Battling oral cancer: revisiting prevention and intervention in clinical practice

Oral cancer, predominantly invasive squamous cell carcinoma, is a lethal and deforming disease of rising incidence and global significance. Even with advances in patient management, five-year survival rates remain stubbornly low at just over 50%. Despite initial successful treatment, long-term prognosis is compromised by advanced tumour presentation, and development of widespread, multifocal disease throughout the mouth and upper aerodigestive tract. The transformation of normal mucosa into potentially malignant and subsequently malignant tissue is a complex, multifactorial process in which accumulated genetic alterations (often instigated by overuse of tobacco and alcohol) disrupt the normal replicative cycle of oral epithelial cells.