Potentially malignant oral lesions in northern Ireland: a 20-year population-based perspective of malignant transformation.
This retrospective laboratory-based study investigates the potential for malignant transformation of oral mucosal lesions in a population of 1.6 million. Over the 20-year period there were 745 patients diagnosed with primary intra-oral squamous cell carcinoma (OSCC), 165 patients with dysplasia and 1182 patients with 'non-dysplastic' lesions (epithelial hyperplasia, hyperkeratosis epithelial atrophy, lichen planus and lupus erythematosus). Malignant transformation occurred in 15% of dysplasias and in 1% of 'non-dysplastic' lesions at average intervals after diagnosis of 48 and 65 months respectively. Only 6% of patients with OSCC had a pre-invasive lesion biopsied. These data suggest that white lesions are only rarely the pre-invasive phase of OSCC. It is possible therefore that early changes are red, small or even microscopic with carcinoma developing without a clinically observable phase. More effective management strategies will require the development of tissue markers to enhance early detection.
Cowan
C G
CG
School of Dentistry, Queen's University Belfast, Royal Group of Hospitals, Grosvenor Road, Belfast BT12 6BP, Northern Ireland.
Gregg
T A
TA
Napier
S S
SS
McKenna
S M
SM
Kee
F
F
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*; D009660:Northern Ireland / Q000453:epidemiology; D011230:Precancerous Conditions / Q000453:epidemiology*; D012189:Retrospective Studies