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CA: A Cancer Journal for Clinicians, Vol 28, 297-303, Copyright © 1978 by American Cancer Society

Early Diagnosis of Oral Cancer: The Erythroplastic Lesion in High Risk Sites

¹ Chief of Oral Surgery and Oral Oncology, Veterans Administration Hospital, East Orange, New Jersey, Clinical Professor of the Department of Surgery, New Jersey Medical School, Newark, New Jersey and Visiting Professor of Oral Surgery, New Jersey Dental School, Newark, New Jersey.
² Assistant Vice President for Epidemiology and Statistics, American Cancer Society, New York, New York.

Our extensive experience at the Veterans Administration Hospital has indicated that males forty years and older who smoke and drink heavily are at high risk for oral cancer. Routine oral examination in our hospital yields approximately one asymptomatic carcinoma for every 200 patients examined, as compared to one oral cancer for every 5,000 in males over age forty in the general population. Fewer than five percent of patients with asymptomatic oral carcinoma had attendant bleeding, ulceration, induration or lymphadenopathy.

Results of surgical treatment are excellent if the carcinoma is detected early. In invasive lesions having a diameter of two cm. or less (84 percent of lesions in our study), our preliminary indications are that recurrence rates are probably less than five percent. Further, post-operative morbidity and disfiguration are minimal, since excision is local and entails little soft tissue and bone loss.

Persistent asymptomatic erythroplasia— rather than leukoplakia—in high risk sites of the oral cavity is the earliest and primary sign of oral carcinoma. The red, velvet-like lesion of the floor of the mouth, ventrolateral tongue and soft palate should, if its duration is 14 days or longer, be considered carcinoma in situ or invasive carcinoma unless indicated otherwise by biopsy. Early recognition and treatment of these cancers is likely to result in decreased surgical morbidity and in significantly increased survival rates.[SEE THE FIG 4a,4b,4c IN THE SOURCE PDF].

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