Screening for oral cancer
Early detection (as distinct from organized screening) of oral cancer using visual inspection of the mouth is being considered in countries where incidence is high, such as Bangladesh, India, Pakistan, and Sri Lanka (Sankaranarayanan et al., 2000).
The oral cavity is easily accessible for routine examination, and nonmedical personnel can readily detect lesions that are the precursors of carcinoma (WHO, 1984). Furthermore, there are indications that precursor lesions may regress if tobacco use ceases and that surgical treatment of early oral cancer is very effective.
Experience in south-east Asia has demonstrated under field conditions that primary health care workers can examine large numbers of people, and detect and classify precancerous lesions and cancers of the oral region with acceptable accuracy.
Some programmes have also encouraged early detection of oral cancer by self-examination using a mirror (Mathew et al., 1995). However, so far it has not been shown that detection of precancerous lesions or early cancers can reduce mortality from the disease.