It is a sobering reality for clinicians in the 21st century that cancer remains one of the principal causes of premature mortality in our populations. Oral squamous cell carcinoma (OSCC), the most frequent malignancy to arise from the mucosal lining of the oral cavity, is a lethal and deforming disease in contemporary clinical practice exhibiting rising incidence and a significant global burden Over 300,000 new cases are diagnosed each year worldwide. Even though early signs of OSCC are readily detectable by oral examination, five-year survival rates have remained around 50 for many years owing to patients presenting late with advanced stage disease. Oral carcinogenesis is driven by the accumulation of complex, multifocal genetic mutations initiated primarily by prolonged exposure to exogenous carcinogens such as tobacco and alcohol although the role of human papillomavirus infection in tonsillar and oropharyngeal cancer, and the significance of cultural and geographic influences on disease progression (particularly low socioeconomic status, impaired nutrition and regional/rural isolation) are all increasingly recognised as important contributory factors.1,2 Improved understanding of the natural history of OSCC coupled with population-based studies to better define the sociodemographic profile, deprivation data and risk factor behaviour in high risk individuals are essential prerequisites to the delivery of effective oral health surveillance, screening, targetted prevention, early disease detection and minimally invasive interventional treatment protocols.
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