The ongoing dental crisis in the UK has led to fears that while many patients now simply cannot get an appointment, an increasing number of mouth cancer cases are potentially being overlooked.
According to a recent study by the BBC, nine-in-10 NHS dental practices across the UK were not accepting new adult patients.
There are many reasons for this; an unworkable NHS dental contract, lack of dental professionals for the expanding population, lack of education funding to train more new dentists to meet the demand, and the slow ORP a contract that doesn’t suit either the public or the profession. It is a complicated issue that sadly has no quick fixes on the horizon.
All of this is a great cause for concern especially when it comes to spotting potential mouth cancers early. Dentists, hygienists and therapists are all in a crucial role in spotting the first symptoms of mouth cancer. But how many fewer patients are being referred due to the lack of NHS dental appointments? This may not be something that we will know for sure for several years.
Mouth cancer statistics
Mouth cancer currently has one of the highest mortality rates due to late diagnosis. Currently, around half (53%) of all mouth cancers in the UK are not diagnosed until stage III and IV, when the cancer is advanced, and more complex to treat. Treatments such as invasive surgery, chemotherapy, radiotherapy, or a combination of all three, are often necessary.
The five-year survival rate has hardly improved in the last few decades because of late detection.
The rate of mouth cancer has also grown year-on-year. The rate of mouth cancer has also grown year-on-year. The latest data shows 8,864 people in the UK were diagnosed within a year. This has more than doubled since 2000. Across the globe, there are now estimated to have reached 650,000 diagnosed cases.
Mouth cancer is strongly linked to a person’s sex and age. It is twice as common in men (68%) compared to women (32%), and many cases (67%) are diagnosed in individuals over 60. This disparity is likely due to lifestyle choices and the length of time a person has been exposed to risk factors.
As the number of cases increases, we are steadily seeing more women and younger people with mouth cancer. While there is no definitive answer as to exactly why, shifting social norms and the rise of HPV related mouth cancer likely play a part.
Mouth cancer awareness
Unfortunately, the public awareness of this dangerous disease is not as high as we would like. Awareness of the major signs and symptoms of mouth cancer is as low as 17% and understanding of the primary risk factors of mouth cancer is even less at 9%.
This is unfortunate but at the same time not entirely unexpected. Mouth cancer can often be difficult to spot in the oral cavity or often asymptomatic. In the past, dental professionals might never have seen a case in their entire career. However, that’s changed. Today, dental teams are not only referring one confirmed case but are identifying several patients with mouth cancer over their careers.
Most patients will be aware that smoking and tobacco use increases the risk of lung cancer or heavy alcohol consumption could impact their liver or heart. However, fewer are aware that tobacco use and alcohol are one of the biggest causes of mouth cancer, and the risk is much high if they use tobacco and drink alcohol to excess together.
Solutions?
Obviously, improving access to NHS dentistry, early diagnosis and effective public health education programmes are some of the improvements that could help to reduce the risk of mouth cancer, and encourage early referral, diagnosis, and treatment.
However, worryingly some NHS Trusts are still not meeting the NHS standard of beginning treatment for mouth cancer within 62 days. This is obviously something that needs to change urgently, to give patients the best chance of making a good recovery.
In the meantime, one of the most powerful tools against mouth cancer is educating patients on the signs, symptoms, and risks. Currently, 24% of patients do not know what any of the symptoms are, and the rest of their knowledge can be somewhat lacking. For example, 58% of patients do not know that mouth ulcers that don’t heal within three weeks could be a sign of mouth cancer.
The quicker mouth cancer is diagnosed, the earlier treatment can start. This usually results in much better outcomes for the patient and less need for invasive treatment. Encouraging patients to do a simple, monthly mouth check at home could save lives.
Simple, regular checks like these can help patients to understand their own mouths and they are more likely to notice any changes that occur. By all working together, we can help to spread the word, not only during November’s Mouth Cancer Action Month but every day.
More information about educating patients about mouth cancer can be found on the Mouth Cancer Action Month website at www.mouthcancer.org.
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