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Screening for Oral Cancer: U.S. Preventive Services Task Force Recommendation Statement FREE

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The full report is titled “Screening for Oral Cancer: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 7 January 2014 issue of Annals of Internal Medicine (volume 160, pages 55-60). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.

This article was published online first at www.annals.org on 26 November 2013.

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Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.

Ann Intern Med. 2014;160(1):I-28. doi:10.7326/P14-9002
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Who developed these guidelines?

The U.S. Preventive Services Task Force (USPSTF) developed these recommendations. The USPSTF is a group of health experts that makes recommendations about preventive health care.

What is the problem and what is known about it so far?

In 2013, there will be more than 41,000 new cases of cancer of the mouth (oral cavity or oral cancer) or throat (pharyngeal cancer) and nearly 8,000 people will die of these types of cancer. Risk factors for oral cancer include tobacco and alcohol use. Oropharyngeal cancer, another subset of neck and head cancer, includes human papillomavirus as an important risk factor. Types of head and neck cancer related to tobacco and alcohol use are decreasing in the United States, but those associated with human papillomavirus infection are increasing.

At the time of initial diagnosis, about one half of people with oral and pharyngeal cancer have disease that has spread beyond the mouth and throat. Looking for oral cancer in people with no symptoms could help if it identified precancerous abnormalities or early cases of cancer that could be successfully treated. The primary screening test for oral cancer is careful examination of the inside of the mouth. The USPSTF wanted to weigh the benefits and harms of screening for oral cancer to decide whether to recommend routine screening for this disease during primary care visits.

How did the USPSTF develop these recommendations?

The USPSTF reviewed published research about the potential benefits and harms of screening healthy people for oral cancer. It was looking for studies that showed that screening during primary care visits improves the outcomes of people diagnosed with this condition.

What did the authors find?

The USPSTF found inadequate evidence that the oral examination by primary care doctors accurately detects oral cancer. It also found inadequate evidence that screening for oral cancer and treatment of screen-detected cancer improves patient outcomes. Furthermore, little is known about the harms of screening, but potential harms are probably due to complications of biopsy of abnormalities found on screening and the complications of early treatment.

What does the USPSTF recommend that patients and doctors do?

The USPSTF cannot recommend either for or against screening for oral cancer during primary care visits. Doctors and patients should consider the patient's risk factors and preferences in deciding whether to screen for this cancer.

What are the cautions related to these recommendations?

These recommendations apply only to screening by primary care doctors of patients with no symptoms. They are not intended for dentists or oral surgeons.





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