Community screening and intervention for high-risk oral premalignancies

Worldwide there are over 300,000 new cases of oral cancer each year with half of these cases dying of the disease; mainly because of late diagnosis. As such, the advanced widespread disease often requires complex and disfiguring treatment, consequently with a huge impact on the quality of life of the patients, at the same time adding stress to the health care system. It is important to prevent and identify the disease at early stages.

In BC, a particular high-risk medically underserved community resides in Vancouver Downtown Eastside (DTES), the location of one of Canada's poorest neighborhood. Residents in this community are at high risk for oral cancer because many are heavy smokers and regular consumers of alcohol, which are the established risk factors for oral cancers. Further aggravating the problem is that many are having complicated immune status; additionally, poor nutrition and oral hygiene and a limited access to dental and medical care.

There is an urgent need to reach this high-risk population to make sure these individuals are equally served. Moreover, a screening program targeted toward such a high-risk community could effectively decrease the suffering and fatal impact attributable to oral cancer. The key focus of my research is to work within high-risk communities to develop a screening strategy targeted towards the hard-to-reach underserved populations where the need is greatest.

The main objective of this study is to establish current research activity in the study of oral cancer and precancers within the context of community-based clinics in a high-risk population in Vancouver. The activities involve: 1) to establish the first oral cancer screening clinic in a high-risk community in BC, 2) to incorporate and evaluate several new visualization tools and molecular markers for the identification of high-risk OPL and early cancer, and 3) to understand the biology of infection and inflammation to OPLs and its role in cancer formation in a high risk community. This work meets the main objectives of the National Cancer Agency, Canada in prevention and early detection of cancers.