Oral cancer in the UK: to screen or not to screen

Although oral squamous cell carcinoma accounts for only a small proportion of malignant neoplasms in the UK, oral cancer incidence and mortality rates have been rising in recent years. The natural history of oral cancer is no t adequately understood at present and there is very little information abo ut the epidemiology of precancerous lesions in the UK. There are also insuf ficient data to provide firm evidence that the percentage of cases arising de novo is greater in the UK and the Western world as compared to the India n subcontinent. Screening for oral cancer by visual examination is simple, inexpensive and causes little discomfort; however, there is no evidence for the effectiveness of screening for oral cancer either in reducing mortalit y from the disease or in reducing the incidence of invasive disease by dete ction and treatment of precancerous lesions. There is currently insufficien t evidence to recommend population screening for oral cancer in the UK. Mea sures aimed at primary prevention of the disease may be a more feasible met hod of disease control at present. (C) 1998 Elsevier Science Ltd. All right s reserved.