MEDIX, God. 25 Br. 136/137  •  Pregledni članak  •  Stomatologija HR ENG

Rano otkrivanje raka usne šupljineEarly detection of oral cavity cancer

Ivan Alajbeg, Mario Šekerija, Petra Čukelj

Rak usne šupljine (RUŠ) u Republici Hrvatskoj je na 11. mjestu prema smrtnosti od malignih bolesti. Iako je incidencija u blagome padu, stopa pomora je stabilna. Njegovo kasno otkrivanje glavni je uzrok visoke smrtnosti. Rano otkriveni slučajevi imali bi dobru prognozu. Glavni su čimbenici rizika duhan i alkohol. Stomatolozi imaju važnu ulogu u primarnoj prevenciji raka usne šupljine (RUŠ) kroz aktivnosti usmjerene prestanku pušenja. U sekundarnoj prevenciji, tj. ranom otkrivanju RUŠ-a, stomatolozi imaju izniman potencijal, jer bi temeljiti pregled oralne sluznice i dobro prepoznavanje oralnih struktura trebali biti sastavni dio svakoga posjeta stomatologu. Trajna briga o oralnome zdravlju bolesnika u kojih se planira zračenje područja glave i vrata, treća je razina u kojoj se isprepleću stomatologija i RUŠ, najviše smanjenjem mukozitisa te prevencijom radijacijskoga karijesa i osteoradionekroze. Rano otkrivanje RUŠ-a često je stomatologu onemogućeno, jer većina visokorizičnih osoba uopće ne posjećuje stomatologa, međutim, zbog komorbiditeta, posjećuje svoga liječnika obiteljske medicine. Poboljšanje rane dijagnostike moglo bi se osigurati partnerstvom liječnika obiteljske medicine i stomatologa u primarnoj zdravstvenoj zaštiti, pogotovo u domovima zdravlja, u kojima bi liječnik obiteljske medicine identificirao pacijenta s rizikom, a zatim odmah organizirao kratki pregled usne šupljine kod stomatologa, koji bi, pak, indicirao eventualnu potrebu za specijalističkim pregledom.

Ključne riječi:
bolesti usne šupljine; oralna medicina; planocelularni karcinom glave i vrata; rak usne šupljine; rana dijagnoza

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 25 Br. 136/137

Oral cancer (OC) ranks the 11th place of the causes of mortality from malignant diseases in Croatia. Although the incidence is slightly decreasing, its mortality rate is stable. Its late detection is the main cause of high mortality. Early diagnosed cases would have a good prognosis. The main risk factors are tobacco and alcohol. Dentists play an important role in primary prevention of  OC through smoking cessation activities. There is a tremendous potential for the dentists role in the OC secondary prevention through its early detection. since a thorough clinical examination of the oral mucosa and a good knowledge of oral structures should be an integral part of each dental appointment. The third level is a permanent care for the oral health in patients undergoing head and neck radiation, primarily through the reduction of mucositis and the prevention of radiation caries and osteoradionecrosis. Dentists are frequently not able to perform early detection of OC, as most of the high-risk individuals do not visit the dentist at all. However, due to their comorbidities, they are seen by their family physicians. Improvement of early diagnosis could be ensured by the partnership of family medicine physicians and the primary health care dentists, espacialy in primary healthcare Centers, where the family medicine physician would identify the patient at risk, and then immediately arrange a brief examination of the oral cavity at a dentist, who would, if needed, indicate the necessity for a specialist examination.

Key words:
early diagnosis; mouth diseases; oral cancer; oral medicine; squamous cell carcinoma of head and neck