The pathology of oral cancer

Oral cancer is a serious public health problem, with over 200 000 new cases reported annually worldwide, two-thirds of which occur in developing countries. The overall mortality rate for intra-oral cancer remains high at approximately 50%, even with modern medical services, probably due to the advanced stage of the disease at presentation. This review outlines recent advances in our understanding of the roles and interactions of major risk factors for oral cancer worldwide, notably tobacco, alcohol and betel quid and the genetic polymorphisms determining their metabolism that may predispose patients to oral carcinoma. Oral epithelial lesions with malignant potential are described. We discuss the histopathology of oral cancer, its grading and the staging of the disease at clinical, microscopic, immunohistological and molecular levels. A recommended minimum dataset for pathology reports is described. The available strategies and current prospects for controlling oral cancer in the community are summarised.