Screening and patient examination

Cancer of the head and neck including the oral cavity remains among the top ten malignancies in the US and worldwide. Among these cancers squamous cell carcinoma originating from the surface epithelium is responsible for over 90% of the malignancies diagnosed in this region. Significant advances in the treatment of these malignancies over the last several decades have not been matched by improvement in survival. The main reason for this failure to improve on outcomes in head and neck and oral cavity cancers is delay in diagnosis. Late diagnosis means advanced stage disease often with presence of regional and even distant metastasis that negatively impact on survival. This disturbing fact maybe difficult to understand and explain given the accessibility of the region that makes it amenable to frequent inexpensive and non invasive examinations by health care providers. The importance of a detailed systematic thorough clinical examination of the head, neck and oral cavity cannot thus be emphasized enough. It is the goal of this chapter to provide a comprehensive review of a detailed clinical examination along with an up to date review of the available adjunct diagnostic aids. In addition guidelines for screening high risk population along with follow up schemas for those diagnosed with head, neck and oral cavity cancers will be provided based on the currently available evidence based information.