Sir, some years ago I suggested a RULE for mouth cancer diagnosis, which focused on the more common features of early cancers and precancers, viz chronic:
Red or white patch,
Ulceration,
Lump, any
Extending for three weeks or more.1
However, cancer can have other and multifarious presentations and we are also intent on diagnosing any such lesion whether early or more advanced as soon as possible. Other such presentations can include tooth loosening2 or cervical lymphadenopathy,3,4 though there can be many other causes for these, so it would seem an improvement to extend the RULE to:
Red or white patch,
Ulceration,
Lump, Loose tooth or Lymphadenopathy,
Extending for three weeks or more.
References
Scully C . RULE for cancer diagnosis. Br Dent J 2013; 215: 265–266.
Lambeth R S, Shaikh Z S, Adcock S D . Oral cancer red flags – a case of misdiagnosis. Dent Update 2016; 43: 335–339.
Dalgic A, Karakoc O, Karahatay S et al. Submandibular triangle masses. J Craniofac Surg 2013; 24: 529–531.
Balikci H H, Gurdal M M, Ozkul M H et al. Neck masses: diagnostic analysis of 630 cases in Turkish population. Eur Arch Otorhinolaryngol 2013; 270: 2953–2958.
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Scully, C. Mouth cancer: Extending the RULE. Br Dent J 221, 280 (2016). https://doi.org/10.1038/sj.bdj.2016.664
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DOI: https://doi.org/10.1038/sj.bdj.2016.664
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