An audit of one surgeon's experience of oral squamous cell carcinoma using computerised malignancy database

The results of an audit of a single surgeon's experience of oral squamous cell carcinoma over a 5-year period is reported and the benefits of adopting a prospective computerized malignancy database outlined. Oral cancer occurred mainly in the 7th decade of life, women were on average 5 years younger than men at presentation. Men were affected 1.7 times as often as women and presented with more advanced disease than women. The mean delay from referral to histological diagnosis was 6.4 days and the mean delay from diagnosis to treatment was 25.8 days. The majority of patients consumed alcohol and smoked tobacco, but a significant minority were lifelong nondrinkers and non-smokers. While the incidence of most site-specific oral cancers were similar to the national averages the incidences of alveolar and floor of mouth cancers were higher than expected. The TNM stage at presentation was an unreliable prognostic indicator of future disease progression and outcome. Auditing treatment and outcome is a major component of the recent proposals to centralise the provision of cancer services in dedicated cancer centres and units (1). Audit can only be effective if it is based on current, reliable and accurate data and this can only be achieved by the use of a computerised malignancy database.