The temporary challenge in the diagnosis of oral cancer, an important challenge

The Digital and Computational Pathology, Immunopathology and Cancer research group of the Biosanitary Research Institute of Granada (ibs.GRANADA), through its researchers Miguel Ángel González Moles and Pablo Ramos García, has carried out an exhaustive review study on studies published based on the maximum scientific evidence (systematic reviews and meta-analyses), in order to better understand the reasons behind the delay in the diagnosis of oral cancer, since it is the main cause that affects less survival rate.

Oral cancer represents a growing problem worldwide, with nearly 380.000 new cases and 180.000 deaths annually, according to the World Health Organization. Oral squamous cell carcinoma constitutes approximately 90% of oral malignancies and has a 5-year mortality rate of approximately 50%. Unfortunately, this considerable mortality rate has not decreased substantially in the last 40 years. The main cause is related to the diagnosis of a high percentage of oral cancers in advanced stages, where treatment becomes complex, mutilating or disabling, as well as ineffective. The fundamental cause of a late diagnosis resides in the delay in its detection, therefore, improving the prognosis of oral cancer would require reducing the delay in its diagnosis.

According to the results of the study carried out by researchers from the ibs.GRANADA and the University of Granada, the reasons that justify the delay in the diagnosis of oral cancer are complex and involve various actors and circumstances, such as patients, health care providers and health services. A part of this delay is due to the patients themselves, due to the lack of information about the importance of the disease, the lack of education and the low sociocultural status. This influences an inadequate interpretation of the initial symptoms and signs of oral cancer. Another factor related to late diagnosis is the patient's fear of being diagnosed with oral cancer and its consequences, causing patients to postpone medical consultation by an average of 104 days.

This team of researchers suggests that resolving this issue is complex and would undoubtedly require the implementation of institutional information campaigns aimed at the population to raise awareness of the importance of this disease, which would presumably have a notable impact on the good prognosis of oral cancer. .

This study also shows that the delay in the diagnosis of this type of cancer is also due to causes related to healthcare providers (doctors, dentists, etc.) and to the organization of the healthcare system. The overload currently faced by public health systems in many parts of the world, including Spain, is widely known. This prevents primary care physicians from having the necessary time to provide adequate care to their patients, to perform oral cavity examinations on all who come to their consultations. In addition, the relatively low prevalence of this type of cancer and its scant initial symptoms make it easy for some to go unnoticed by doctors and dentists.

About the research group

The Digital and Computational Pathology, Immunopathology and Cancer group, whose joint leaders are Javier López Hidalgo (head of the Pathological Anatomy Service, PTS, Granada) and Miguel Ángel González Moles (Professor of Oral Medicine, Faculty of Dentistry, University of Granada) conducts research Translational Applied Medicine in Cancer, Gynecopathology, and Immunopathology. His main line of research focuses on the identification of new markers of prognostic and diagnostic interest in cancer. Research is also carried out on the biopathology of oral squamous cell carcinoma, essentially aimed at the analysis of cell proliferation markers in premalignant epithelia and in tumor tissue, as well as the study of proliferation-stimulating proteins. In recent years the main line of the group has been directed to the field of expression of cancer stem cell markers in premalignant epithelium and oral cancer. Currently, through digital pathology and computational pathology tools, this research group is developing learning models through Deep-learning as a new line in cancer research.

More information about the group at https://www.ibsgranada.es/grupos-de-investigacion/a04-aparato-digestivo-cancer-nefropatias/

Bibliographic reference: González-Moles, M. Á., Aguilar-Ruiz, M., & Ramos-García, P. (2022). Challenges in the Early Diagnosis of Oral Cancer, Evidence Gaps and Strategies for Improvement: A Scoping Review of Systematic Reviews. Cancers, 14(19)