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26 November 2013 Annals of Internal Medicine Tip Sheet

Below is information about articles being published in the September 17 issue of Annals of Internal Medicine. The information is not intended to substitute for the full article as a source of information. Annals of Internal Medicine attribution is required for all coverage.

1. Task Force updates oral cancer screening recommendations

The United States Preventive Services Task Force (USPSTF) found insufficient evidence to recommend for or against screening for oral cancer by primary care physicians in asymptomatic adults, according to an article published in Annals of Internal Medicine (http://www.annals.org/article.aspx?doi=10.7326/M13-2568). Oral cancer and pharyngeal cancer include cancer of the lip, oral cavity, and pharynx. Up to 75 percent of oral cancers are attributable to tobacco and alcohol use, but sexually transmitted oral HPV infection has recently been recognized as an increasingly important risk factor for oropharyngeal cancer. More than half of people diagnosed with oral cancer will have regional or distant metastases, suggesting that earlier diagnosis could be beneficial. The Task Force reviewed published evidence to determine if oral cancer screening in primary care settings reduces morbidity or mortality and to assess the accuracy of screening for identifying oral cancer or its precursors. The researchers found no evidence on screening for oral cancer by primary care physicians in the general or high-risk U.S. population, nor did they find direct evidence on whether screening reduces morbidity or mortality among those populations. This statement is an update to the 2004 USPSTF recommendation on screening for oral cancer, which also found insufficient evidence to recommend for or against screening. This recommendation does not include an evaluation of the evidence on oropharyngeal cancer, which cannot be adequately visualized in primary care settings.