The Oral Health Foundation is calling for urgent action around cancer diagnosis, following new data that shows mouth cancer referrals have fallen by a third (33%) since the beginning of the pandemic.
New figures collected from seven NHS Trust Hospitals across the UK, reveals the number of people being referred for possible mouth cancer fell from 2,257 in the six months prior to March 2020, to 1,506 in the six months after March 2020.
In total, six out of the seven NHS Trusts saw mouth cancer referrals tumble during this time, with two hospitals in Wales recording a 47% drop in referrals – the most in the UK.
In Northern Ireland, mouth cancer referrals have fallen by 36% since the beginning of the pandemic while England and Scotland have seen decreases of 31% and 30%, respectively.
Many mouth cancers are spotted in the early stages by a dentist during a routine check-up. With Covid-19 limiting dental practice activity to 20% of normal activity, the Oral Health Foundation is deeply concerned that many people with early stages of mouth cancer are going undiagnosed.
In the absence of seeing health professionals face-to-face, Dr Nigel Carter OBE, chief executive of the Oral Health Foundation highlights the importance of self-checks at home and knowing how to spot mouth cancer in the early stages.
Dr Carter says: “Regular dental check-ups and GP appointments are the main routes for identifying the early stages of mouth cancer. We fear that without access to dental and wider health professionals, that many mouth cancer cases will go undiagnosed.
“A person’s quality of life after being treated for mouth cancer, as well as their chances of beating the disease, is highly dependent on the time of diagnosis. By allowing so many potential mouth cancers to go untreated, there is a real danger of more people losing their life to the disease.
“While dental and GP visits remain disrupted it is important that everybody knows how to check themselves for mouth cancer. If you notice anything out of the ordinary, contact your dental practice, who will be able to see you as an emergency patient.”
Mouth cancer can appear on the tongue, tonsils, gums and lips. It can also be found on the roof and floor of the mouth, as well as the head and neck.
Mouth ulcers lasting three weeks, red or white patches in the mouth, or unusual lumps and swellings, are the typically early warning signs. Persistent hoarseness can also be a symptom.
Covid-19 has had a significant impact on dental access in the UK. Research by the Oral Health Foundation shows that more than half (56%) of UK adults claim to have had dental check-ups postponed or cancelled.
During this time, one-in-six (16%) have experienced at least one of the potential early warning signs of the disease.
Meanwhile, the British Dental Association estimate a 10 million backlog of appointments due to dental practices being forced to shut down during the pandemic.
Dr Catherine Rutland, Clinical Director at Denplan, part of Simplyhealth, believes it is crucial that dental practices remain open during the remainder of the pandemic.
Dr Rutland says: “Dentists continue to play a vital role in identifying mouth cancer at routine check-ups. However, during the Covid-19 pandemic, access to dentistry was severely curtailed and opportunities to catch mouth cancer early will have been missed. If mouth cancer is spotted early, the chances of a complete cure are good.
“The Foundation’s recent research has revealed that nearly four in 10 people reported encountering an issue and being unable to see or get advice from their dentist because of the current limited access to dentistry caused by the pandemic. Keeping practices open from now on is vitally important to help ensure the early detection of mouth cancer. It could save thousands of lives.”
Stuart Caplan was diagnosed with tongue cancer in 2012. The husband and father-of-one from Marble Arch, lost two-thirds of his tongue to the disease but says acting quickly was key for him beating the disease.
Stuart says: “Mouth cancer is a hidden cancer, unlike a lot of cancers where there are obvious symptoms. People think ‘oh it’s only a mouth ulcer, it’ll pass’. It’s easy to just put a mouth ulcer treatment on and ignore it, and without visiting a dentist regularly it’s likely to get missed.
“If it’s not normal for you, get it checked immediately, especially you have had something for a few weeks. Cancer symptoms don’t go away. That’s the litmus test. Go and see a dentist or hygienist.”
Figures collected by the Oral Health Foundation show that 8,722 people in the UK were diagnosed with the disease last year, increasing by 97% since 2000.
Mouth cancer cases in the UK have soared for the 11th year in a row and have more than doubled within the last generation.
It is also vital that government issues updated advice about fallow periods for dental practices. Some practices are still working to the original one-hour fallow period, while others have reduced their time between patients. More frequent communication and direction is needed.
- Oral Health Foundation (2020) ‘State of Mouth Cancer UK Report 2020/21’ Published November 2020, online at www.mouthcancer.org.
- Mouth cancer referral data was collected from; NHS Greater Glasgow & Clyde, NHS Ayrshire & Arran, Bwrdd Lechyd Prifysgol Aneurin Bevan, NHS Birmingham Community Healthcare Foundation Trust, Belfast Health and Social Care Trust, NHS Wye Valley NHS Trust, and NHS South Tyneside and Sunderland NHS Foundation Trust.