Oral cancer accounts 3% of all cancers worldwide with an increase in rates for both sexes and rising trends in young men. As survival rate increases when diagnosed at early stages, systematic visual inspection is recommended at the beginning of dental treatment in each patient. However, diagnosis in clinically normal appearing mucosa and determine the malignant transformation of clinically visible erythroplakia and leukoplakia is not possible. Public awareness of OC has been reported to be very low, causing delay in referral and treatment. This study is aimed to assess VELscope system as a diagnostic adjunct to visual screening in symptomatic and asymptomatic patients. Additional aim was to evaluate the awareness of patients on oral cancer and their confidence with an adjunctive visualization tool.
Material and methods
Eighty patients who admitted to oral surgery department for routine oral surgical procedures were examined by unaided eye and also by a hand-held device (VELscope) which permits direct fluorescence visualization of oral mucosa. Incisional biopsies were obtained from the areas with loss of autofluorescence that may indicate a neoplastic change in 14 patients. Awareness and knowledge of patients on oral cancer, and their reliability on an adjunctive aid in the diagnosis of oral cancer were evaluated by a written questionnaire.
Results
Oral incisional biopsies revealed moderately differentiated squamous cell carcinoma, malign melanoma, lichen planus, and melanin incontinence. Direct fluorescence visualization was effective in distinguishing between normal and abnormal tissue but was unable to distinguish between different types of abnormal tissue. Awareness of patients on oral cancer was found to be very low. Screening with VELscope has been found more reliable than screening with unaided eye.
Conclusions
Direct fluorescence visualization as a diagnostic adjunct, is a simple, efficient and reliable method for screening oral cancer that also helps to raise awareness.
