Patients with oral preneoplastic lesions and integration of dental pathology referrals

Rachel Thompson, Jayson Haws, Nelson L. Rhodus, Frank G. Ondrey

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Oral cancers lack standardized monitoring systems. Our institution has developed an active surveillance system which provides detailed monitoring and follow up of patients with oral preneoplastic lesions (OPL). We examined a historic cohort of patients with OPL seen by regional dental professionals and a current cohort of clinic patients. The major aim was to examine follow up practices for biopsy proven dysplasia to gauge appropriateness of an active monitoring system for oral carcinoma. Materials and methods: Questionnaires regarding patients with OPL were sent to 285 dentists who had requested oral pathology services from our institution. The follow up practices of 141 dentists were evaluated for patients with OPL. We then examined our current clinic referral patterns for the number of dental referrals after the creation of an oral carcinoma active surveillance clinic. Results: There were 76.5% (108/141) of patients who received follow up after diagnosis of preneoplastic oral lesions with 14.1% who underwent repeat biopsy. There was a malignant transformation rate of 11.3% including transformation of 42.8% of severe dysplasias into carcinoma within 2 years. After establishment of a dental referral clinic, 21.8% of tumor visits in a six-week period were referred from the regional dental community. Conclusions: A high rate of transformation of OPL to cancer in this cohort may support a role for joint dental and otolaryngology surveillance of dysplasia with longitudinal follow up.

Original languageEnglish (US)
Article number103270
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume43
Issue number1
DOIs
StatePublished - Jan 1 2022

Bibliographical note

Funding Information:
This work was supported by the Cancer Center Support Grant [grant numbers NCI/NIH P30 CA77598-07 ]; and the Summer Research Fellowship Program [ University of Minnesota Dental School].

Publisher Copyright:
© 2021 Elsevier Inc.

Keywords

  • Leukoplakia
  • Oral carcinoma
  • Patient Care
  • Preneoplasia
  • Surveillance

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