Sir, there is not only evidence for an increase in oral (mouth) cancer in the UK and many other countries, but also an increase in interest in the early diagnosis both from patients, the profession, regulators, charities and the legal profession.1,2,3,4,5
There are already a number of lists and tables highlighting warning signs but, in an effort to facilitate learning as in other areas,6 I suggest the RULE for suspecting oral cancer should be any single mucosal:
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Red and/or white lesion
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Ulcer
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Lump
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Exceeding three weeks duration.
This is not to say that other signs/symptoms may herald cancer, as referenced elsewhere: if in doubt – ask.
References
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Dave B . Why do GDPs fail to recognise oral cancer? The argument for an oral cancer checklist. Br Dent J 2013; 214: 223–225.
Hertrampf K, Wenz H J, Koller M, Grund S, Wiltfang J . Early detection of oral cancer: dentists' opinions and practices before and after educational interventions in Northern-Germany. J Craniomaxillofac Surg 2013; pii: S1010-5182(13)00034-6. DOI: 10.1016/j.jcms.2013.01.019. [Epub ahead of print].
Ogden G, Lewthwaite R, Shepherd S D . Early detection of oral cancer: how do I ensure I don't miss a tumour? Dent Update 2013; 40: 462–465.
irwinmitchell solicitors. Lawyer welcomes calls for improvements in diagnosis of oral cancer. 3 October 2012. Available at: www.irwinmitchell.com/newsandmedia/2012/october/lawyer-welcomes-calls-for-improvements-in-diagnosis-of-oral-cancer (accessed September 2013).
Scully C . Aide memoires in oral diagnosis: mnemonics and acronyms (the Scully system). J Investig Clin Dent 2012; 3: 262–263.
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Scully, C. Rule for cancer diagnosis. Br Dent J 215, 265–266 (2013). https://doi.org/10.1038/sj.bdj.2013.884
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DOI: https://doi.org/10.1038/sj.bdj.2013.884
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