Early detection offers the best prognosis.
Oral cancers have been reported as the 6th most common cancer worldwide, and the five years survival rate is still disappointingly low. It is a major health problem especially in developing countries and a serious cause of morbidity and mortality worldwide. They comprise about 85% of all head and neck cancers. Orofacial cancers may be derived from: epithelial tissues (carcinomas), mesenchymal tissues (sarcomas) and haematolymphoid tissues (leukaemias/lymphomas/ plasmacytomas).
Mortality resulting from oral cancer is strongly correlated with the stage of diagnosis, as detection at an early stage of cancer i.e. stage 1 or a low grade disease is associated with significantly improved survival with lower morbidity. In our environment, oral cancer is frequently diagnosed in late stages because most patients present to the hospital late into the course of the disease leading to high mortality in Nigeria.
Several prevalence rates (7.6% – 36.8%) of oral cancers have been reported by several authors in different geopolitical locations in Nigeria. Actually, the burden of cancer in Nigeria is unknown, mainly because of lack of statistics or under reporting as must of our data are hospital-based and not population-based.
The etiology (causes) of oral cancers is multifactorial and various studies have identified the following risk factors:
- Tobacco and alcohol use
- Excessive sun exposure,
- Sexual behaviors leading to exposure to the human papilloma virus (HPV)
- Ingestion of smoked fish,
- Infections especially by viruses,
- Dietary deficiencies
- Industrial pollution
- Kola nuts (Cola acuminate) has been reported to promote palatal mucosa keratinization of cigarette smokers and is considered a co-carcinogen
- Poor oral hygiene and
- Chronic malaria
Oral cancer affects males more frequently than females, although the ratio is equalizing, and tend to occur more often with increasing age. The tongue and floor of the mouth have been cited as the two most common sites for oral cancer. Orofacial carcinomas and Non-Hodgkin’s Lymphomas have been reported mostly in the older age groups while the Orofacial sarcomas were mostly found in the slightly younger age groups.
There is a low level of awareness of these lesions especially among the low socio-economic group which makes them present late in our health care facilities for treatment hence a poor prognosis. Therefore, there is a need for increased awareness, regular dental visits, early detection, advocacy, preventive care (avoidance of the possible risk factors) and oral cancer screening.
Sources:
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