Mouth cancer referrals plummet by a third since start of pandemic

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.

References: 

  • 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.

New data reveals most people do not know the symptoms associated with mouth cancer despite record number of cases

Cases of mouth cancer in the United Kingdom have nearly doubled in the last 20 years, yet an alarming number are unable to identify the early warning signs and symptoms. Last year, more than 8,700 British adults were given the news that they had mouth cancer.  The disease is diagnosed on one person nearly every hour.

New research by the Oral Health Foundation as part of November’s Mouth Cancer Action Month reveals that seven-in-ten (71%) do not know the symptoms of mouth cancer.

Further findings show more than four-in-five (83%) do not feel confident in what they are looking for when it comes to doing a mouth cancer check at home while around two-in-three (62%) confess to never checking themselves for signs of the disease.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, believes with the number of cases on the rise, it is important for everybody to know how to spot the early signs of mouth cancer and know how to perform a simple self-check.

Dr Carter says: “In the UK, and around the world, the number of people affected by mouth cancer continues to grow at an astonishing rate.  Anybody is at risk of mouth cancer, and with limited  access to dentistry at the moment, it is more important than ever for people to be vigilant. That’s why it is so important to know how and where mouth cancer can strike.

“Look for mouth ulcers that do not heal within three weeks, red or white patches in the mouth and unusual lumps or swellings in the mouth or head and neck.

“Most mouth cancers appear on the tongue – around a third of all cases – but it can also strike on the tonsils, gums and lips.  It can also be found on the roof or floor of the mouth, as well as the throat.”

The new research shows that around one-in-two (52%) are aware that long lasting mouth ulcers could be a sign of mouth cancer while fewer know that red patches (41%) and white patches (48%) could be a symptom. Similarly, less than half (47%) identify lumps or swellings in the mouth, head or neck as a potential sign of mouth cancer, and even less (23%) know that persistent hoarseness might be a link.

The research has been published to coincide 20 years of Mouth Cancer Action Month.

The last two decades have painted a bleak picture for mouth cancer numbers in the UK.  New annual cases have soared by 97% since the year 2000, while those losing their life to the disease have increased by 48% in the last decade.  

For the last 20 years, the Oral Health Foundation has received support for the campaign from Denplan, part of Simplyhealth.  The partnerships between the two mouth cancer campaigners bids to turn the tide against the disease and create a more mouthaware population.

Catherine Rutland, Head Dental Officer of Denplan, part of Simplyhealth, highlights that conducting a potentially life-saving mouth cancer check is easy and can take as little as 45 seconds.

Dr Rutland says: “By spotting mouth cancer early, patients have a much better chance of beating it. With early diagnosis, the chances of surviving mouth cancer are nine out of ten and that’s why knowing what to look out for is so important. 

“A simple self-examination should involve checking your cheeks, gums, lips, tongues and tonsils. Also check the floor and roof of the mouth, as well as your head and neck. You should be looking for mouth ulcers that don’t heal within three weeks, red or white patches in the mouth or unusual lumps or swellings in the mouth, head and neck.

“Mouth Cancer Action Month is the perfect opportunity to become mouthaware by learning the risks and early signs of mouth cancer. It is also important that we not only recognise, but act on unusual changes in the mouth.  If you notice anything out of the ordinary, get checked out by your dentist or doctor.”

For more information about mouth cancer, including how to do a self-check for the disease, visit www.mouthcancer.org.

BAPD seeks new guidance from government to help to screen for oral cancer

The British Association of Private Dentistry (BAPD) has advised the government that it needs to change its guidance in order to help dental practices successfully screen for oral cancer.

The Association recently conducted a straw poll of its members in order to find out whether dental professionals were encountering problems in referring patients who were suspected of having mouth cancer. The results found that 676 out of the 755 respondents had experienced referral problems when seeking secondary care.

The poll comes following research, which has suggested that more than 24,000 cases of cancer have gone undiagnosed due to the Covid-19 pandemic.

Jason Smithson, Co-founder of the BAPD, said: “The comments would suggest a multi-factorial problem; however, there would seem to be some common themes. Clearly, this is a serious problem for the profession. Therefore, we have compiled a survey that we hope to present to PHE and NHSE and may impact fallow and PPE.”

Diagnosis of mouth cancer down during Covid-19 pandemic

The Mouth Cancer Foundation is concerned that, because of the current closure of dental practices, patients are not receiving regular routine examinations for early signs of mouth cancer. It seems likely that even when general dental practices re-open it may be a considerable time before a full service becomes widely available. Sadly, many cases of all head and neck cancers could be going undetected.

Since the beginning of the coronavirus pandemic, diagnoses of all types of cancer have dramatically diminished. There are a number of reasons for this, including the reluctance of the public to visit clinical settings for fear of exposing themselves to the virus. Doctors and hospitals are assuring the public that these risks have now been minimised; however, it may still be a while before people feel completely comfortable in making appointments.

“The number of patients being diagnosed with mouth cancer has dramatically reduced in recent weeks due to coronavirus,” said Dentist and Mouth Cancer Foundation President, Dr Philip Lewis. “Prior to the pandemic the incidents of newly diagnosed mouth cancers was on the rise, so this is an alarming situation. Dental Practices are largely closed so it is more important than ever that people check themselves for mouth caner in the same way they would carry out routine examinations for other types of cancer.”

The Mouth Cancer Foundation has two important messages. Firstly, people should examine themselves regularly at home, just as they do for early signs of other cancers. Conditions to look for include:

  • Swellings in the mouth, face or neck
  • Red or white patches on the skin of the mouth, the tongue or the palate
  • Ulcers that do not heal in a maximum of 3 weeks
  • Changes in texture of the lips or inside the mouth
  • Difficulty swallowing or chewing
  • Numbness of the tongue or lips
  • A feeling of something stuck in the throat
  • Hoarseness of the throat lasting 6 weeks or longer

The Mouth Cancer Foundation publishes a free self-examination leaflet which is available for download at: www.mouthcancerfoundation.org/get-involved/merchandise. This leaflet explains exactly what to look for and how.

The foundation’s second message is: If a patient of yours is concerned that any problems in their mouth may be due to early mouth cancer, they should contact the dental practice immediately, as even during closure we can still arrange referral to a specialist if necessary and still have access to fast-track referrals. If the patient is not registered with a dentist, they should contact their doctor.

Oral Health Foundation: “Decision to finally offer boys a HPV vaccination is one which will save many lives”

The decision to offer boys a vaccination against the Human Papilloma Virus (HPV) by the Joint Committee on Vaccination and Immunisation (JCVI), announced yesterday by Health Secretary, Jeremy Hunt, has been hailed by the Oral Health Foundation as a decision that will save thousands of lives every year.

The charity believes the decision, which has been under consideration since 2013, will lead to many lives being saved due to the vaccination’s ability to prevent HPV related mouth cancer, as well as other life-threatening diseases.

Under the current programme almost 400,000 boys go unvaccinated every year, which has millions at risk of developing HPV related cancers later in life – cancers which are on the increase.

Dr Nigel Carter, CEO of the Oral Health Foundation, discussed this momentous ruling: “This decision has been an incredibly long time coming and one we firmly believe it will be a significant moment in the ongoing battle against many types of cancer in the UK.

“This decision brings to and end what has been a dangerously discriminatory and unfair HPV vaccination programme in Britain, which has left millions of boys and men unprotected from the biggest sexually transmitted infection in the world.

“HPV is one of the leading causes of mouth cancer; but now we hope that with the swift implementation of the vaccination programme we will see a significant reduction in these numbers.

“Since 2008, girls have been offered a HPV vaccination through a school based programme to protect against cervical cancer, but this has been proven to offer little protection for men from life-threatening diseases caused by HPV; including mouth, penile and anal cancers as well as genital warts.”

Every year more than 7,500 Brits are diagnosed with mouth cancer, with the disease claiming in excess of 2,000 lives – more than testicular and cervical cancer combined.

“There has also been overwhelming support for the vaccine from health professionals and public alike,” added Dr Carter.

“A recent poll from campaign group HPV Action discovered that 97 per cent of dentists and 94 per cent of GPs believe that the national HPV vaccination programme should cover both boys and girls, we have also seen roughly 84 per cent of the public support an extended vaccination programme.

“It has become very apparent that the only certain way to protect boys effectively from HPV is through a national vaccination programme and now this has finally come to fruition we will push for it to be implemented swiftly and effectively so we can ensure that it is most effective in saving lives in the future.”