Oral, Pharyngeal, and Laryngeal Cancer Screening

Oral cancer refers to the formation of cancerous cells in the tissues of the mouth or oral cavity, which are commonly found in the following:

• Gingiva (gums)
• Lips
• Front two-thirds of the tongue
• Buccal mucosa (the lining of the inside of the cheeks)
• Hard palate (the roof of the mouth)
• Floor (bottom) of the mouth under the tongue
• Retromolar trigone (the small area behind the wisdom teeth)

Pharyngeal cancer forms in any of the following areas of the pharynx (throat):

• Nasopharynx (the upper part of the throat behind the nose)
• Oropharynx, which includes the following tissues:
  • The middle part of the throat behind the mouth
  • Back one-third of the tongue
  • Soft palate (the back of the roof of the mouth), including the uvula
  • Side and back walls of the throat
  • Tonsils
• The hypopharynx (the bottom part of the throat)

Laryngeal cancer develops in the following parts of the larynx:

• Supraglottis (area above the vocal cords)
• Vocal cords (two small bands of muscle within the larynx that vibrate to produce the voice)
• Glottis (middle part of the larynx)
• Subglottis (the lowest part of the larynx that extends from just below the vocal cords to the top of the trachea)

Screening can help identify and treat oral and pharynx cancer. Cancer of the oral cavity and pharynx accounted for over 54,000 cases in the United States in 2022. These cancers cause approximately 11,230 deaths per year. The five-year survival data for these types of cancers is less than 60 percent. People who survive often are unable to speak, breathe, and chew, requiring them to bear major functional, cosmetic, and psychological burdens.

The Surveillance, Epidemiology, and End Results (SEER) stages are based on the database maintained by the National Cancer Institute. The SEER database groups cancers into the following stages:

• Localized: There is no indication that cancer has spread outside of the bladder.
• Regional: Cancer has invaded the nearby structures or lymph nodes.
• Distant: Cancer has spread to distant parts of the body, such as the lungs, liver, or bones.

Screening does not lower the risk of death from these cancers. The physician will examine for abnormal white or red patch cells during the oral examination. If the physician detects any lesion, the following procedures may help find abnormal tissue that might lead to the oral cavity, pharyngeal, and laryngeal cancer:

• Fluorescence staining: Utilizes a special light to view lesions. After the person consumes a fluorescent mouth rinse, healthy tissues look different from the cancerous cells.
• Toluidine blue stain: Involves coating the lesions in the mouth with a blue dye. Lesions that are cancerous or may become cancerous will stain darker.
• Brush biopsy: Cells are removed using a special brush to collect all layers of a lesion.
• Exfoliative cytology: Involves gentle scraping of cells from the lesion with the help of a cotton, brush, or small wooden stick. The cells are viewed under a microscope to identify any abnormal cells.

Even though screenings could effectively detect cancer early, they have their share of risks, which include:

• Detecting these cancers may not lower the risk of death from the disease
• At times, your result may have a negative report even when you have oral or pharyngeal cancer
• Sometimes, your test result could be positive even when you do not have cancerous cells
• Misdiagnosis may occur when the pathologist does not diagnose the exact condition