pain, indurations or hard spots in the mucosa, or a red or white patch or ulceration that does not resolve within 2 weeks. If any of these are evident, the patient should return within 7-14 days to confirm either persistence or resolution. Later symptoms include difficulty chewing, swallowing, and/or moving the tongue or jaws.2

Early stage (1 and 2) lesions, which may not be readily evident during a routine exam, usually are asymptomatic and often mimic other conditions.5 It is important for dentists to acknowledge that malignant and benign lesions are virtually indistinguishable clinically, and their biological relevance cannot be assessed based on their appearance.5 Most resources advise referring any persistent abnormalities to a specialist. “We have a highly defined referral system in dentistry,” Hill points out. “You don’t have to learn anything new; you don’t have to be the expert. You just have to refer suspect tissues up the professional chain for proper evaluation/biopsy. There are many kinds of oral lesions. You may see only 3 cancer cases in 20 years of practicing dentistry, but every time you find something, especially in stage 1 or 2, you have the opportunity to save a life. Dentists are the first line of defense.”

The American Cancer Society estimated in 2009 that almost 90% of oral cancers are squamous cell carcinomas, and more than 97% of these cancers occur in adults 35 years and older.5 People ranging in age from 25-50 who never smoked are the fastest growing group being diagnosed with HPV16-related oral cancer.6

Standard treatment usually involves radiation therapy and surgery, and often chemotherapy.2 Relative survival rates vary by stage at the time of diagnosis—in 2009, about 83% survived 1 year after diagnosis, 60% 5 years after diagnosis, and 49% after 10 years.2 However, today, the 5-year survival rate is only about 57% when you include all stages of the disease at time of discovery. This high death rate is directly tied to late discovery, when treatments are less effective.7 Studies reveal that oral and pharyngeal cancer are diagnosed at a localized stage in only one-third of patients in the United States.5 It’s time to make a difference.

The Oral Cancer Foundation

The Oral Cancer Foundation (OCF) is a national public service, non-profit organization dedicated to oral cancer prevention, education, research, advocacy, and patient support activities. Its website,, provides vetted information about rates of occurrence, risk factors, signs and symptoms, treatments, current research, complications, nutrition, clinical trials, related news, links to other sources, and treatment institutions. A free, anonymous, 8700-member patient/survivor discussion forum is open to the public, providing insights and inspiration. OCF also has a free RSS oral cancer news feed you may subscribe to which is updated several times a week. OCF is a valuable resource for patients, students, and practicing medical and dental professionals.

Visit to learn of its Oral Cancer Awareness Month initiatives (such as hosting a free screening event in April), and find information to share with your patients.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Studies underscore genetic complexity of head and neck squamous cell cancers

Source: Dentistry IQ

By Maria Perno Goldie, RDH, MS

While we should be screening patients for oral and pharyngeal cancer daily, April has been designated as the month when we highlight this disease, and increase awareness about its prevention and treatment.

Powerful new technologies that pinpoint the connections between human genes and diseases have clarified the background of cancer, singling out changes in tumor DNA that force the development of certain types of malignancies. Several major biomedical centers have collaborated to study head and neck squamous cell cancer. Their large-scale analysis has revealed a surprising new set of mutations involved in this disease.

The studies underscored the genetic complexity of head and neck squamous cell cancers. Two independent, multi-institution research teams identified a large number of genetic defects associated with head and neck squamous cell carcinoma (HNSCC), the most common form of head and neck cancer. The researchers sequenced the entire protein-coding regions, or exomes, of the DNA in dozens of patient tissue samples.(1,2)

Tobacco use, excessive alcohol consumption, and human papillomavirus (HPV) infection are known risk factors for HNSCC, including cancers occuring in the mouth and throat. The 5-year survival rate for many types of HNSCC has improved little over the past 40 years.

According to the authors, the degree of differentiation, or tumor cell grade, has never consistently been shown to be a clinical prognostic factor in HNSCC. They said it was surprising to find mutations in a series of genes that appear to contribute to differentiation.

Both studies found far fewer mutated genes in HPV-positive tumors than in HPV-negative tumors, supporting the idea that HPV-positive HNSCC, which has a better prognosis, is a distinct disease and thus merits different treatment.

Head and neck cancer has complex biology with many forms, and is not one disease. It’s many diseases, despite appearing identical under the microscope.

Human Papillomavirus (HPV)

The prevalence of HPV infections in the oral cavity is significantly higher among men than women in the United States, according to a study from researchers at Ohio State University and NCI’s Division of Cancer Epidemiology and Genetics (DCEG). Oral HPV infections have been associated with oropharyngeal cancer, subset of head and neck cancers that arise in the back of the tongue, throat, and tonsils, rates of which have risen dramatically over the last several decades. The study is the first to comprehensively document the prevalence of oral HPV infections in men and women in the United States. Overall, approximately 7 percent of people between the ages of 14 and 69 have an oral HPV infection. The prevalence of oral infections is much lower than that of infections in the genital tract. About 1 percent of the population has an oral infection with HPV 16, a type that is linked to cancer.(3)

HPV Virus

Using data from the National Health and Nutrition Examination Survey (NHANES), the researchers studied nearly 5,600 men and women ages 14 to 69, who provided an oral rinse and mouthwash gargle samples.(4) The most common subtype of HPV in the oral cells of study participants was HPV 16, the HPV type that is responsible for more than half of all oropharyngeal cancer cases.(3)

Oral HPV infections were three times more common in men than in women (10.1 percent versus 3.6 percent), with older men having the highest rates. Oral infections with HPV 16 were seen in 1.6 percent of men and 0.3 percent of women. The prevalence of HPV infections was highest among people who smoke at least a pack a day and those with more than 20 lifetime sexual partners.(3) HPV-related head and neck cancers are much more common among men than women. The higher oral HPV infection rates in men, in particular the over fivefold higher prevalence of HPV 16 among men compared to women, likely explains the discrepancy, according to the study authors.(3).

On October 25, 2011, U.S. vaccine advisers voted to recommend that boys be routinely vaccinated with Merck & Co.’s Gardasil vaccine to protect them from human papillomavirus or HPV infections, which cause genital warts and oral, penile, and anal cancers in males and cervical cancers in women.(5) The Advisory Committee on Immunization Practices, which advises the U.S. Centers for Disease Control and Prevention, voted unanimously to recommend routine use of Gardasil in 11- and 12-year-old boys to fight the sexually transmitted virus, with 13 yes votes and one abstention. (6)

Previously, the CDC has said doctors are free to use the vaccine in boys but it has did not go as far as recommending routine vaccination. The CDC also recommends HPV vaccinations made by Merck and GlaxoSmithKline for girls and women between the ages of 11 and 26.(5)

The CDC said in a statement the HPV vaccine will afford protection against certain HPV-related conditions and cancers in males, and vaccination of males with HPV also may provide indirect protection of women by reducing transmission of HPV. The CDC experts advised the panel there is no evidence the vaccine can cause “mental retardation,” a concern raised in a Republican presidential candidate debate. The vaccine costs $360 for a course of three shots.

Some experts acknowledge there may be concerns about the use of this vaccine in children. However, they say that if there is concern about vaccinating children against a potential sexually transmitted disease in the future, consider that we regularly vaccinate children against diseases that primarily occur in adults. Most people eventually get HPV infection, albeit it may not be a cancer-causing strain. However, once you get the infection, the vaccine does not help.(6) For more information on HPV and oral cancer, visit The Oral Cancer Foundation website.(7)

New Throat Cancer Gene Uncovered

Researchers at King’s College London and Hiroshima University, Japan, have identified a specific gene linked to throat cancer following a small genetic study of a family with 10 members who have developed the condition.(8) The researchers discovered a mutation in the ATR (ataxia telangiectasia and Rad3 related) gene, demonstrating the first evidence of a link between abnormality in this gene and an inherited form of cancer. The researchers say this finding raises new ideas about genetic factors linked to throat cancer and provides a platform for exploring the role of ATR more generally in cancer biology. They conducted a genome-wide linkage study in a U.S. family with an unusual hereditary condition affecting 24 members of the family over five generations.

Characteristics include developmental abnormalities of hair, teeth and nails as well as dilated skin blood vessels. Remarkably, nearly every person with the condition involved in the study had developed throat cancer (oropharyngeal squamous cell carcinoma) in their 20s or 30s. After analyzing blood samples, the scientists found that a single mutation in ATR was present in all the people with the condition, but none of the unaffected people had the mutation. Ten of the 13 people with the condition had developed throat cancer.(8) They plan to investigate the cancer pathways in more detail to try to find new treatments.

Squamous cell carcinoma

In summary, screen all patients for oral cancer!

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Fluorescent spray that can catch throat cancer early offers hope to 8,000 Britons diagnosed each year


A throat spray has been developed to spot cancer of the oesophagus at an early stage.

The disease, which killed Morse star John Thaw, is one of the most deadly cancers because it is often missed or wrongly diagnosed until too late.

Current methods used to detect it can be inaccurate, so many patients are given unnecessary invasive treatment including removal of their oesophagus, the ‘food pipe’ that connects the throat to the stomach.

Early detection key: If caught early, the cancerous cells can be zapped with an electric current which kills them without surgery

Early detection key: If caught early, the cancerous cells can be zapped with an electric current which kills them without surgery.

Now scientists have developed a fluorescent dye spray which sticks to healthy cells in the oesophagus but cannot attach itself to cancer cells or those in the early stages of turning cancerous. This gives a clear signpost to where the disease is developing.

If caught at this stage, the cancer cells can be ‘zapped’ with an electric current which kills them without surgery.

The treatment offers hope to more than 8,000 Britons a year who are diagnosed with oesophageal cancer.

One of the patients in the study had their entire oesophagus removed because a small pre-cancerous area had been identified – which using the dye was found to have been very small and could have been treated without surgery.

Deadly: Oesophageal cancer is one of the most fatal because it is often missed or wrongly diagnosed until it is too late

Deadly: Oesophageal cancer is one of the most fatal because it is often missed or wrongly diagnosed until it is too late.

Two patients whose cancer had not shown up using the current imaging methods – which usually only detect when a tumour has formed

– were found to have clear areas which needed treatment.

Lead researcher Dr Rebecca Fitzgerald, of the  Medical Research Council’s Cancer Cell Unit in Cambridge said: ‘Current methods to screen for oesophageal cancer are controversial – they are costly, uncomfortable for the patient and are not completely accurate.

‘Our technique highlights the exact position of a developing oesophageal cancer, and how advanced it is, giving a more accurate picture.

‘This could spare patients radical surgery to remove the oesophagus that can result in having to eat much smaller more regular meals and worse acid-reflux.’

Cases of the disease have doubled over the past 25 years particularly in men, thought to be linked to alcohol and smoking. Only 1 in 12 people survive for five years after diagnosis.

The researchers, funded by Cancer Research UK, tested the treatment on 80 biopsies from people with Barrett’s oesophagus, a condition which increases the risk of oesophageal cancer, as well as four patients with cancer.

They say the dye is ‘relatively cheap’ and unlikely to cause side effects as it uses a type of wheat germ protein found in our normal diet.

This binds to glycans, sugar molecules on the surface of cells inside the oesophagus and they added a flourescent tag to make it glow green under light of a specific wavelength.

It can then be seen using an endoscope – an optical tube passed down the oesophagus.

When diseased, the glycans’ structure changes – and current imaging methods cannot pick up these tiny changes.

The test needs to be trialled on newly diagnosed patients but the researchers, whose study is published today (Mon) in the journal Nature Medicine, believe it could be used routinely on patients within five years.

A UK trial is already being planned.

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: ‘Oesophageal cancer is one of the most difficult cancers to detect and treat.

‘We urgently need new ways to detect the cancer earlier, and this dye offers a great opportunity to treat the cancer more promptly and more successfully, potentially saving many lives a year.’

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
January, 2012|Oral Cancer News|

Oral Cancer Foundation Sponsors 13th Annual Oral Cancer Awareness Month in April 2012

Source: Dentistry IQ

Organization encouraging dental professionals to offer free screenings to the public

Did you know that the fastest growing segment of the oral cancer community is young, healthy non-smokers? It’s shocking but true. Exposure to the HPV-16 virus, the most common sexually transmitted infection, is now the leading cause of oral cancers in the U.S. There is little that can be done to stop this virus from spreading. Our only hope to save lives is through increased professional involvement and public awareness to generate early discovery of the disease process. To that end, the Oral Cancer Foundation (OCF) is encouraging the dental community to get involved in Oral Cancer Awareness Month this April 2012 by offering free oral cancer screenings to the public in a national effort to raise awareness of this silent killer.

Oral cancer has existed outside the consciousness of much of the public, which is one reason 37,000 Americans will be newly diagnosed this year alone. That is about 100 new people a day. That lack of awareness has contributed to this cancer not being discovered until very late in its development. By implementing a public awareness campaign, OCF wants to educate the public about the risk factors, early signs and symptoms of the disease, as well as the need for all adults to undergo an annual oral cancer screening. In the early stages of oral cancer’s development, it is often is painless, and physical signs may not be obvious to an individual. This makes it a very dangerous disease and is also the reason it is crucial to have an annual oral cancer screening. OCF is asking dental and medical professionals nationwide to act as the first line of defense against oral cancer through the process of early discovery, and to raise public awareness of this cause by opening their doors for at least a half-day, during the month of April, to opportunistically screen members of their community.

These screenings are more important now than ever. Oral cancer is one of the few cancers that are on the rise in the U.S. When found early, oral cancers have an 80% or better survival rate. Unfortunately, most oral cancers are found in late stages, when the five-year survival rate plummets to about 30%. Late stage diagnosis can be greatly reduced through increased public awareness of these facts, and OCF believes that a national program of opportunistic screenings is the best means of creating that awareness.

A visit to the dentist is no longer just about a cleaning or restorative procedures; when a dental exam includes a simple, painless, visual and tactile oral cancer screening, it can save your life. The Oral Cancer Foundation urges you to find out if your local dentist is participating in Oral Cancer Awareness Month this April by visiting OCF’s event section of the website at If you do not see your dental practice listed, please encourage them to contact the Foundation for more information on how easy it is for them to participate. Like other screenings you may receive, such as cervical, skin, prostate, colon and breast examinations, oral cancer screenings are an effective means of finding cancer at its earliest and highly treatable stage. Of all these screenings, the one for oral cancer is the least invasive and time-consuming. It is also affordable and in many cases, it may even be free.

The Oral Cancer Foundation is a big believer in the development of strategic partnerships. In April 2012, OCF will again join forces with both professional societies and private sector companies who are stakeholders in this disease. The American Dental Association, the American Academy of Oral and Maxillofacial Surgery, the Academy of General Dentistry and the American Academy of Oral Medicine form the core of the professional society sponsorship. OCF has also aligned with private sector entities Henry Schein Inc., LED Dental, and Bristol-Myers Squibb, who are asking their customer base to be active in this April’s endeavor. In addition, the 21 treatment facilities with head and neck departments that participated in 2011’s effort are expected to participate again in 2012. With the help of these partners in 2011, OCF was able to create over 2,000 screening sites/events, a ten-fold increase over any previous year. These events, combined with 7 major walk/run awareness events coordinated by OCF, resulted in over 50,000 individual screenings for this deadly disease during April alone. For 2012, the Foundation and its partners have set of goal of at least doubling those results.

Oral cancer is not a rare disease. Each hour of every day, one American dies of the disease, and four more Americans are newly diagnosed. These staggering statistics are the result of the public’s low awareness of the diseases risk factors, which makes these free screening events so crucial. This disease can be defeated, but only with an informed public supported by involved professionals who want to make a difference in the world of oral cancer.

About the Oral Cancer Foundation: The Oral Cancer Foundation, founded by oral cancer survivor Brian R. Hill, is a non-profit 501(c) 3 public service charity that provides information, patient support, sponsorship of research, and advocacy related to this disease. Oral cancer is the largest group of those cancers that fall into the head and neck cancer category. Common names for it include such things as mouth cancer, tongue cancer, head and neck cancer, and throat cancer. It maintains a Web site at, which receives millions of hits per month. Supporting the foundation’s goals is a scientific advisory board composed of leading cancer authorities from varied medical and dental specialties, and from prominent educational, treatment, and research institutions in the United States.

Biosciences aims to lower oral cancer mortality with simple screening test

Author: Amanda Brandon

Vigilant Biosciences is a privately held medical technology company based in Norcross, Georgia focused on improving healthcare products to improve patient care. Their most recent research efforts center on early oral cancer detection.

In the United States, approximately 37,000 people will be diagnosed with oral cancer this year and its most common risk factor is exposure to the human papillomavirus (HPV). Nearly 40 percent of oral cancer patients will die within five years of diagnosis.

The high mortality rate for oral cancer is due to late discovery of the malignancy. In its early stages, the disease can either present no symptoms or the symptoms are often mistaken for other conditions.

VigilantBIO is currently trialing an easy-to-use, low-cost and noninvasive oral cancer screening product which tests the saliva (a very desirable biofluid). The patient and practitioners (e.g. dentists, hygienists, periodontists) benefit from the simplicity of the test – no venipuncture means higher test participation and no specialized staff is required to perform the test. In the oral clinical setting, this is ideal because it does not interfere with chair turnover ratio. In addition, test results can be delivered at the point of care.

When oral cancer is detected early, patients experience an 80-90 percent survival rate. Combined with the lowered treatment cost (an estimated 36 percent) and easy-to-implement product for oral care practitioners, the early detection product appears to be a winner for all involved.

With two clinical trials in process at the University of Miami, the sensitivity and specificity of the VigilantBIO salivary oral cancer biomarkers in detection of pre-cancerous cells are comparative to that of the Pap smear, which is considered the “gold standard” in HPV detection. The sensitivity factor falls within the 62-79 percent range for the VigilantBIO biomarkers compared with the 61-72 percent range for the Pap smear. Specificity is in the 88-100 percent range for the VigilantBIO oral cancer test compared with 82-94 percent for the Pap smear.

VigilantBIO has an exclusive license on the intellectual property from the University of Miami and the U.S. Patent Office issued a Notice of Allowance in October 2011 for key claims related to the technology. Additional patent applications are pending.

1. VigilantBIO will be presenting its products and technologies at OneMedForum SF 2012, on January 9–12.

December, 2011|Oral Cancer News|

New Evaluation for HPV16 Related Cancers Using “Pap-Test Equivalent”

Source: Cancer Prevention Research


Human papillomavirus (HPV) is responsible for the rising incidence of oropharyngeal squamous cell cancers (OSCC) in the United States, and yet, no screening strategies have been evaluated. Secondary prevention by means of HPV detection and cervical cytology has led to a decline in cervical cancer incidence in the United States. Here, we explored an analogous strategy by evaluating associations between HPV16 infection, cytopathology, and histopathology in two populations at elevated risk for OSCCs. In the first, a cross-sectional study population (PAP1), cytology specimens were collected by means of brush biopsy from patients presenting with oropharyngeal abnormalities. In the second (PAP2), a nested case–control study, bilateral tonsillar cytology samples were collected at 12-month intervals from HIV-infected individuals. The presence of cytopathologic abnormality in HPV16-positive tonsil brush biopsies (cases) was compared with HPV16-negative samples (controls) matched on age and gender. HPV16 was detected in samples by consensus primer PCR and/or type-specific PCR. Univariate logistic regression was used to evaluate associations. In PAP1, HPV16 alone (OR: 6.1, 95% CI: 1.6–22.7) or in combination with abnormal cytology (OR: 20, 95% CI: 4.2–95.4) was associated with OSCC. In PAP2, 4.7% (72 of 1,524) of tonsillar cytology specimens from HIV-infected individuals without oropharyngeal abnormalities were HPV16 positive. Tonsillar HPV16 infection was not associated with atypical squamous cells of unknown significance (ASCUS), the only cytologic abnormality identified. Therefore, HPV16 was associated with OSCCs among individuals with accessible oropharyngeal lesions but not with cytologic evidence of dysplasia among high-risk individuals without such lesions. An oropharyngeal Pap-test equivalent may not be feasible, likely due to limitations in sampling the relevant tonsillar crypt epithelium. Cancer Prev Res; 4(9); 1378–84. ©2011 AACR.

September, 2011|Oral Cancer News|

Artificial nose could hold the key in detecting head and neck cancer

Author: staff

An artificial nose could hold the key in detecting head-and-neck (HNC), according to scientists.

The results1 have shown the man-made Nanoscale Artificial Nose (NA-NOSE), developed at the Israel Institute of Technology2, can effectively distinguish between head-and-neck cancer patients, lung cancer patients and those free of oral cancer simply by sampling a breath test.

Head-and-neck cancer is the eighth most common curable cancer worldwide and is often diagnosed late due to a lack of successful screening methods.

Research suggests overall cure is achieved in less than one in two patients, while sufferers often develop a second primary tumour that can affect the entire aero-digestive tract, making lifelong follow-up necessary.

As this appears to be the first study of its kind, Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, believes more needs to be done in order to validate this promising breakthrough in the battle against oral cancer.

Dr Carter said: “The discovery of an effective screening method for a cancer which kills one person every five hours in the UK using a relatively simple method represents excellent progress. However, the Foundation urges greater investigation into the feasibility of using such a device on a larger scale.

“The Foundation runs Mouth Cancer Action throughout November under the tagline ‘If in doubt, get checked out’. The campaign aims to raise awareness of mouth cancer among the public and encourage people to visit their dentist or doctor for regular check-ups. If a breath test could hold the key to discovering mouth cancer, it would provide a simple, cost-effective, fast, and reliable method for practices across the country to diagnose patients.”


1. Methods: Alveolar breath was collected from 87 volunteers (HNC and LC patients and healthy controls) in a cross-sectional clinical trial. The discriminative power of a tailor-made Nanoscale Artificial Nose (NA-NOSE) based on an array of five gold nanoparticle sensors was tested, using 62 breath samples. The NA-NOSE signals were analysed to detect statistically significant differences between the sub-populations using (i) principal component analysis with ANOVA and Student’s t-test and (ii) support vector machines and cross-validation. The identification of NA-NOSE patterns was supported by comparative analysis of the chemical composition of the breath through gas chromatography in conjunction with mass spectrometry (GC-MS), using 40 breath samples. Results: The NA-NOSE could clearly distinguish between (i) HNC patients and healthy controls, (ii) LC patients and healthy controls, and (iii) HNC and LC patients. The GC-MS analysis showed statistically significant differences in the chemical composition of the breath of the three groups. Conclusion: The presented results could lead to the development of a cost-effective, fast, and reliable method for the differential diagnosis of HNC that is based on breath testing with an NA-NOSE, with a future potential as screening tool.

2. Hakim, M., Billan, S., Tisch, U., Peng, G., Dvrokind, I., Marom, O., Abdah-Bortnyak, R., Kuten A., Haick, H. (2011) Diagnosis of head-and-neck cancer from exhaled breath, British Journal of Cancer, 104, 1649-1655.

Source: British Dental Health Foundation