Oral Cavity and Oropharyngeal Cancer Screening (PDQ®): Screening - Patient Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
What is screening?
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.
It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.
If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
General Information About Oral Cavity and Oropharyngeal Cancer
Oral cavity and oropharyngeal cancer are diseases in which malignant (cancer) cells form in the mouth and throat.
Oral cavity cancer forms in any of these tissues of the oral cavity:
- The front two thirds of the tongue.
- The gingiva (gums).
- The buccal mucosa (the lining of the inside of the cheeks).
- The floor (bottom) of the mouth under the tongue.
- The hard palate (the front of the roof of the mouth).
- The retromolar trigone (the small area behind the wisdom teeth).
Anatomy of the oral cavity. The oral cavity includes the lips, hard palate (the bony front portion of the roof of the mouth), soft palate (the muscular back portion of the roof of the mouth), retromolar trigone (the area behind the wisdom teeth), front two-thirds of the tongue, gingiva (gums), buccal mucosa (the inner lining of the lips and cheeks), and floor of the mouth under the tongue.
Oropharyngeal cancer forms in any of these tissues of the oropharynx:
- The middle part of the pharynx (throat) behind the mouth.
- The back one third of the tongue.
- The soft palate (the back of the roof of the mouth).
- The side and back walls of the throat.
- The tonsils.
Most oral cavity and oropharyngeal cancers start in squamous cells, the thin, flat cells that line the lips, oral cavity, and oropharynx. Cancer that forms in squamous cells is called squamous cell carcinoma.
See the following PDQ summaries for more information about the screening, diagnosis, and treatment of oral cavity and oropharyngeal cancer:
- Oral Cavity and Oropharyngeal Cancer Prevention
- Lip and Oral Cavity Cancer Treatment
- Oropharyngeal Cancer Treatment
The number of new cases of oral cavity and oropharyngeal cancer and the number of deaths from oral cavity and oropharyngeal cancer varies by race and gender.
Over the past ten years, the number of new cases and deaths from oral cavity and oropharyngeal cancer slightly increased in white men, but remained the same for white women. The number slightly decreased for both black men and black women.
Oral cavity and oropharyngeal cancer is more common in men than in women. Although oral cavity and oropharyngeal cancer may occur in all adults, it occurs more often in older adults who are 65 years and older.
France, Brazil, and parts of Asia have much higher rates of oral cavity and oropharyngeal cancer than most other countries.
The number of new cases of oropharyngeal cancer caused by certain types of human papillomavirus (HPV) infection has increased. One kind of HPV, called HPV 16, is often passed from one person to another during sexual activity.
Different factors increase or decrease the risk of oral cavity and oropharyngeal cancer.
Anything that increases your chance of getting a disease is called a risk factor. Anything that decreases your chance of getting a disease is called a protective factor.
For information about risk factors and protective factors for oral cavity and oropharyngeal cancer, see the PDQ summary on Oral Cavity and Oropharyngeal Cancer Prevention.
Oral Cavity and Oropharyngeal Cancer Screening
Tests are used to screen for different types of cancer.
Some screening tests are used because they have been shown to be helpful both in finding cancers early and in decreasing the chance of dying from these cancers. Other tests are used because they have been shown to find cancer in some people; however, it has not been proven in clinical trials that use of these tests will decrease the risk of dying from cancer.
Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.
Clinical trials that study cancer screening methods are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI website.
There is no standard or routine screening test for oral cavity and oropharyngeal cancer.
Screening for oral cavity and oropharyngeal cancer may be done during a routine check-up by a dentist or medical doctor. The exam will include looking for lesions, including areas of leukoplakia (an abnormal white patch of cells) and erythroplakia (an abnormal red patch of cells). Leukoplakia and erythroplakia lesions on the mucous membranes may become cancerous.
If lesions are seen in the mouth, the following procedures may be used to find abnormal tissue that might become oral cavity or oropharyngeal cancer:
- Toluidine blue stain: A procedure in which lesions in the mouth are coated with a blue dye. Areas that stain darker are more likely to be cancer or become cancer.
- Fluorescence staining: A procedure in which lesions in the mouth are viewed using a special light. After the patient uses a fluorescent mouth rinse, normal tissue looks different from abnormal tissue when seen under the light.
- Exfoliative cytology: A procedure to collect cells from the lip or oral cavity. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the lips, tongue, mouth, or throat. The cells are viewed under a microscope to find out if they are abnormal.
- Brush biopsy: The removal of cells using a brush that is designed to collect cells from all layers of a lesion. The cells are viewed under a microscope to find out if they are abnormal.
More than half of oral and oropharyngeal cancers have already spread to lymph nodes or other areas by the time they are found. No studies have shown that screening would decrease the risk of dying from this disease.
Risks of Oral Cavity and Oropharyngeal Cancer Screening
Screening tests have risks.
Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.
The risks of oral cavity and oropharyngeal cancer screening include the following:
Finding oral cavity or oropharyngeal cancer may not improve health or help a person live longer.
Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. Finding these cancers is called overdiagnosis. It is not known if treatment of these cancers would help you live longer than if no treatment were given, and treatments for cancer, such as surgery and radiation therapy, may have serious side effects.
Screening may also find oral cavity and oropharyngeal cancers that have already spread and cannot be cured. When these cancers are found, treatment may cause serious side effects and not help a person live longer.
False-negative test results can occur.
Screening test results may appear to be normal even though oral cavity and oropharyngeal cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.
False-positive test results can occur.
Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests and procedures (such as biopsy). which also have risks.
Misdiagnosis can occur.
A biopsy is needed to diagnose oral and oropharyngeal cancer. Cells or tissues are removed from the oral cavity or oropharynx and viewed under a microscope by a pathologist to check for signs of cancer. When the cells are cancer and the pathologist reports them as not being cancer, the cancer is misdiagnosed. Cancer is also misdiagnosed when the cells are not cancer and the pathologist reports there is cancer. When cancer is misdiagnosed, treatment that is needed may not be given or treatment may be given that is not needed.
About This PDQ Summary
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about oral cavity and oropharyngeal cancer screening. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
PDQ® Screening and Prevention Editorial Board. PDQ Oral Cavity and Oropharyngeal Cancer Screening. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/head-and-neck/patient/oral-screening-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389441]
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Last Revised: 2016-06-15
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