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:

  • Red and/or white lesion

  • Ulcer

  • Lump

  • Exceeding three weeks duration.

This is not to say that other signs/symptoms may herald cancer, as referenced elsewhere: if in doubt – ask.