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Potentially malignant oral lesions in Northern Ireland: a 20‐year population‐based perspective of malignant transformation
Author(s) -
Cowan CG,
Gregg TA,
Napier SS,
McKenna SM,
Kee F
Publication year - 2001
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1034/j.1601-0825.2001.70104.x
Subject(s) - medicine , malignant transformation , hyperkeratosis , leukoplakia , dysplasia , pathology , population , lesion , epithelial dysplasia , carcinoma , dermatology , cancer , environmental health
This retrospective laboratory‐based study investigates the potential for malignant transformation of oral mucosal lesions in a population of 1.6 million. Over the 20‐year period there were 745 patients diagnosed with primary intra‐oral squamous cell carcinoma (OSCC), 165 patients with dysplasia and 1182 patients with ‘non‐dysplastic’ lesions (epithelial hyperplasia, hyperkeratosis epithelial atrophy, lichen planus and lupus erythematosus). Malignant transformation occurred in 15% of dysplasias and in 1% of ‘non‐dysplastic’ lesions at average intervals after diagnosis of 48 and 65 months respectively. Only 6% of patients with OSCC had a pre‐invasive lesion biopsied. These data suggest that white lesions are only rarely the pre‐invasive phase of OSCC. It is possible therefore that early changes are red, small or even microscopic with carcinoma developing without a clinically observable phase. More effective management strategies will require the development of tissue markers to enhance early detection.