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Oral cancers are by definition, cancers of the lip, tongue and mouth. ' Combined together with pharyngeal cancers, oral cancer i s the 6th most common cancer in the world. ' Although the incidence of oral cancer i s greater in certain parts of the world, such a s South and South East Asia, certain parts of France, Eastern Europe, Latin America, Caribbean and the Pacific Region, it i s prevalent all over the world. ' Oral Cancer has an annual global incidence of about 275,000. The 5 year survival rates for oral cancer remained at about 50% during the greater part of the twentieth century. 2 However, a recent improvement in the oral cancer survival rates has been observed with the 20'0 reported rates being a s high a s 65.5%. The 5 year survival rates vary accordingtothe site and the stage at which detected. An improvement in the survival rate has been seen in the past few years in certain parts of the world, such a s Canada, owing to a reduction in related risk factors, such a s smoking. Poor survival rate among the oral cancer patients has been attributable to the advanced extent of the disease at the time of diagnosis. More than 60% of these cancers are diagnosed when the patient has already reached stage s III or IV of the cancer.4 Oral cancer arises in the surface oral epithelium, which i s easily accessible for direct visual and tactile examination. It i s known, through evidence that survival rates of oral cancer vary according to the stage of cancer at the time of diagnosis. A randomised controlled trial study reported that 5 year survival rates for oral cancer diagnosed at stage I i s 66.2%, while that for a cancer diagno sed at stage IV i s 22.2%. 2Early diagnosis of oral cancer increases the survival rate, improving the quality of life along with that. Also, the cost of treating an oral cancer patient at stage IV i s three time s that of treating one at stage I. 5Hence, early diagnosis of oral cancer i s cost efficient a s well. Although all the above mentioned facts apparently suggest that screening for oral cancer should be carried out, there are certain factors that must be
Correspondence: Dr. Muhammad Humza Bin Saeed Assistant Professor, Community Dentistry Islamic International Dental College Riphah International University Islamabad E-mail: humza.saeed@riphah.edu.pk
considered before any screening programme can be implemented. First of all, it must be ensured that the screening for the disease in question i s suggested on sound scientific evidence. In the case of oral cancer, the need for screening and the importance of early detection of disease has been shown through the earlier mentioned argument. Then, before any screening programme i s put into practice, it must be ensured that the benefit of the specific programme clearly outweighs the harm, for example, if the disease i s diagnosed earlier on during its clinical course, does an effective intervention exist that would improve the disease prognosis? I s the intervention available acceptable to the public and i s it economically feasible? If any of these problems are realised once the programme i s fully functional, efforts to modify the programme or to stop it all together might be faced by severe criticism and opposition from the general public and the media.6Any screening program fulfilling its criteria automatically caters for any associated problems.7The main aim of screening i s to detect the
disease and its predictors.
Muhammad Humza Bin Saeed. (2015) Oral Cancer Screening and its Implementation in Pakistan, Journal of Islamic International Medical College, Volume-10, Issue-2.
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