Oral Cancer Screening

Oral cancer screening involves examining the mouth and neck for red and white lesions, as well as feeling (palpating) the jaw and head for lumps. It may also include tests such as toluidine blue dye to check for a change in color or texture.


The 4 scenarios depicted illustrate lead time bias and overdiagnosis. Aggressive oral squamous cell carcinomas progress rapidly and are unlikely to be detected in asymptomatic patients during screening.


In addition to high attendance rates and standardized testing procedures, an organized screening program includes referral pathways for detected cases. This helps prevent unnecessary treatment of lesions that would not have progressed (overdiagnosis).

Oral cancers can develop in people of all ages and smoking does not protect against them. In fact, smoking increases the risk for developing mouth and throat cancers, especially in the back of the tongue and throat. In the front of the mouth, cancers are most often related to tobacco or chewing tobacco and alcohol consumption, but they can also be caused by a genetic predisposition in some people. In the very rear of the mouth (oropharynx), cancers are most frequently associated with the human papillomavirus (HPV). These HPV-related cancers can affect anyone, regardless of their lifestyle or habits.


Smoking and alcohol consumption increase the risk of oral cancer. Therefore, these factors should be avoided as much as possible. Similarly, if you are a heavy drinker, it’s important to seek regular oral health exams. Heavy drinking can also lead to liver problems, which can cause a smooth appearance of the tongue, throat and lips.

The Kerala trial showed that screening through visual inspection provided a significant oral cancer mortality reduction compared to control in the overall trial population and in ever-tobacco and/or ever-alcohol users. This suggests that risk-based screening is likely to be more effective in high-risk individuals. Using a validated oral cancer risk prediction model to identify individuals at highest risk could substantially enhance efficiency (47.4% screened for 27.1% oral cancer mortality reduction at NNS = 2023) without compromising program sensitivity.


Eating a well-balanced diet is important for everyone. But it is especially important for people fighting or recovering from oral cancers. Cancer treatments such as radiation and chemotherapy cause damage to healthy cells of the mouth and digestive tract. These damaged cells need good nutrition to repair themselves and fight the cancer.

PDQ cancer information summary has current information about nutrition before, during and after oral cancer treatment. This information is based on an independent review of the medical literature. It is not intended to replace the advice of your doctor or other health care provider.

Cost-effectiveness studies indicate that visual inspection of the mouth as part of a population-based screening program reduces oral cancer death rates in high-risk individuals (Brocklehurst and others 2013). However, it may be difficult to implement this approach in LMICs because patients often cannot afford to lose a day’s wages for attendance at screening clinics or travel to health centers to receive follow-up diagnostic testing and treatment.

Family History

A person with a family history of cancer is at higher risk of developing the disease. To assess the impact of a screening program on this risk, studies should include information about an individual’s relatives who have had cancer.

Screening programs should be evaluated by measuring true-positive and false-negative rates. False-negative rates may occur because of nonspecific findings or because of testing in areas not normally screened (see Table 3).

It is important that people with abnormalities in the mouth seek medical care promptly. Detecting and treating these lesions at an early stage can improve a patient’s prognosis and increase the likelihood of survival. However, treatment for some of these lesions is unnecessary and is referred to as overdiagnosis. PDQ cancer information summaries are regularly updated as new evidence is reviewed and published.


Oral and oropharyngeal cancers are largely preventable. They occur in an area of the mouth that is easily accessible and have readily identifiable risk factors that can be detected with a visual exam by a trained healthcare provider. However, 2 in 5 oral cancer cases are diagnosed late when the prognosis is poor.

Several epidemiological studies have reported favorable stage shifts with screening programs. The Kerala Trial is a notable example of this. However, our imprecise understanding of the natural history of oral squamous cell carcinoma (OSCC) and OPMDs suggests caution in interpreting this reduction as a reduction in mortality.

Furthermore, the US Preventive Services Task Force concluded that the evidence is insufficient to establish that screening for oral and oropharyngeal cancers improves outcomes. In addition, screening can have a number of costs such as false positives, missed cancers and overdiagnosis.


Dentures can cause irritation to the tissues of the mouth. This can lead to a condition called apthous ulcers, or sore spots that look like precancerous cells or very early cancers.

It is important that patients keep their teeth, dentures and other oral appliances as clean as possible to control this condition. They should also make sure to see a dentist for regular preventive exams.

A patient’s risk factors for oral cancer will determine how often they should receive screenings. The recommended frequency varies. Patients should visit their dentist for a visual examination of the lips, gums, throat, cheeks and tongue at least once a year. If a suspicious lesion is observed, the dentist may recommend a biopsy or refer the patient to a doctor for one.

Talk to Your Dentist

Oral cancer is a serious disease, but it can be prevented or detected early with regular oral cancer screenings. Dentists and hygienists are trained to spot the signs of oral cancer, such as red or white patches and other sores that don’t heal. They also look for lumps or swellings in the neck, cheek, lips, mouth, tongue, palate, and floor of the mouth.

They may ask about your medical history, including your history with smoking or excessive alcohol consumption, which can lead to higher risk of developing oral cancer. They will examine your neck and face, feel the sides and front of your neck for lumps and will retract your lips to inspect their inner surfaces. They may also use special lights to detect abnormal tissues.