Early diagnosis

Oral cancers comprise cancer of the lips, tongue, mouth (gums and palate), tonsils and the oropharynx. It can spread quickly, which is why early detection and referral is very important - early diagnosis significantly increases the five-year survival rate, and detection of lesions under 2cm is key.

There are also multiple factors that can reduce the risk of a delayed oral cancer diagnosis and any subsequent legal action. The GDC recommends that continuing professional development should include the early detection of oral cancer to ensure dentists have the requisite skills and knowledge to detect oral cancer clinically.

While primary care dentists will not see oral cancer cases all that frequently, the published data clearly indicates that the incidence of oral cancer in the population is increasing. Because of this, a high level of awareness is crucial in terms of fully considering the cause of new symptoms or suspicions lesions in a patient's mouth.

Reducing the risks of a claim

Follow-up and referrals

In order to reduce the risk of oral cancer misdiagnosis and any subsequent legal action, it is essential that the correct NICE guidelines for urgent referral are followed. It is also good practice to follow up on referrals to hospital, to make sure it has been received and is being dealt with - especially in terms of confirming that an appointment with a specialist has been arranged.

Records and reports

It's also essential to record all important clinical information. This could include palpation of the lymph nodes in the neck as part of the clinical examination, the duration of symptoms, the size, site, shape and texture in relation to the lesion, and accurately monitoring any changes by using photographs and previously recorded clinical information in relation to the lesion. Using mouth maps could also be useful.

Having detailed, accurate and contemporaneous clinical records is essential for defending clinical negligence claims, as the records can provide justification for the treatment provided and demonstrate professional reliability. In order for a claimant to succeed in a civil claim for negligence, they will have to prove there was breach of duty by the clinician, which caused injury to the claimant, so good record keeping is an important element of a successful defence.

The importance of early diagnosis of oral cancer

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