June 2007

Although of low frequency in industrialised countries, squamous cell carcinoma of the oral cavity and adjacent structures has high morbidity and mortality. In the Indian sub-continent, the mouth ranks among the most frequent sites where cancer occurs. As far as the United Kingdom is concerned, there are over 3,000 new cases of oral and oropharyngeal cancer per year and about 60% of patients will die of their disease within five years. Despite many advances in surgical techniques and rehabilitation there have been no improvements in survival of oral cancer patients for decades. Whilst oral cancer incidence showed an overall reduction during the last century from a peak which occurred at around 1920, from the mid sixties significant increases in incidence and mortality were observed in males aged 35-64 years in particular (Hindle et al., 1996). when a tumour is already well advanced. The reasons for patient delay in reporting oral cancer are not well understood (Scott et al., 2006). It would seem that the key to better quality and length of survival is more effective detection of disease at a premalignant stage or when the invasive lesion is small. This supposition combined with our knowledge of the risk factors for oral cancer, and the consequent possibilities for health promotion and education, has major public health implications.