[Epidemiology of oral cancer]

In Hungary, the mortality rate from oral cancer is dramatically increasing, causing great concern. Smoking, drinking and poor oral hygiene are the major risk factors, and their combined effect could only be prevented by primary preventive measures in a long time period and therefore the benefit from primary prevention can be detected much later. The possibilities of the secondary preventive measures are much better to identify the premalignant conditions and lesions for these cancers. Screening could be used to detect both precancerous lesions and early invasive cancers, however, no study as yet has demonstrated a reduced mortality from screening, therefore, sui generis regular, organised screening, based on personal call-and-recall system, is not recommended. In the same time, regular opportunistic screening by clinical examination, i.e. visual inspection, using dental mirror, and palpation of the region in asymptomatic persons at high risk offers prime opportunity for early detection and early treatment. Recently, the government has decided to take action by promoting the clinical examination. To this effect, a Working Group consisting of subject experts and headed by the Chief Medical Officer has been appointed and charged with elaboration of a workable plan of action. In terms of action, priority',should be given to men and women above 40 years of age who are heavy smokers and drinkers; socioeconomic differentials should be taken into account. In the first place, dentist-patient encounters provide opportunity for such an examination, but primary care physicians and those engaged in occupational medicine are also requested to take part in the endeavour. As a prerequisite, the screening method needs to be incorporated in the curriculum of dental/medical education. From all these, the oral cancer-related epidemiological situation is expected to improve in Hungary.