What is an oral cancer screening?

Oral cancer is the general term used to describe most cancers that occur in the mouth. It can affect your mouth, tongue, gums, and throat. Most cases of oral cancer affect patients who are over 60 years old, but recent studies have shown that rates in younger people are on the rise. That’s why it’s a good idea to receive an oral cancer screening, no matter your age, race, or gender identity, if you haven’t had one in the last year or two. Here’s what to expect if you receive one.

What is an oral cancer screening?

In a cancer screening, a medical provider examines you to see if you might have cancer before you have any symptoms. Note that just because a doctor has recommended a screening does not mean they think you have cancer, so there’s no need for alarm. Their goal in performing screenings is to try to catch cancer at an early stage, as this may help them treat it.

Why you should get screened

 The American Cancer Society estimates that in 2023, there will be more than 50,000 new cases of oral cavity or oropharyngeal cancer in the United States, resulting in more than 11,000 deaths.

The biggest case for oral screening is that it can allow medical providers to identify precancerous lesions at an early stage, when they are more easily removed. Waiting until symptoms are bothering you could mean that the cancer has already spread. According to National Cancer Institute, more than half of oral cancers have already spread to other areas by the time they’re detected.

Who can perform an oral cancer screening?

A licensed dentist or medical doctor (MD) can examine your mouth and throat to look for lesions and abnormalities. If fact, most providers already perform this screening during routine medical and dental checkups.

What can a screening detect?

By looking closely at your mouth, a doctor or dentist may be able to detect patches of tissue of abnormal color, size, or texture. If they see unusual or unexplained lesions in your mouth, they may recommend additional procedures to help determine whether these are abnormal tissues that might become oral cancer.

Dentists recommend regularly checking your own mouth in between checkups to look for anything unusual and sharing these observations with your dentist. Even if you see something irregular, it’s very possible that nothing is wrong. Many people get small bumps or sores in their mouths that turn out to be harmless.

A screening alone will not be able to diagnose cancer, but it can help healthcare providers detect concerns. The only way to have cancer diagnosed is for a provider to collect a sample of your cells and send them to a laboratory for testing. If they deem it necessary, your provider may refer you to an oncologist (a doctor who is specially trained to diagnose and treat cancer).

When should you get screened for oral cancer?

According to the Mayo Clinic, most dentists evaluate the entirety of their patient’s mouths during routine check-ups. However, there isn’t universal agreement among medical organizations about how often to seek oral cancer screening. Some, such as The Oral Cancer Foundation, believe that people should be screened for oral cancer every year beginning at age 18 (or even younger, if they use tobacco). Others, such as Moffitt Cancer Center only recommend yearly screenings for those over 40 years old, and every three years for those between 20-40.

The National Cancer Institute notes that that there are some risks associated with screening. For the most part, the risks of screening come down to the possibility that it will lead to more testing. As with many medical tests, there’s not a 100% guarantee that these tests will provide accurate results.

If you are unsure whether you should get an oral exam, discuss your concern with your doctor or dentist to decide what makes the most sense for you based on your risk factors and lifestyle.

Who should be screened for oral cancer?

While some organizations say everyone should be screened for oral cancer, those at higher risk of developing oral cancer may especially benefit from early detection. You are in a higher risk group if any of the following applies to you:

• You use tobacco products of any kind (cigarettes, including e-cigarettes or vapes, pipes, chewing tobacco, and more)
• You drink excessive amounts of alcohol
• You’ve been exposed to the sun for prolonged periods of time throughout your life (which increases the risk of lip cancer)
• You’ve already been diagnosed with oral cancer in the past

Research also shows that oral cancer is significantly more common among men than women, and more common among older people. The average age of diagnosis for oral and oropharyngeal cancer is 64 years old. However, women and younger people still develop these cancers---about 20% of cases occur in people who are younger than 55. There is also an association between mouth and throat cancers and certain strains of HPV (Human Papillomavirus), resulting in more younger people developing these cancers in recent years.

As with any medical exam, it’s wise to tell your provider about any other medications you’re taking and any other conditions affecting you.

What to expect during an oral cancer screening

When you have an oral cancer screening, a dentist or doctor will begin by looking inside your mouth to check for anything unusual, such as bumps, discolored or swollen areas. A thorough exam should include your entire mouth including your gums, tongue, inner cheeks, and the top and bottom of your mouth. They will also look at the outside of your neck, cheeks, and jaw. If they observe anything strange, they may move onto different kinds of tests:

• They may use a blue stain (called toluidine) to cover areas in your mouth, as the parts that stain darker are more likely to be cancerous or precancerous.
• They may recommend you use a fluorescent mouth rinse and then look in your mouth with a special light, as this will make abnormal tissue easier to see.
• They may use a brush or small stick to gently scrape the inside of the mouth, tongue, or lips. In doing so, they collect a sample of cells that can be examined under a microscope.

If a provider is concerned about your potential for having or developing oral cancer, they may recommend that you come back in to see them in a few weeks so they can monitor abnormal areas. They may also want to send a sample of your cells to a laboratory to be tested for the presence of cancer cells. Sometimes general dentists perform biopsies themselves, while other times, they refer patients to medical or dental specialists.

What to do if your dentist or doctor detects something abnormal

Remember that a screening is not a diagnosis. Though it can be alarming and anxiety-inducing to be told that you might have signs of cancer, keep in mind that your medical provider is using their expertise to help you. There’s no way to know whether any cells are cancerous without a lab test, so they won’t be able to give you a definitive answer during your appointment. If you’re told to wait for lab results or to simply come back for a checkup in a few weeks, try to take care of yourself and cope with stress during the waiting period to the best of your ability.