the dentist, sentinel cancers of the upper aerodigestive tract?

e dentist should play the role of sentinel in the detection of cancers aerodigestive tract, says an expert who spoke at the congress of the French Dental Association opened in Paris
In France cancers of the upper aerodigestive tract (mouth, nose, pharynx, larynx, esophagus) represent 8% of cancers (as well as the lung cancers) and ranked fourth in order of frequency, the all cancers.

Among them, 96% of carcinomas, that is to say malignancies arising from cell layers in the superficial portion of the mucous covering.

France holds the sad record of the first in Europe and second in the world, both in frequency and mortality rates for these cancers. "This is a real public health problem," said Dr. Didier Gauzeran. Especially since these cause cancer metastases quickly and easily and have a very poor prognosis (50% mortality at 3 years).

One of the factors behind this poor prognosis is the delay in diagnosis. The majority of cancers are actually diagnosed with advanced stages too.

The ignorance of the vast majority of the population, the discretion of the functional signs, neglect of the patient, the timidity of some practitioners who do not practice a systematic screening of the mouth and neck and maxillofacial region in subjects with risk (tobacco, alcohol, older people, families with cancer) cause loss of time and therefore a loss of therapeutic opportunity for the patient, says Dr. Gauzeran.

The mouth is a very easily accessible organ and these cancers are surface lesions very readily visible practitioners but also by patients in most cases.

The World Health Organization (WHO) and other international bodies also consider that it is the responsibility of the dentist to detect lesions at risk precancerous and cancerous lesions.

A lesion that persists, especially a painless ulceration and bleeding often should suggest a cancerous lesion.

There are also a large number of benign lesions, in some clinical forms, according to the very specific field that shelters may undergo malignant transformation in 1-20% of cases depending on the conditions, eg the reaction to tobacco keratoses (lesions whitish, more or less raised and do not come off of the mucosa), lichen planus, some fungal chronic candidiasis, chronic trauma. These lesions are suspicious when they have an erosive appearance (superficial ulceration) and keratotic or giving a red appearance dotted with small white patches of keratosis.

The dentist must be involved in the detection of diseases of the oral mucosa in general. In any case, it is at the forefront for screening at-risk lesions, precancerous lesions and cancers of the oral cavity, especially in patients at risk during the first visit.

For its part, the physician expects the patient to consult when it has a mouth problem that "it becomes aware of the scourge of tobacco and its association with alcohol, he heard the advice and guidance the medical profession, "said the expert.