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Oral, Pharyngeal, and Laryngeal Cancer Screening

Oral Pharyngeal Laryngeal Cancer Screening Related Articles

Facts on Oral Screening for Head and Neck Cancer

  • Oral cavity, pharyngeal, and laryngeal cancer are diseases in which malignant (cancer) cells form in the mouth and throat.
  • The number of new cases of oral cavity, pharyngeal, and laryngeal cancer and the number of deaths from these cancers varies by race and sex.
  • Different factors increase or decrease the risk of oral cavity and oropharyngeal cancer.
  • Tests are used to screen for different types of cancer.
  • There is no standard or routine screening test for oral cavity, pharyngeal, and laryngeal cancer.
  • Screening tests have risks.
  • The risks of oral cavity, pharyngeal, and laryngeal cancer screening include the following:
  • Finding oral cavity, pharyngeal, or laryngeal cancer may not improve health or help a person live longer.
  • False-negative test results can occur.
  • False-positive test results can occur.
  • Misdiagnosis can occur.

What Is the Oral Screening for Head and Neck Cancer?

  • Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
  • Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.
  • It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.
  • If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.

What Are Oral, Pharyngeal, and Laryngeal Cancers?

Oral cavity, pharyngeal, and laryngeal cancer are diseases in which malignant (cancer) cells form in the mouth and throat. Oral cavity, pharyngeal, and laryngeal cancers usually form in the squamous cells (thin, flat cells that line the oral cavity, pharynx, and larynx). Oral cavity cancer forms in any of these tissues of the oral cavity:

  • The lips.
  • The front two thirds of the tongue.
  • The gingiva (gums).
  • The buccal mucosa (the lining of the inside of the cheeks).
  • The floor (bottom) of the mouth under the tongue.
  • The hard palate (the front of the roof of the mouth).
  • The retromolar trigone (the small area behind the wisdom teeth).

Pharyngeal cancer forms in any of these tissues of the pharynx (throat):

  • The nasopharynx (the upper part of the throat behind the nose).
  • The oropharynx, which includes the following tissues:
  • The middle part of the throat behind the mouth.
  • The back one third of the tongue.
  • The soft palate (the back of the roof of the mouth), including the uvula.
  • The side and back walls of the throat.
  • The tonsils.
  • The hypopharynx (the bottom part of the throat).

Laryngeal cancer forms in any of these tissues of the larynx (voice box):

  • The supraglottis (the area above the vocal cords, including the epiglottis).
  • The vocal cords (two small bands of muscle within the larynx that vibrate to produce the voice).
  • The glottis (the middle part of the larynx, including the vocal cords).
  • The subglottis (the lowest part of the larynx, from just below the vocal cords to the top of the trachea).

Who Is at Risk for Head and Neck Cancer?

The number of new cases of oral cavity, pharyngeal, and laryngeal cancer and the number of deaths from these cancers varies by race and sex. Oral cavity and oropharyngeal cancer: From 2005 to 2014, the number of new cases of oral cavity and oropharyngeal cancer slightly increased in white men and women. The number slightly decreased in black men and women.

Oral cavity and oropharyngeal cancer is more common in men than in women. Although oral cavity and oropharyngeal cancer may occur in adults of any age, it occurs most often in those aged 55 to 64 years. France, Brazil, and parts of Asia have much higher rates of oral cavity and oropharyngeal cancer than most other countries.

The number of new cases of oropharyngeal cancer caused by certain types of human papillomavirus (HPV) infection has increased. One kind of HPV, called HPV 16, is often passed from one person to another during sexual activity.

  • Laryngeal cancer: Laryngeal cancer is less common than oral cavity and oropharyngeal cancers. The number of new cases of laryngeal cancer has slightly decreased over the past ten years. The decrease in new cases is likely because of a decrease in cigarette smoking.
  • Hypopharyngeal cancer: Hypopharyngeal cancer is rare. The number of new cases of hypopharyngeal cancer has slightly decreased over the past twenty years. The decrease in new cases is likely because of a decrease in cigarette smoking.
  • Nasopharyngeal cancer: Nasopharyngeal cancer is rare in the United States. It is more common in parts of Asia, the Arctic region, North Africa, and the Middle East.

Different factors increase or decrease the risk of oral cavity and oropharyngeal cancer.

Anything that increases your chance of getting a disease is called a risk factor. Anything that decreases your chance of getting a disease is called a protective factor.

How Is Oral Cavity, Pharyngeal, and Laryngeal Cancer Diagnosed?

Tests are used to screen for different types of cancer.

Some screening tests are used because they have been shown to be helpful both in finding cancers early and in decreasing the chance of dying from these cancers. Other tests are used because they have been shown to find cancer in some people; however, it has not been proven in clinical trials that use of these tests will decrease the risk of dying from cancer. Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.

There is no standard or routine screening test for oral cavity, pharyngeal, and laryngeal cancer.

No studies have shown that screening for oral cavity, pharyngeal, or laryngeal cancer would decrease the risk of dying from this disease. A dentist or medical doctor may check the oral cavity during a routine check-up. The exam will include looking for lesions, including areas of leukoplakia (an abnormal white patch of cells) and erythroplakia (an abnormal red patch of cells). Leukoplakia and erythroplakia lesions on the mucous membranes may become cancerous.

If lesions are seen in the mouth, the following procedures may be used to find abnormal tissue that might become oral cavity cancer:

Toluidine blue stain: A procedure in which lesions in the mouth are coated with a blue dye. Areas that stain darker are more likely to be cancer or become cancer.

Fluorescence staining: A procedure in which lesions in the mouth are viewed using a special light. After the patient uses a fluorescent mouth rinse, normal tissue looks different from abnormal tissue when seen under the light.

Exfoliative cytology: A procedure to collect cells from the oral cavity. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the lips, tongue, or mouth. The cells are viewed under a microscope to find out if they are abnormal.

Brush biopsy: The removal of cells using a brush that is designed to collect cells from all layers of a lesion. The cells are viewed under a microscope to find out if they are abnormal.

More than half of oral cancers have already spread to lymph nodes or other areas by the time they are found.

Epstein-Barr virus (EBV) has been linked to nasopharyngeal cancer. Screening for nasopharyngeal cancer using the EBV antibody test or EBV DNA test has been studied. These are laboratory tests used to check the blood for EBV antibodies or EBV DNA. If EBV antibodies or DNA are found in the blood more tests may be done to check for nasopharyngeal cancer. No studies have shown that screening would decrease the risk of dying from this disease.

What Are the Possilble Complications of Oral, Pharyngeal, and Laryngeal Cancer Screening

Screening tests have risks. Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.

The risks of oral cavity, pharyngeal, and laryngeal cancer screening include the following:

Finding oral cavity, pharyngeal, or laryngeal cancer may not improve health or help a person live longer.

Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. Finding these cancers is called overdiagnosis. It is not known if treatment of these cancers would help you live longer than if no treatment were given, and treatments for cancer, such as surgery and radiation therapy, may have serious side effects.

False-negative test results can occur.

Screening test results may appear to be normal even though oral cavity, pharyngeal, or laryngeal cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.

False-positive test results can occur.

Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests and procedures (such as biopsy), which also have risks.

Misdiagnosis can occur.

A biopsy is needed to diagnose oral cavity, pharyngeal, and laryngeal cancer. Cells or tissues are removed from the oral cavity, pharynx, or larynx and viewed under a microscope by a pathologist to check for signs of cancer. When the cells are cancer and the pathologist reports them as not being cancer, the cancer is misdiagnosed.

Cancer is also misdiagnosed when the cells are not cancer and the pathologist reports there is cancer. When cancer is misdiagnosed, treatment that is needed may not be given or treatment may be given that is not needed.

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Reviewed on 7/6/2018
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