Oral Cancer Screening

Oral cancer screening helps identify early-stage oral cancers before they spread to other parts of the body. This allows for more treatment options and a better chance of survival.


Screening can be done by a trained healthcare professional or a member of the general public. A recent study found that screening lowered oral cancer mortality with 9 years of follow-up.

Risk Factors

Most cases of oral cancer begin as abnormal tissue changes in the mouth. These changes can be either precancerous or malignant. Often, they are not noticeable and may only be discovered when the patient is examined for another reason. Many times, the cancer has already spread to other parts of the body by the time it is diagnosed. Early detection is important because it can improve the chances of successful treatment.

A variety of different tests can be used to evaluate the risk of developing oral cancer. However, a visual examination of the mouth by a health care professional is the most common method for screening. The Task Force recommends that health care professionals who are trained in performing this exam offer it to people at high risk for oral cancer.

These individuals include those who use tobacco (including snuff, chewing tobacco and cigarettes) or excessive amounts of alcohol. They also include people who have a history of head and neck cancers in the past, especially those of the esophagus, larynx or cervix. In addition, people who have a first-degree relative with head and neck cancer have a greater risk of developing squamous cell carcinoma (SCC) of the mouth.

The Kerala trial results provide evidence that risk-based screening can enhance the efficacy of oral cancer screening programs while maintaining high program sensitivity. The relative efficacy of screening increased with increasing model-predicted 7-year oral cancer mortality. Specifically, the 25% of individuals with the highest model-predicted risk experienced the greatest mortality reduction from oral cancer screening.


The dentist will feel the tissues inside your mouth for lumps and bumps. They will also look at your tongue, gums and cheek for areas that are red or swollen. These areas could be a sign of oral cancer. But they might also be signs of other, less serious conditions. That is why it’s important to see a doctor if you have symptoms that last longer than two weeks. The doctor can tell you if the problem is a sign of a serious condition and if it needs to be treated.

The doctor may do more tests to find out if you have oral cancer. One way is to rinse your mouth with a blue dye during an exam and then shine a special light in your mouth. Healthy tissue shows up dark under the light, while abnormal cells appear white. Another test is called a biopsy. A provider will remove a sample of the suspicious area from your mouth and send it to a lab for analysis.

A doctor can use the results of these tests to determine if your cancer is stage 1, 2, 3 or 4. The stage describes how far the cancer has grown and whether it has spread to other parts of the body. A biopsy can also help your doctor recommend the best treatment for you.


A healthcare provider will examine your mouth, checking for areas of leukoplakia (an abnormal white patch of cells) and erythroplakia (an abnormal red patch of cells), which may become cancerous. Some healthcare providers also use other tools to help look for lesions. These include toluidine blue staining, in which the tissues are coated with a dye; areas that stain darker have more of a chance of being cancerous. Another tool is fluorescence staining, in which the tissues are viewed under a special light.

Some cancers, including oral squamous cell carcinoma (OSCC), grow more slowly than others, which allows for screening to detect them early. This increases the potential for a reduction in morbidity and mortality from the disease.

The US Preventive Services Task Force recommends that routine visual examination be done by a dentist or a medical doctor to check for signs of oral pre-cancer and cancer. These exams are quick and painless. Healthcare providers can feel (palpate) for lumps and bumps in the neck, jaw and throat, as well as under the chin.

Other approaches to cancer detection are being researched, such as panels of salivary or blood-based diagnostic tests that can identify the biomarkers associated with certain cancers. These may lead to more accurate, cost-effective methods of detecting cancers in their early stages and ultimately reducing the burden of cancer on individuals and society.


If a doctor finds mouth cancer at an early stage, treatment is more effective. The five-year survival rate is 85%. But less than one-third of oral cancers are found in the early stages. If the cancer spreads, it’s harder to treat.

There are several ways to screen for oral cancer. These include using a screening tool, examining the mouth with a mirror and probe, and taking a sample of tissue (biopsy). The US Preventive Services Task Force recommends that providers use an organized screening program. This includes an invitation system, training and calibration of screeners, a referral pathway for screening-detected cases, and follow-up treatment.

The most common way to check for cancer is to shine a light in your mouth. Healthy tissues look bright, but abnormal tissues appear dark. Sometimes, additional tests are needed to get an official diagnosis. These tests might include exfoliative cytology or brush biopsy. In exfoliative cytology, a provider uses a brush, piece of cotton, or wooden stick to collect cells from a lesion in your mouth. Then a pathologist looks at the cells under a microscope to see if they’re abnormal.

A cancer that’s detected by screening might never cause symptoms or death, even if it is very aggressive. This is called lead time bias or overdiagnosis.