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Chemoprevention and screening in oral dysplasia and squamous cell head and neck cancer

Nabil F Saba, MD, FACP
Dong Moon Shin, MD, FACP
Section Editors
Bruce E Brockstein, MD
Marshall R Posner, MD
Deputy Editor
Michael E Ross, MD


Squamous cell carcinoma of the head and neck (SCCHN) is common in several regions of the world. The primary risk factors include tobacco use, alcohol consumption, and human papillomavirus (HPV) infection. The relative prevalence of these risk factors contributes to the variation in the observed distribution of head and neck cancer in different areas of the world. (See "Epidemiology and risk factors for head and neck cancer".)

The chronic exposure of the upper aerodigestive tract to these and other risk factors is thought to produce field cancerization, a process in which patients with cancer or premalignant dysplastic lesions in the oral mucosa are at significant risk for head and neck cancer. The understanding of field cancerization provides the rationale for chemoprevention to decrease the incidence of SCCHN.

The use of chemoprevention to block the progression of precancerous lesions and the potential role of screening are discussed in this topic, focusing primarily on carcinogen-related head and neck cancer.


The rationale for pharmacologic chemoprevention in patients at risk for the development of invasive cancer is based upon two factors:

Field cancerization – Patients with carcinogen-related squamous cell carcinoma of the head and neck (SCCHN) have a predilection for cancer development throughout the oral and oropharyngeal mucosa. Whether this is also true for human papillomavirus (HPV) associated oropharyngeal tumors is not clear.

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Literature review current through: Nov 2017. | This topic last updated: Nov 10, 2017.
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