Mortality rates associated with oral cancer have remained unchanged for over 30 years, partly due to the limitations of white light examination of the oral mucosa. This has created a dire need for an improved oral mucosal screening procedure that would make it possible for clinicians to accurately identify tissue changes at and below the surface before they become apparent under white light examination.

In response to such a need, the Vancouver-based company LED Medical Diagnostics Inc. (LED-MD) has developed the VELscope System in partnership with the British Columbia Cancer Agency (BCCA). The technology has received over 50 million dollars in NIH and other government grants, as well as public and private equity financing to assist in its development. It is a technology platform based on the direct visualization of human tissue fluorescence and the changes in fluorescence that occur when abnormal tissue is present.

VELscope is currently manufactured by LED Dental Inc., a wholly owned subsidiary of LED-MD.

Risk Factors

Understanding the causative factors of cancer will contribute to prevention of the disease. Age is frequently named as a risk factor for oral cancer, as most of the time it occurs in those over the age of 40. The age of diagnosed patients may indicate a time component in the biochemical or biophysical processes of aging cells that allows malignant transformation, or perhaps, immune system competence diminishes with age. However, it is likely that the accumulative damage from other factors, such as tobacco use, are the real culprits. It may take several decades of smoking for instance, to precipitate the development of a cancer. Having said that, tobacco use in all its forms is number one on the list of risk factors. At least 75% of those diagnosed are tobacco users. When you combine tobacco with heavy use of alcohol, your risk is significantly increased, as the two act synergistically.Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others.

Tobacco and alcohol are essentially chemical factors, but they can also be considered lifestyle factors, since we have some control over them. Besides these, there are physical factors such as exposure to ultraviolet radiation. This is a causative agent in cancers of the lip, as well as other skin cancers. Cancer of the lip is one oral cancer whose numbers have declined in the last few decades. This is likely due to the increased awareness of the damaging effects of prolonged exposure to sunlight, and the use of sunscreens for protection. Another physical factor is exposure to x-rays. Radiographs regularly taken during examinations, and at the dental office, are safe, but remember that radiation exposure is accumulative over a lifetime. It has been implicated in several head and neck cancers.

Biological factors include viruses and fungi, which have been found in association with oral cancers. The human papilloma virus, particularly HPV16 and 18, have been implicated in some oral cancers. HPV is a common, sexually transmitted virus, which infects about 40 million Americans. There are about 80 strains of HPV, most thought to be harmless. But 1% of those infected, have the HPV16 strain which is a causative agent in cervical cancer, and now is linked to oral cancer as well. There are other risk factors which have been associated with oral cancers, but have not yet been definitively shown to participate in their development. These include lichen planus, an inflammatory disease of the oral soft tissues.

There are studies which indicate a diet low in fruits and vegetables could be a risk factor, and that conversely, one high in these foods may have a protective value against many types of cancer.