Mouth cancers, a growing scourge in general and oral health.

Every year, about a half-million people develop cancer in this country (based on 2000 estimates).

Sites in the oral cavity and pharynx (throat) account for about 2% of all cancers. More than 95% of oral cancers occur in individuals aged 35 and older.

The overall five-year survival rate for people with oral and pharyngeal cancers is 52 percent, which is worse than that for cancers of the prostate, corpus and uterus, breast, bladder, cervix, colon, and rectum.

Compared to patients with other types of cancer, oral and pharyngeal cancer patients who survive have the highest rate of development of new cancers in the mouth or in other parts of the body.

Males have higher incidence rates than females. Oral and pharyngeal cancers are the seventh most common cancer among white males and the fourth most frequently diagnosed cancer among black males.

Overall, the incidence rate for oral cavity and pharyngeal cancers is decreasing and there are wide variations in the incidence of site-specific cancers.

The largest annual declines in incidence were noted for lip cancer; this is for the years 1973 to 1996, the most recent data now available.

In contrast, the incidence of tongue cancer, the most common form of oral and pharyngeal cancer, may be increasing among young men.


Tobacco-related Lesions

Tobacco use has been estimated to account for more than 90% of cancers of the oral cavity and pharynx and the greatest single preventable risk factor for oral cancer.

Both smoking and chew (smokeless) tobacco are associated with a number of other oral conditions, including oral mucosal lesions that may progress to oral cancer.

The prevalence of tobacco-related lesions increased with increasing duration and frequency of spit tobacco use.


Oral Herpes Simplex Virus Infections

The prevalence of recurrent herpes lesions is estimated to be between 15 and 40 percent. Presence of antibodies and occurrence of herpes lesions vary by age.

Frequency of recurrence also varies greatly, ranging from once to several times per year.

Infection with the oral herpes simplex virus has been related to socioeconomic factors, with 75-90% of individuals from lower socioeconomic populations developing antibodies by the end of the first decade of life.

In comparison, only 30-40% of individuals from middle and upper socioeconomic groups evidence antibodies by the middle of the second decade of life.


Recurrent Aphthous Ulcers

Various epidemiologic studies of recurrent aphthous ulcers have indicated that the prevalence in the general population can vary from 5 to 25 percent.

In selected population groups, the prevalence of recurrent aphthous ulcers can be as high as 50 to 60 percent.


Other Mucosal Lesions

Other mucosal conditions contribute to the burden of oral diseases. The following are among the most common:

—Oral candidiasis (commonly called thrush) is a particular problem for individuals with impaired immune function. It is estimated that 3.6 percent of full denture wearers have candidiasis.

—Denture stomatitis, a condition in which the mucosa underneath a denture becomes inflamed and sometimes painful, affects some 25% percent of people aged 18 and older who have two full dentures.

—Oral human papilloma virus infections, oral and genital papillomas (or condyloma acuminata, also called venereal warts), are especially common among HIV-positive patients. Human papilloma viruses may be associated with some oral leukoplakias with a high risk for malignant transformation.

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