On February 19, 2019, Chiemi Hori, a renowned Japanese singer, publicly announced her diagnosis of stage IV tongue cancer. The news was widely reported by the Japanese media. This study examined the association between the celebrity's tongue cancer disclosure and trends in the number of oral cancer diagnoses in the national population-based cancer registry (NCR) in Japan.

Data from the NCR were used to plot monthly changes in the number of oral cancer diagnoses from 2016 to 2019 according to sex, age, residential area (divided into five categories based on the density of dentists), cancer site, and clinical stage at initial treatment. Time trends were analyzed using Joinpoint regression.

Between 2016 and 2019, 39,415 oral cancer cases were registered. After Ms. Hori's disclosure, oral cancer diagnoses increased significantly, while other head and neck cancers showed no significant changes. The number of oral cancer diagnoses increased from 784 in January 2019 to 1195 in March 2019 (an average monthly change rate of 8.6% from December 2018 to March 2019).

There has been a sharp increase in the number of oral cancer diagnoses since the celebrity's disclosure. This suggests that it has raised public awareness of oral cancer.

To address the limitations and complexities associated with tissue biopsy, emerging nanotechnology methods show promise in enhancing the detection and management of oral squamous cell carcinoma and oral potential malignant disorders. Among them, the characterization of the protein corona, the biomolecular layer that envelops materials when exposed to biological fluids, has recently emerged as a powerful tool for distinguishing oncological patients from healthy people.

Building upon recent insights, here we formulated a new diagnostic method for oral squamous cell carcinoma and oral potentially malignant disorders based on the characterization of the personalized protein corona formed on graphene oxide nanosheets when exposed to the plasma of the patients.

The findings highlighted a discernible distinction between oncological subjects and healthy ones, resulting in an overall accuracy of 87%. Subsequently, we applied this method to monitor the progression of the diseases of the patients undergoing treatment, and we observed a trend indicating a convergence of protein profiles between oncological patients and healthy subjects throughout the treatment course.

If further confirmed in larger prospective studies, this new approach could discriminate oral squamous cell carcinoma and oral potentially malignant disorders and can be considered in the management of these oral diseases.

Timely cancer diagnosis is important, but delays are common, also among women. This study reviews recent literature on diagnostic delays in women with breast cancer, focusing on individual-level factors and their interaction with micro, meso, exo, and macrosystem factors. Following PRISMA-ScR guidelines, we conducted a scoping review on diagnostic delays in cancer among women, including qualitative and quantitative studies with oncological patients or healthcare professionals. We searched PubMed/MEDLINE and Scopus for publications from 2018 to November 28, 2023, excluding studies not meeting the inclusion criteria, not in English or Dutch, or focused solely on cancer screening. Titles and full texts were screened, with disagreements resolved through discussion. Two reviewers independently extracted study details, population characteristics, study design, and factors contributing to diagnostic delays. Initially, 9699 records were retrieved, resulting in 129 relevant studies after exclusions. We focused on women's health and breast cancer, narrowing our scope to 22 studies in high-income countries. Studies explored diagnostic delays and factors at various levels: microsystem (demographics, health behaviours, psychology, healthcare interactions), mesosystem (schedules, peer and support networks), exosystem (social, cultural, environmental, accessibility factors), and macrosystem (broader cultural, societal contexts, healthcare policies). In high-income countries, diagnostic delays in breast cancer care involve factors across various systems, affecting individuals, peers, healthcare, and policies. Enhancing awareness, communication, and access is important, requiring targeted campaigns and infrastructure upgrades. The Bronfenbrenner's ecological model effectively addresses the multifaceted factors influencing diagnostic delays. Future research can benefit from applying this model to various cancers and income settings.

The advanced stage of cancer is a determining factor in poor prognosis. Head and neck squamous cell carcinomas (HNSCC) are highly incident in Brazil, but similarly to many Low and Middle-Income Countries, data is limited regarding the proportion of tumours diagnosed at advanced clinical stages and the main factors associated with it. Therefore, this study aimed to identify the factors associated with advanced stage of HNSCC in Brazil.

Cross-sectional study based on secondary data collected from Hospital-based Cancer Registries (HBCR) between 2000 and 2017. Descriptive data analysis and Poisson regression with robust variance were performed to determine prevalence ratios (PRs).

Among 145,365 HNSCC cases, 78.2% (90,267/115,371) were diagnosed at stages III or IV. The highest percentage of advanced-stage tumours were hypopharyngeal [91.3% (10,186/11,159)], followed by oropharyngeal [86.6% (28,578/32,991)], oral cavity [75.1% (27,121/36,120)], and laryngeal cancer [69.5% (24,382/35,101)]. We observed annual increase trends of 0.29% and 0.38% for oral cavity and oropharyngeal late-stage tumours, respectively. Patients younger than 50 years old, with a low education level, presenting a primary tumour located in the hypopharynx or oropharynx, and alcohol and tobacco consumers were positively associated with advanced stage. Furthermore, we observed a dose-response effect of a statistically significant reduction in the prevalence of cases diagnosed in advanced stages as the patients' age group or education level increased.

Diagnosis of HNSCC at advanced clinical stages in Brazil was associated with age, primary tumour site, and socioeconomic factors that must be mitigated, allowing more universal and equitable access and diagnosis at earlier stages.

No funding.

This study aimed to explore coping strategies adopted by patients diagnosed with oral squamous cell carcinoma (OSCC) and investigate the reasons for delayed healthcare-seeking help STUDY DESIGN: Data were collected through semi-structured interviews based on the Semi-Structured Self-Regulatory Model (SRM) with participants diagnosed with advanced OSCC, between 2021 and 2023. The sample size was determined based on the saturation point. In this context, saturation refers to the point when no new issues emerge, signaling sufficient sample size. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed using framework analysis.

The sample consisted of 15 patients, 13 male and 2 female, aged between 52 and 80 years (mean 64.5, SD ± 7.5). Four types of coping strategies causing delayed help-seeking emerged: 1) self-medication, 2) seeking medical appointments, 3) abandoning consultations (or treatment), and 4) consulting general dental practitioners. Participants believed that the disease could heal spontaneously and did not consider seeking health help immediately. Socio-economic factors and lack of knowledge on the part of healthcare professionals may have influenced the delay in the diagnosis CONCLUSION: Patients with advanced OSCC demonstrated inadequate disease awareness, oral cancer knowledge, misdiagnosis, and insufficient referrals to specialized treatments.

Background/Objectives: Oral cancer (OC) is a disease with poor prognosis mainly due to late diagnosis. There is considerable interest in the use and development of rapid, point of care (POC) non-invasive methods that can accelerate the diagnostic process. Bioimpedance (BI) is resistance to the passage of electric currents through tissue that reflects structural changes in the tissue. The aim of this study was to determine the spectrum of BI values in patients with oral cancer, to compare them with other oral lesions and healthy controls, and to determine the diagnostic value of the BI-based method for diagnosis of OC. Methods: Ninety-three participants divided into three groups participated in this study. The first group (31 participants) consisted of patients with histologically confirmed OC, the second group (31 participants) consisted of patients with an active reticular form of oral lichen planus (positive controls; OLP) and the third group (31 participants) consisted of healthy controls. In OC and OLP patients, BI was measured at three points (non-ulcerated lesional mucosa, clinically unaffected perilesional mucosa and unaffected mucosa on the contralateral side). In healthy controls, BI was measured on a healthy mucosa in the corresponding anatomical region. Measurements were performed at nine frequencies (1, 2, 5, 7, 10, 20, 70 and 100 kHz). Results: In OC patients, BI values in the lesion were significantly lower than BI values in clinically intact perilesional mucosa and the unaffected contralateral side at all frequencies. Furthermore, BI values of the clinically intact perilesional mucosa were significantly lower than the BI values of the healthy contralateral mucosa at frequencies of 1 kHz, 2 kHz, 5 kHz, 7 kHz and 10 kHz. Patients with OC had significantly lower BI values compared to patients with OLP and individuals with healthy oral mucosa at all frequencies. Conclusions: This study demonstrated the very good to excellent ability of this method to detect OC lesions, which needs to be confirmed by further studies on a larger number of participants.

This study aimed to investigate total diagnostic delay (TDD) in periodontitis and identify the factors associated with it.

In this cross-sectional study, 145 newly examined and diagnosed periodontitis patients were recruited. A structured questionnaire was used to gather data on demographics, symptom onset, duration of diagnostic delay(s), and potential associated factors. Multiple regression analysis and the Mann‒Whitney U test were used to analyse the impact of various factors on the timing of diagnosis delay.

TDD averaged 59.3 ± 70.2 months, with a median of 36 months. Patient delay accounted for 74.4% of the cases, which was attributed to misconceptions about symptoms and reliance on self-medication. Professional delay accounted for 25% of the cases, with a significantly longer median delay (36 months) than patient delay (24 months) (p < 0.05). Factors predicting longer TDD included older age, multiple dentist visits, and the presence of calculus. The use of home remedies was associated with a longer TDD, whereas smoking and gingival swelling were associated with a significantly shorter TDD (P < 0.05).

This first-of-its-kind study identified significant diagnostic delays in periodontitis, one of the most common oral diseases, underscoring critical gaps in patient education and care. Age, frequency of dental visits, and misconceptions regarding calculus contribute to these delays.

Delayed diagnosis of periodontitis has significant implications, leading to extensive oral damage and eventual tooth loss, which compromises oral function, aesthetics, and quality of life. Addressing these delays through comprehensive public health strategies and improving dental training in periodontology can significantly improve oral and systemic health outcomes, reduce economic burdens, and contribute to the overall well-being of the population.

Oral squamous cell carcinoma (OSCC) is a prevalent malignancy with high morbidity and mortality rates. Timely diagnosis is critical for improving patient outcomes; however, diagnostic delays remain a concern. Understanding the factors that contribute to these delays is essential for developing effective interventions. This cross-sectional study aimed to investigate the demographic, socioeconomic, and clinical determinants of diagnostic delay in patients with OSCC.

This cross-sectional study included 226 patients with OSCC. Demographic data, including age, sex, marital status, education, and monthly household income, were collected. The time from symptom onset to definitive diagnosis was recorded. Stratified analysis and chi-square tests were conducted to assess the association between demographic and socioeconomic factors and diagnostic delays.

The mean diagnostic delay was 55.2 days, with 61.9% of the patients experiencing delays exceeding 40 days. Older age (>50 years), single marital status, lower educational level, and lower monthly income were associated with longer diagnostic delays (p < 0.05). Delays in biopsy sample collection also correlated with increased diagnostic delay (p < 0.05).

Demographic and socioeconomic factors significantly influence diagnostic delays in patients with OSCC. Targeted interventions to address these disparities are crucial for improving early detection and enhancing patient outcomes.

Oral cancer, a malignancy that is prevalent worldwide, is often diagnosed at an advanced stage. MicroRNAs (miRNAs) in circulating exosomes have emerged as promising cancer biomarkers. The role of miRNA let-7c-5p in oral cancer remains underexplored, and its potential involvement in tumorigenesis warrants comprehensive investigation.

Serum samples from 30 patients with oral cancer and 20 healthy controls were used to isolate exosomes and quantify their RNA content. Isolation of the exosomes was confirmed through transmission electron microscopy. Quantitative PCR was used to assess the miRNA profiles. The effects of let-7c-5p and TAGLN overexpression on oral cancer cell viability, migration, and invasion were analyzed via CCK-8 and Transwell assays. Moreover, we conducted mRNA sequencing of exosomal RNA from exosomes overexpressing let-7c-5p to delineate the gene expression profile and identify potential let-7c-5p target genes.

let-7c-5p was upregulated in serum-derived exosomes of patients with oral cancer. Overexpression of let-7c-5p in the TCA8113 and CAL-27 cell lines enhanced their proliferative, migratory, and invasive capacities, and overexpression of let-7c-5p cell-derived exosomes promoted oral cancer cell invasiveness. Exosomal mRNA sequencing revealed 2,551 differentially expressed genes between control cell-derived exosomes and overexpressed let-7c-5p cell-derived exosomes. We further identified TAGLN as a direct target of let-7c-5p, which has been implicated in modulating the oncogenic potential of oral cancer cells. Overexpression of TAGLN reverses the promoting role of let-7c-5p on oral cancer cells.

Our findings highlight the role of exosomal let-7c-5p in enhancing oral cancer cell aggressiveness by downregulating TAGLN expression, highlighting its potential as a diagnostic and therapeutic strategy.

Artificial intelligence (AI) is revolutionizing head and neck cancer (HNC) care by providing innovative tools that enhance diagnostic accuracy and personalize treatment strategies. This review highlights the advancements in AI technologies, including deep learning and natural language processing, and their applications in HNC. The integration of AI with imaging techniques, genomics, and electronic health records is explored, emphasizing its role in early detection, biomarker discovery, and treatment planning. Despite noticeable progress, challenges such as data quality, algorithmic bias, and the need for interdisciplinary collaboration remain. Emerging innovations like explainable AI, AI-powered robotics, and real-time monitoring systems are poised to further advance the field. Addressing these challenges and fostering collaboration among AI experts, clinicians, and researchers is crucial for developing equitable and effective AI applications. The future of AI in HNC holds significant promise, offering potential breakthroughs in diagnostics, personalized therapies, and improved patient outcomes.

This study aims to evaluate the expression of salivary and plasmatic miRNAs as diagnostic biomarkers in patients with oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs). A total of 25 patients were divided into three groups, according to their diagnosis: OSCC patients (n = 14); OPMDs patients (n = 6); and healthy controls (n = 5). At the time at diagnosis/enrolment, patients underwent salivary and plasmatic collection. The expression of miRNA -21, -31, -138, -145, -184, and -424 were evaluated by real-time PCR. An F-test and ANOVA test were performed to evaluate the miRNA levels (significance at p < 0.05). By comparing miRNA expression levels from saliva, a statistically significant difference emerged in the expression of miR-138 and miR-424 between the three groups (p < 0.05). In particular, these two miRNAs showed decreased expression levels in saliva samples from OSCC and OPMD patients compared to those from healthy controls. On the other hand, miRNA expression levels in plasma were low in all the groups, and no statistically significant differences were found. Overall, our results showed that liquid biopsy from saliva may be a useful tool for the identification of diagnostic molecular biomarkers in OSCC and OPMDs.

Oral cancer is one of the ten most common malignancies in the world and approximately 90 % of cases are OSCC. Despite the progress in available treatment modalities, the mortality of patients with OSCC has remained steadily high during the last 20 years. Survival data is strongly influenced by the timing of diagnosis: with more than 50 % of patients being diagnosed at an advanced stage, and their 5-year survival rate being less than 50 %. Therefore, early diagnosis plays a crucial role in improving a patient's prognosis, as early stage cancers show a survival rate of over 90 %, whereas it drops to 5-20 % stage III and IV disease. This prospective study has been conducted with an aim of assessing diagnostic delays and looking at the various patient and tumour factors and their association with them.

This prospective observational study was conducted from December 2023 to February 2024. The cases for the present study included cases of oral squamous cell carcinoma diagnosed by clinical, radiological and/or histological confirmation. The patient delay was recorded in days as informed by the patients themselves, about the onset of their symptoms to time taken to seek medical attention. This was then associated with various patient and tumour related factors.

A total of 120 (n) patients were interviewed and these patient's case sheets were recruited for the present study. The median primary delay for the entire population was found to be 90 days while the median secondary delay was 11 days. The median total delay was found to be 106 days. The median total delay was higher among females and younger population though this was not statistically significant. However education showed a significant impact with literate patients presenting much earlier. Smoking and alcohol abuse did not show a significant effect on delay. Various tumour factors also did not show any statistically significant effect on delay although, patients with advanced stage and nodal secondaries presented at a much later time.

Both patient and tumour related factors as well as the decisions made during the first contact with health care providers influence delay before specialist consultation. Raising awareness of HNC symptoms among the general population and GPs is the way to get patients to curative treatment without long delay.

To assess the influence of diagnosis and referral provided by specialists in oral diagnosis on disease-free survival and overall survival of patients with oral cancer.

A cohort of 282 patients with oral cancer treated at a regional cancer hospital from 1998 to 2016 was analyzed retrospectively. The referral register of the patients was analyzed and assigned to two groups: (1) those referred by oral diagnosis specialists (n = 129), or (2) those referred by nonspecialized professionals (n = 153). The cancer treatment evolution was assessed from the patients' records, and the outcome was registered concerning cancer recurrence and death. Sociodemographic and clinicopathological variables were explored as predictors of disease-free survival and overall survival.

Group 1 exhibited lower T stages and a reduced incidence of regional and distant metastases. Surgery was performed in 75.2% of cases in Group 1, while in Group 2, the rate was 60.8%. Advanced T stages and regional metastases reduced the feasibility of surgery. Higher TNM stages and tumor recurrence were associated with decreased disease-free survival, while surgical intervention was a protective factor. Higher TNM stage had a negative impact on the overall survival.

Specialized oral diagnosis did not directly impact disease-free survival and overall survival and did not influence the indication of surgery in oral cancer; however, it was associated with the diagnosis of early tumors and better prognosis.

Oral squamous cell carcinoma (OSCC) is one of the most common cancers worldwide. A delay in the diagnosis of OSCC can have a drastic impact on management and patient outcomes. One of the most crucial elements in oral management is the timely histopathological final diagnosis. Turnaround time (TAT) is regarded as the most important component of the quality performance evaluation. Many labs have struggled to improve their TATs despite advancements in computerization, transport systems, and analytical technologies.  Aim: This study aimed to assess the TAT of OSCC cases, assess the mean TAT period, evaluate any TAT delays, and explore the reasons behind the TAT delays.  Materials and methods: OSCC reports in Saveetha Dental College and Hospitals, Chennai, for one year from January 1, 2022, to December 31, 2022, were retrieved from the Dental Information Archival Software (DIAS), and the mean TAT was noted. Further, the number of cases with delay in TAT was also observed, and the reason for their delay was listed. Descriptive statistics and graphical representation were performed utilizing IBM SPSS Statistics for Windows, V. 23.0 (IBM Corp., Armonk, NY, USA). One-way ANOVA was performed with a significance set at a p-value less than 0.05.

230 OSCC cases were retrieved and included in the TAT evaluation for this study. Among 230 cases, 161 (70%) were incisional and 69 (30%) were excisional biopsies. Only seven (4%) incisional cases and seven (10%) excisional biopsies showed a delay in TAT. The most common reason for the delay in TAT was the requirement for deeper sections and decalcification of bone specimens. Out of 161 incisional cases, only 48 (29%) have undergone excision and further treatment. Twenty-one out of 69 (30%) excisional cases were found to be referral cases from other private institutions. The overall average TAT for 12 months was 3.24 ± 0.41 days for incisional biopsies and 11.88 ± 2.07 days for excisional biopsies. One-way ANOVA revealed a statistically significant p-value of less than 0.00001.

Our study sheds light on specific challenges in TAT delay and opportunities for the improvement of TAT. This can result in faster TAT of OSCC reports, further improve patient care, and enable prompt treatment. This study quantified the TAT for OSCC cases and identified critical areas for process improvement. The findings can inform strategies to streamline diagnostic workflows, reduce delays, and ultimately improve the timely delivery of care to patients with OSCC.

Objectives: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area. This paper aims to determine the occurrence and characteristics of OM in patients with head and neck cancer (HNC), as well as the involvement of dentists/oral medicine specialists in treating such patients. Methods: This study was conducted at the Department of Otorhinolaryngology and Department of Oral Medicine, University Hospital Center Zagreb, from April to August 2022, on patients irradiated in the head and neck area. A unique OM questionnaire was created on the incidence, characteristics, oral care, and involvement of dentists in the overall care. Results: Thirty patients filled out the questionnaire. Of the 22 patients who had developed OM, 14 had grade-three OM. Ten patients were treated for OM in line with the instructions of an oral medicine specialist, eight based on the instructions of a specialist responsible for monitoring of the underlying disease, and four were not treated at all. Sixteen patients had not been referred to a dentist before the start of RT. Conclusions: These results showed insufficient care and treatment of OM, as well as insufficient involvement of dentists in the oncology team.

This ecological study aimed to identify the factors with the greatest power to discriminate the proportion of oral and oropharyngeal cancer (OOC) records with time to treatment initiation (TTI) within 30 days of diagnosis in Brazilian municipalities. A descriptive analysis was performed on the variables grouped into five dimensions related to patient characteristics, access to health services, support for cancer diagnosis, human resources, and socioeconomic characteristics of 3,218 Brazilian municipalities that registered at least one case of OOC in 2019. The Classification and Regression Trees (CART) technique was adopted to identify the explanatory variables with greater discriminatory power for the TTI response variable. There was a higher median percentage of records in the age group of 60 years or older. The median percentage of records with stage III and IV of the disease was 46.97%, and of records with chemotherapy, radiation, or both as the first treatment was 50%. The median percentage of people with private dental and health insurance was low. Up to 75% had no cancer diagnostic support services, and up to 50% of the municipalities had no specialist dentists. Most municipalities (49.4%) started treatment after more than 30 days. In the CART analysis, treatment with chemotherapy, radiotherapy, or both explained the highest TTI in all municipalities, and it was the most relevant for predicting TTI. The final model also included anatomical sites in the oral cavity and oropharynx and the number of computed tomography services per 100,000. There is a need to expand the availability of oncology services and human resources specialized in diagnosing and treating OOC in Brazilian municipalities for a timely TTI of OOC.

The occurrence and causes of primary professional delay in diagnosis of oral squamous cell carcinoma (OSCC) were examined.

Factors related to initial diagnosis or malignancy suspicion were evaluated in patients with primary OSCC. The outcome variable was primary professional delay for missed suspicion of malignancy or wrong diagnosis or delayed referral. The primary predictor variable was active care-seeking. Secondary predictor variables were patients' symptoms and clinical findings.

Primary professional delay was found in 9.5% of the 528 patients included. Professional delay was 6.6 times more likely to occur in patients actively seeking care than in those whose tumor was an incidental finding (95% CI 1.58-27.58, p = 0.010). Pain (OR = 2.0, 95% CI 1.07-3.87, p = 0.031), ulceration (OR = 2.3, 95% CI 1.29-4.19, p = 0.005), denture fit problem (OR = 3.1, 95% CI 1.25-7.56, p = 0.014), and unhealed tooth extraction socket (OR = 29.6, 95% CI 8.89-98.71, p < 0.001) were significant predictors for primary professional delay.

OSCC patients seek care actively. Primary professional delay affects the care of every tenth OSCC patient.

The role of health care professionals is essential for early OSCC diagnosis, especially in urgent care. Clinicians' knowledge of the typical symptoms and findings of OSCC should be improved.

Oral cancer is the sixteenth most common malignant neoplasm worldwide, with a high mortality rate, greater than 50% at five years, and high morbidity. The effect of oncological treatment in the oral cavity is broad and has multiple levels, therefore knowing these effects and preventing them is essential for avoiding an increase in the oral pathology related with oncological therapy, maintaining the quality of life of the patient, and improving the efficacy of the treatment itself.

A group of experts belonging to the fields of Dentistry, Maxillofacial Surgery and Oncology of the University of Seville and the Virgen del Rocío University Hospital of Seville in collaboration with the University of Valencia, University of Barcelona, and University of the Basque Country, developed this Clinical Practice Guideline for the proper clinical management of patients diagnosed with oral cancer. The clinical questions were formulated in PICO format. The databases consulted were Medline/PubMed and Embase/Elsevier. The systematic reviews published on the topic were identified on Tripdatabase, Cochrane Library and CRD (Centre for Reviews and Dissemination). The recommendations were prepared based on the GRADE methodology.

Various recommendations were defined, derived from the 21 PICO questions, referring to prevention, treatment and care for alterations arising from the pathology of oral cancer itself and its treatment.

The preparation of this clinical practice guideline allows recommendations to be generated based on the scientific evidence available, on dentistry actions in patients with oral cancer and undergoing oncological treatment, which may be of use to the multidisciplinary team treating this type of patient.

Through awareness campaigns, we can change the patient's abilities to detect oral cancer at an early stage and their ability to seek help. To focus these campaigns, we need to know the level of knowledge of the population and its interest in learning about this disease. The aim of this study was to assess the level of oral cancer awareness in Asturias and the interest of the population in learning about this pathology.

A representative community-based survey was carried out online using Google Forms®. Responses were transferred to a Microsoft Excel and analysed using the R-program. The relationship between two qualitative variables was studied using Pearson's Chi-square test or Fisher's test. Univariate and multivariate logistic regression models were used to determine which factors are associated with knowledge of oral cancer.

We found that those having over 50 years and being health professionals are more likely to know about the existence of oral cancer. Almost 85.1% of participants mentioned tobacco as a risk factor, only 39.8% identified alcohol. The ulcer was the most frequently recognized alarm sign (70.6%). The primary care physician was chosen as the first option for consultation by the 56.5% of the sample. Only 12.4% of the participants reported knowing how to self-examine their mouth. The number of views of a video of how-to self-inspection oral cavity displayed at the end of the questionnaire increased in a 39.38% during our study period.

This survey showed a worrying lack of awareness and knowledge about oral cancer among the population of Asturias, especially among those under 50 years old. The interest shown in increasing their knowledge, give us hope in the success of future awareness campaigns.

The aim of this study is to explore knowledge, practice, and attitude on oral cancer (OC) among a cohort of Italian dental hygienists, in consideration of their role in the field of early diagnosis.

A cross-sectional study of 150 Italian dental hygienists was performed to assess the participant's knowledge, practice, and attitude on OC. Data were collected using a structured self-administered questionnaire (through Google Forms). The questionnaire included four sections: sociodemographic information, disease knowledge, answers related to attitudes toward OC, and a questionnaire assessing the practice of dental hygienists on oral screening.

Responses were received from 137 participants (83 women and 54 men). Overall, there is a good knowledge of the real risk factors among the participants (98.5%, 98.5%, and 94.2% regard smoking, alcohol, and HPV, respectively). The analysis related to the knowledge of non-risk factors, oral potentially malignant disorders, and clinical features of OC showed more heterogeneous results. Only 60% considered university education to be adequate. The totality of dental hygienists considered continuing education necessary, but despite this, only half took updating courses. Finally, 90% performed intraoral screening visits, and 95% and 69% investigated smoking and alcohol consumption, respectively.

Our data showed the need to implement OC training courses by re-evaluating pre- and post-graduate training programs.

This study analyzes the effect of the Brazilian National Oral Health Policy (NOHP) on oral cancer mortality rates (OCMR).

This is an ecological study with secondary oral cancer death data, using interrupted time series analysis (ARIMA, Autoregressive Integrated Moving Average). Annual death data were collected from the Mortality Information System (1996-2019). The outcome was the OCMR, standardized by gender and age We considered the NOHP, categorized as "0" (before its implementation), from 1996 to 2004, and "1 to 15", from 2005 to 2019. ARIMA modeling was carried out for temporal analysis, and regression coefficient estimation (RC).

The Brazilian NOHP implementation was associated with an increase in OCMR in the North region (CR = 0.16; p = 0.022) and with a decrease in the Southeast region (CR = -0.04; p<0.001), but did not affect the other macro-regions nor Brazil. The forecast models estimated an increase in OCMR for the North, and Northeast, a decrease for the Southeast, and stability for the South and Brazil.

The Brazilian NOHP is not being effective in reducing the OCMR. The trends behaved differently in the Brazilian territory, highlighting health inequities. We recommend that the NOHP strengthen the oral health care network, incorporating oral cancer as a notifiable disease, adopting strategies for prevention, screening, and providing opportunities for early treatment of the disease.

Oral squamous cell carcinoma (OSCC) is frequently diagnosed at an advanced stage, with the five-year survival rate varying around 50%, however, ifs the sooner OSCC in early-stage is treated, the lower the chances of recurrence and death. In this study, we described an OSCC diagnosed early, highlighting how the early surgical excision prevents the morbidity.

A 74-year-old man presented a whitish and symptomatic plaque and a discreet ulcerated area on the right lateral border of the tongue. Due to close contact with the second inferior molar, a clinical diagnosis of a frictional keratosis was suspected, however as the lesion persisted after two weeks of follow-up, an incisional biopsy was performed and the microscopic features revealed an OSCC. Early surgical resection was performed, preventing the morbidity and improve benefits to patient.

OSCC can manifest of several clinical forms, including indolent appearances, which can delay the diagnosis, and consequently the prognosis. Further, it is important to recognize and not neglect any intraoral lesions, in order to avoid the far more invasive surgery that a more advance disease would imply.

Previous studies measuring intervals on the oral cancer care pathway have been heterogenous, showing mixed results with regard to patient outcomes. The aims of this research were (1) to calculate pooled meta-analytic estimates for the duration of the patient, diagnostic and treatment intervals in oral cancer, considering the income level of the country, and (2) to review the evidence on the relationship of these three intervals with tumor stage at diagnosis and survival.

We conducted a systematic review with meta-analysis following PRISMA 2020 guidelines (pre-registered protocol CRD42020200752). Following the Aarhus statement, studies were eligible if they reported data on the length of the patient (first symptom to first presentation to a healthcare professional), diagnostic (first presentation to diagnosis), or treatment (diagnosis to start of treatment) intervals in adult patients diagnosed with primary oral cancer. The risk of bias was assessed with the Aarhus checklist.

Twenty-eight studies reporting on 30,845 patients met the inclusion criteria. The pooled median duration of the patient interval was 47 days (95% CI = 31-73), k = 18, of the diagnosis interval 35 days (95% CI = 21-38), k = 11, and of the treatment interval 30 days (95% CI = 23-53), k = 19. In lower-income countries, the patient and treatment intervals were significantly longer, and longer patient intervals were related to later stage at diagnosis. In studies with a lower risk of bias from high-income countries, longer treatment intervals were associated with lower survival rates.

Interval duration on the oral cancer care pathway is influenced by the socio-economic context and may have implications for patient outcomes.

We undertook a rapid review of literature relating to the diagnosis of blood cancers, to find out what factors contribute to delays in diagnosis, including symptom recognition, appraisal and help-seeking behaviours.

We used rapid review methodology following Tricco et al. to synthesise current literature from two electronic databases. We searched for studies about symptom appraisal help-seeking for all blood cancers published between 2001 and 2021, written in English.

Fifteen studies were included in the review, of which 10 were published in the United Kingdom. We found a number of factors associated with delays in blood cancer diagnosis. These included patient factors such as gender, age and ethnicity, as well as health system factors such as poor communication and seeing a locum clinician in primary care. A narrative synthesis of the evidence produced four types of symptom interpretation by patients: (1) symptoms compatible with normal state of health, (2) event-linked problems, (3) mild or chronic illness and (4) non-specific unwell state. These four interpretations were linked to different help-seeking behaviours. After seeking help, patients often experienced delays due to healthcare professionals' (HCPs') non-serious interpretation of symptoms, misleading blood tests, discontinuity of care and other barriers in the diagnostic pathway.

Blood cancers are difficult to diagnose due to non-specific heterogeneous symptoms, and this is reflected in how those symptoms are interpreted by patients and managed by HCPs. It is important to understand how different interpretations affect delays in help-seeking, and what HCPs can do to support timely follow-up for patients.

The aim of this study was to identify clinicopathologic features, treatment and prognosis of oral adenocarcinoma (OADC).

Retrospective cohort analysis.

National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program.

Patients diagnosed with OADC between 2000 to 2018 were identified from the SEER database. Overall survival (OS) and disease-specific survival (DSS) were assessed using Kaplan-Meier analyses and Cox regression models.

There were 924 OADC and 37,500 oral squamous cell carcinoma (OSCC) patients identified. Patients with OADC were more significantly associated with younger age, female gender, well differentiation and early AJCC Clinical stage. The study revealed that patients with OADC had better 10-year OS and DSS than those with OSCC (OS: 69.3% vs 40.8%, P < 0.001; DSS: 83.6% vs 53.3%, P < 0.001). The survival advantage still persisted in multivariable analyses (OS: hazard ratio [HR] = 0.427, P < 0.001; DSS: HR = 0.320, P < 0.001). For OADC, multivariable analysis showed that advanced age, stage, and histologic grade were associated with worse OS and DSS, and surgery was associated with better OS and DSS.

OADC has a significantly better prognosis than OSCC, with better differentiation, and more early stage. Surgery was the preferred treatment, for patients with lymph node metastasis, radiotherapy may afford a survival benefit.

The aim of the study was to verify the knowledge on oral cancer and to assess possible differences in awareness and information basing on different demographic and subject-related factors. An anonymous survey was provided to 750 random subjects using online-based questionnaires. Statistical analysis was performed in order to evaluate the influence of demographic variables (gender, age, education) on knowledge of oral cancer and its risk factors. 68.4% of individuals knew about the existence of oral cancer, mostly from media and family/friends. Awareness was significantly influenced by gender and higher education, but not by age. Most participants recognized smoking as a risk factor, but alcohol abuse and sunlight exposure are less known, especially among less educated subjects. On the contrary, our study shows a diffusion of false information: more than 30% of the participants indicated the possible role of amalgam fillings in oral cancer onset, independently of gender, age or education. The results of our study suggest the need for oral cancer awareness campaigns, where school and healthcare professionals should be actively involved in promoting, organizing and finding methods to monitor the medium and long-term efficacy with proper methodological quality.

One of the most prevalent malignancies diagnosed today is cancer of the mouth or oral cancer. Compared to systemic malignancies like lung cancer, colon cancer, etc., oral cancer tends to get less attention from the general public. However, these lesions may be lethal if not treated, even if diagnosed early. Early diagnosis improves the prognosis for successful therapy. Delayed diagnosis is hypothesized to be a pivotal contributor to the dismal oral cancer survival rate over five years. The current standard of care for diagnosis and detection is based on clinical evaluation, the histological study of biopsy material, and genetic methods. There have been several advancements in the diagnostic technologies available to detect oral cancer at the initial phase. This study aims to dissect the cutting-edge methods for detecting oral cancer in its earliest stages.

To assess the effect of coverage of the Bolsa Família Program (BFP) on oral cancer mortality rates in Brazil between 2005 and 2017, adjusting for health care coverage and socioeconomic characteristics of the Brazilian federative units.

This is an ecological study using annual data (2005-2017) from all the Brazilian federative units. The dependent variable for this study was the oral cancer mortality rate, standardized by gender and age using the direct standardization technique. BFP coverage was the main independent variable, calculated as the ratio of the number of BFP beneficiaries to those families that should potentially be entitled to this conditional cash transfer. Socioeconomic background and health care coverage were covariables. Choropleth maps were drawn, and space-time cube analysis was used to assess changes in the spatiotemporal distribution of BFP and oral cancer mortality rates. Mixed-effects linear regression analysis estimated the coefficients (β) and 95% confidence intervals (CI) for the association between BFP coverage and oral cancer mortality rates.

BFP coverage trends increased and oral cancer mortality rate trends stabilized in Brazilian federative units, except for Maranhão, Goiás, and Minas Gerais, where the oral cancer mortality rates have increased. In the adjusted model, greater BFP coverage was associated with lower oral cancer mortality rates (β -2.10; 95% CI [-3.291, -0.919]).

Egalitarian strategies such as BFP can reduce the oral cancer mortality rate. We recommend the follow-up of families benefiting from conditional cash transfer program by oral health teams to reduce the oral cancer mortality rate.

The mortality rate of patients affected with oral squamous cell carcinoma (OSCC) has been stable in recent decades due to several factors, especially diagnostic delay, which is often associated with a late stage diagnosis and poor prognosis. The aims of this paper were to: analyze diagnostic delay in OSCC and to discuss the various psychological factors of patients with OSCC, with particular attention to the patient's fear of receiving news regarding their health; and the professional dynamics related to the decision-making processes in cases of suspected OSCC. A preliminary review of literature focusing on OSCC diagnostic delay was performed. Seven articles were included with the diagnostic delay ranging from 45  days to approximately 6  months. Patients' fears and, to a lesser degree, the concerns of dentists, were found to be still poorly investigated. On the basis of the authors' professional experience, the development of oral lesions of unknown origin may generate different behaviors in the decision-making processes by patients and clinicians, and fear may play a key role in the distinct steps of this process. It is crucial to increase awareness and inform patients about the onset of OSCC, and contemporaneously encourage experimental studies on patients' fear and professional behaviors with respect to communication regarding OSCC.

Oral cancer is a growing problem, accounting for 377,713 worldwide new cases per year, and 177,757 deaths annually and representing a 5-year mortality rate close to 50%, which is a considerable mortality that has not decreased substantially in the last 40 years. The main cause of this high mortality is related to the diagnosis of a high percentage of oral cancers in advanced stages (stages III and IV) in which treatment is complex, mutilating or disabling, and ineffective. The essential cause of a cancer diagnosis at a late stage is the delay in diagnosis, therefore, the achievement of the objective of improving the prognosis of oral cancer involves reducing the delay in its diagnosis. The reasons for the delay in the diagnosis of oral cancer are complex and involve several actors and circumstances-patients, health care providers, and health services. In this paper, we present the results of a scoping review of systematic reviews on the diagnostic delay in oral cancer with the aim to better understand, based on the evidence, and discuss in depth, the reasons for this fact, and to identify evidence gaps and formulate strategies for improvement.

The identification of non-invasive biomarkers from biological fluids collected by liquid biopsy provides new horizons for individualized therapeutic strategies and improves clinical decision-making in OSCC patients. Circulating microRNAs have emerged as biomarkers that may reflect not only the existence of cancer, but also the dynamic, malignant potential, and drug resistance of tumors. The aim of the systematic review is to evaluate and summarize the results of the published studies regarding the use of microRNAs as biomarkers for OSCC.

A literature search was conducted on PubMed, Scopus, Web of Science, and Cochrane databases till November 2020. A total of 34 studies met the inclusion criteria and were therefore subjected to quality assessment. Each study was subjected to data extraction including; patient characteristics, type of fluid sample (whole blood, plasma, serum, or saliva), molecular analysis method, specific dysregulated microRNA, and microRNA expression pattern.

The analysis showed that 57 microRNAs of liquid biopsy samples of four different fluids (whole blood, serum, plasma, and saliva) were analyzed. The prognostic and therapeutic significance of these microRNAs were suggested by several studies; where 41 microRNAs were upregulated while 16 were downregulated.

Scientific evidence supports the interest in the use of microRNAs in the diagnosis and prognosis in OSCC patients; however, further studies in a larger cohort of patients are mandatory to introduce liquid biopsy in the routine clinical practice for the OSCC management. Key words:Biomarkers, liquid biopsy, microRNA, oral squamous cell carcinoma, systematic review.

Oral squamous cell carcinoma (OSCC) of the gingiva represents less than 6% of intraoral carcinomas.

A 51-year-old male patient presented with a history of a symptomatic red spot with periods of remission and recurrence in the mandibular gingiva. On clinical examination red and white areas were observed in the gingiva, particularly around the left lower molars. Diagnosis of gingival lichen planus was suspected and topical corticosteroids was prescribed. A good clinical response was observed with reduction of symptom. The patient remained in regular follow-up and after 9 months, the lesion suddenly changed, became ulcerated and diagnosis of OSCC was established.

The clinical manifestation of OSCC can eventually mimic other even more common lesions of the oral mucosa, highlighting the importance of considering OSCC as differential diagnosis of any unexplained and persistent lesion in the oral cavity.