General medical practitioners not likely to be part of the oral cancer solution

Source: HighWire- Stanford University Summary of a study by: LA Shanks, TW Walker, PJ McCann, and MJ Kerin There has been little improvement in the survival of patients with oral cancer despite advances in treatment. One observation is that late presentation of the disease is this reason for this continuing poor outcome. However research and experience tell us that tuition in medical schools about examination of the oral cavity is poor. This study aimed to ascertain the opinions and experience of medical students regarding this at Stanford by dissemination of a web-based anonymous questionnaire that focused on education about examination of the oral cavity, and experience in carrying it out. From a cohort of 600 students 458 (76%) responded. A total of 334 (73%) had not been taught how to examine the oral cavity, 372 (81%) had had no experience of doing so in patients, and only 15%  felt confident to diagnose a carcinoma of the lip or oral cavity. Eighty-nine percent felt that the tuition given had not been adequate. OCF From this survey it is clear that examination of the oral cavity cannot be considered part of the core clinical curriculum, and medical schools and departments of oral and maxillofacial surgery urgently need to embrace the introduction of the necessary skills.

2011-03-03T22:46:25-07:00March, 2011|Oral Cancer News|

Detection of human papilloma virus (HPV) in oral mucosa of women with cervical lesions and their relation to oral sex practices

Source: 7thspace.com Authors: Luis Sanchez-Vargas et al Previous studies have either investigated the relationship of HPV with oral cancer or the prevalence of HPV on the oral cavity. The purpose of this investigation was to study the prevalence of HPV in oral cavity of women with oral sex practices and cervical lesions. Methods: Forty six (46) non-smokers and non-alcoholic patients attended the "Clinica de Displasias"of "Ciudad Juarez"were sampled. This population had a CIN (cervical intraepithelial neoplasia) diagnosis sometime between the previous six months. On previous consent they filled out a questionnaire related to their oral sex practices. Afterwards one swab from cheeks and another from palate/gum were taken; PCR (polymerase chain reaction) was used to determine generic HPV, HPV16 and HPV18. Results: Seventy two percent (72%) of the patients stated to have oral sex practices regularly which all of them were positive to HPV either in oral mucus, palate/gum or both. The total of the given results showed that 35% had HPV16; among those distributed in 26% with regular oral sex practices and 9% stated as never practiced oral sex. An association was found between oral HPV16 positivity and progression to CIN advanced lesions. On the other hand HPV18 was not detected. The frequency of HPV16 was higher in buccal mucosa (23%) versus palate/gum (16%). Conclusions: This study suggests that buccal HPV16 infection is associated with CIN progression. Source: Infectious Agents and Cancer 2010, 5:25 Authors: Luis Sanchez-Vargas, Cecilia Diaz-Hernandez, Alejandro Martinez-Martinez

2010-12-05T17:44:18-07:00December, 2010|Oral Cancer News|

Would the effect of HPV vaccination on non-cervical HPV-positive cancers make the difference for its cost-effectiveness?

Source: PubMed.gov Besides cervical cancer, the human papillomavirus (HPV) is found in other cancers and may be preventable with HPV vaccination. However, these other cancers are often not accounted for in cost-effectiveness analyses of HPV vaccination. This study estimates the potential maximum effect on the cost-effectiveness ratio (CER) of HPV vaccination in preventing non-cervical HPV-positive cancers. For the Dutch situation, a mathematical equation was used to estimate the maximum impact if all cancer cases of the penis, vulva/vagina, anus, oral cavity and oro-pharynx with HPV16/18 are prevented, in terms of number of life years gained, savings and improvement in the CER of the vaccination. For other countries and for future developments, we show how the impact on the CER varies depending on the incidence of cervical/non-cervical HPV 16/18-positive cancers, vaccine costs and clinical costs. If in the Netherlands all HPV 16/18-positive cancers are prevented by vaccination in women only, compared to if only HPV 16/18-positive cervical cancer is prevented, the life years gained increase with 14%, the savings increase with 18%, and the CER decreases with 13%. If vaccination prevents HPV-positive cancers in both men and women, these figures increase to 25%, 26% and 21%, respectively. In conclusion, if HPV vaccination fully prevents all non-cervical HPV-positive cancers, this would substantially increase its cost-effectiveness. The impact of the vaccination varies depending on the incidence of cervical/non-cervical HPV16/18-positive cancers, the vaccine costs and clinical costs. Observed combinations of these parameters in different countries show a decrease in the CER between 10% and [...]

2010-11-08T13:20:40-07:00November, 2010|Oral Cancer News|

Patterns of alcohol and tobacco use affect head and neck cancer risk

Source: www.rtmagazine.com Author: staff Assuming that total exposure is the same, it is worse to smoke lightly for many years than to smoke heavily for a few years when it comes to the risk of head and neck cancer, new research shows. With alcohol use, however, the opposite is true. The results, which were published in the October 15th issue of the American Journal of Epidemiology, also confirmed previous research showing that smoking was more strongly associated with laryngeal cancer and that alcohol consumption was more strongly associated with pharyngeal and oral cavity cancers. "Cigarette smoking and alcohol consumption are known risk factors for head and neck cancers, including cancers of the larynx, oral cavity, and pharynx," co-researcher Dr. Jay H. Lubin, of the National Cancer Institute, Rockville, Maryland, told Reuters Health. "This paper presented a detailed quantitative evaluation of their effects, using data which were pooled from 15 case-control studies." The researchers modeled the excess odds ratio (EOR) to assess risk by total exposure (pack-years and drink-years), as well as the modification of risk by exposure rate (cigarettes/day and drinks/day). The smoking analysis included 1761 laryngeal, 2453 pharyngeal, and 1990 oral cavity cancer cases. For controls, 7963 were included for laryngeal and 10,114 for pharyngeal and for oral cavity cancer cases. The alcohol analysis included 2551 laryngeal, 3693 pharyngeal, and 3116 oral cavity cancer cases. For controls, 12,179 were included for laryngeal cancer and 15,589 for pharyngeal and oral cavity cancer cases. While smoking increased the risk of all [...]

2009-11-07T11:01:10-07:00November, 2009|Oral Cancer News|

Understanding the link between HPV and oropharyngeal cancers

Source: www.jaapa.com (Journal of the American Academy of Physician Assistants, October, 2009) Authors: Denise Rizzolo, PA-C, PhD, Mona Sedrak, PA-C, PhD Head and neck cancer is diagnosed in approximately 650,000 patients each year worldwide.1 The term head and neck cancer refers to a group of biologically similar cancers originating from the upper aerodigestive tract, including the lip, oral cavity (mouth), nasal cavity, paranasal sinuses, pharynx, and larynx. Oropharyngeal refers to all the structures of the mouth and pharynx, including the tonsils and tongue. Oral squamous cell carcinoma (OSCC) is the most common form of head and neck cancer.2 Seventy-five percent of all OSCCs are attributable to tobacco and alcohol use.3 People who smoke cigarettes are 4 times more likely to develop oral cancer than nonsmokers. Furthermore, individuals who consume alcohol are 3 times more likely than nondrinkers to develop oral cancer.3 According to the Substance Abuse and Mental Health Services Administration, the prevalence of cigarette smoking has decreased among Americans, and alcohol use has also declined since the 1970s.4,5 However despite this, the incidence of oropharyngeal cancers, including cancer of the base of the tongue and tonsils, has increased, especially in younger patients. These trends have led researchers to investigate other potential risk factors.6-8 New studies suggest that there may be an alternative pathway for the development of oropharyngeal cancers. The high-risk types of human papillomavirus (HPV), especially type 16 (HPV-16), are now thought to be potential etiologic agents.2,3 The concept that HPV plays a role in head and neck [...]

Quality of life in patients treated for cancer of the oral cavity requiring reconstruction: a prospective study

Source: Acta Otorhinolaryngol Ital, June 1, 2008; 28(3): 120-5 Authors: AB Villaret et al. Surgical treatment for cancer of the oral cavity can result in dramatic aesthetic and functional sequelae partially avoidable by reconstructive techniques. Many studies concerning quality of life have been carried out in order to retrospectively assess outcomes after such major oncological procedures. Aim of this study was to evaluate, in a prospective fashion, the quality of life as a primary endpoint in patients treated for cancers involving the oral cavity and requiring reconstruction. The study design consisted of a prospective evaluation of pre- and post-operative quality of life at 3, 6, and 12 months to assess variations during follow-up using two different questionnaires: the University of Washington Quality of Life and the Head and Neck Performance Status Scale. Between May 1999 and October 2004, 92 patients with oral cancer requiring reconstruction were treated. All were included in the study, but only 35 (38%) concluded the evaluation protocol at one year after surgery without evidence of disease. The mean pre- and post-operative (3, 6, and 12 months) scores of the questionnaires and the scores of specific University of Washington Quality of Life categories (disfigurement, chewing, swallowing, comprehension of speech) were evaluated. The impact on residual quality of life of different factors such as gender, extension of tongue and mandibular defects, type of reconstruction, and radiotherapy was statistically quantified with a Wilcoxon non-parametric test and logistic regression for multivariate analysis. Comparison of mean pre- and post-operative scores between [...]

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