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Worldwide, oral cancer has one of the lowest survival rates (lethal disease for over 50% of cases diagnosed annually) and remains unaffected despite recent therapeutic advances. Unfortunately, almost half of the oral cancers are diagnosed at stages III or IV, probably due to delays in reaching a definitive diagnosis. Many preventive approaches (secondary prevention) have been designed assuming the logical hypothesis that the longer the diagnostic delay, the more advanced the cancer and the worse the prognosis. However, a number of studies failed to prove this association or even found an inverse relationship. We hypothesize that tumour’s biological heterogeneity in terms of aggressiveness may explain shorter delays linked to advanced stages and bad prognosis. The assumption of this hypothesis would entail favouring oral cancer and precancer screening strategies at the preclinical stage of the disease, and therefore strategies of opportunistic screening for oral cancer and precancer on asymptomatic at risk population should be reinforced.

Does Tumour Biological Behaviour Influence Prognosis More than Diagnostic Delay in Oral Cancer?