CDA Essentials 2017 • Volume 3 • Issue 4

24 | Volume 3 Issue 4 N ews and E vents The Forum was an occasion for all stakeholders to “share the issues they face, and learn about innovations, models, or ideas that have the potential to catalyze positive change globally and help to reduce these statistics.” CDA Oasis was an intellectual partner of the event. Epidemiology Among the Canadian researchers presenting their work at the forum was Dr. Ajit Auluck from the British Columbia Cancer Research Centre and the BC Oral Cancer Prevention Program. He explained that despite the decline in tobacco consumption, data from 1992 to 2012 show that oropharyngeal and tongue cancers are on the rise in both Canadian men and women, just like salivary gland cancer. “These important trends can guide dental professionals and help us know which areas of the mouth to focus on,” he noted. “When looking at a patient’s mouth, we should not forget to examine the tongue and back of the mouth, where the throat and the mouth meet. Visual examination is the first step, but if you notice a suspicious lesion, investigate using other aids—including referral to our ENT colleagues for further examination of hard-to-reach areas in the back of the mouth.” Following a session on regional disparities, Dr. Allan Hovan, department head in oral oncology and dentistry at the British Columbia Cancer Agency, mentioned that the absence of cancer and premalignant disease registries in many countries—particularly low- resource countries—is a cause for concern as it does not allow to capture the totality of the disease and its overall burden. Screening and Diagnosis Many sessions and poster presentations discussed the importance of early detection—and its associated barriers. These discussions led Dr. Hovan to reflect on the strengths and weaknesses of the Canadian approach. While he believes undergraduates receive appropriate training in how to perform a thorough examination, he’s afraid that “maybe we’re failing at making them comfortable to do the next step, which is the biopsy. In working with residents, I’ve noticed they don’t seem confident in performing a biopsy.” Dr. Richard Logan, head of oral diagnostic services and deputy head of the school of dentistry at the University of Adelaide (Australia), added to Dr. Hovan’s point and suggested a possible compound effect leading to late detection: “Key factors are the differences in how dentists take responsibility for diagnosing conditions like oral cancer, and how the medical field might be complacent about oral lesions and maybe not be taking them seriously. Combined, this may lead to delays in detection.” A path forward could be to train allied health care professionals in screening at-risk patients for oral cancer, proposed Dr. Deborah Saunders, medical director of dental oncology at the Health Sciences North hospital in Sudbury, Ontario. This approach could be a timely option considering the rapidly increasing HPV-positive population. “We need comprehensive oral examinations that include palpation of the neck,” she stressed. In full agreement with his Canadian colleague, Dr. Hovan added that “In cases of HPV, you might not see the lesion, but there may be symptoms that the patient will report (voice changes, sore throat, difficulty swallowing, etc.) that warrant further questioning and possible investigation.” Emerging Technologies and Disease Management Considering the higher prevalence of oral cancer in low- and middle- development countries, Dr. Saunders highlighted the fact that new diagnostic tools must be inexpensive to ensure that the underdeveloped countries who need these tools the greatest have access to them. “We can have the most reliable and specific tests... but if they’re not affordable, they can’t be used in certain areas.” Another key aspect should be ensuring that the tool is non-invasive, as many patients are not comfortable with biopsies. The latest advances in the use of biomarkers in oncology give a glimpse of their potential in guiding disease management. Specific biomarkers will help determine which 5% of