Oral Cancer: Screening and Prevention-Oral Cancer Screening and Prevention

Video Transcription

Video Summary

Dr. Ashley Clark’s webinar focused on oral cancer screening, prevention, and the critical role of recognizing and biopsying oral potentially malignant disorders, especially leukoplakia. She emphasized that true leukoplakia is a clinically defined, sharply demarcated white lesion that cannot be explained by another condition and must always be biopsied immediately. Most leukoplakias are benign hyperkeratosis, but because clinical appearance cannot reliably distinguish benign from dysplastic or cancerous lesions, biopsy is essential.<br /><br />Clark reviewed risk factors such as tobacco use, alcohol, and high-risk HPV, while noting that patients without obvious risk factors can be especially concerning. She discussed high-risk sites like the lateral and ventral tongue and floor of mouth, and contrasted leukoplakia with benign frictional or tobacco-related keratosis. She also covered proliferative verrucous leukoplakia (PVL), a dangerous, often subtle condition that frequently recurs and can progress to cancer.<br /><br />The lecture then shifted to oral and oropharyngeal squamous cell carcinoma, including the rise of HPV-related cancers, especially in younger men. Clark explained that HPV-negative oral cancers often have a visible precancerous stage, while HPV-positive oropharyngeal cancers often present late, frequently after nodal metastasis. She reviewed biopsy strategy, warning signs such as non-healing ulcers, red or mixed red-white lesions, induration, and unexplained gingival or tonsillar changes.<br /><br />Prevention strategies included smoking cessation counseling using the five A’s and HPV vaccination with Gardasil 9. She also discussed the limited current role of salivary HPV testing and the use of adjunctive screening devices. Overall, her message was clear: spot it early, biopsy it promptly, and follow patients long term.

Keywords

oral cancer screening

leukoplakia

oral potentially malignant disorders

biopsy

dysplasia

proliferative verrucous leukoplakia

HPV-related cancers

oral squamous cell carcinoma

oropharyngeal squamous cell carcinoma

tobacco use

alcohol risk factors

HPV vaccination

salivary HPV testing