Early Diagnosis of Oral Cancer: A Complex Polyhedral Problem with a Difficult Solution

SIMPLE SUMMARY: Oral and oropharyngeal cancers account for a worldwide incidence of 377,713 and 98,412 new cases annually and 177,757 and 48,143 deaths per year, respectively. Approximately 90% of oral malignancies are squamous cell carcinomas, showing a 5-year mortality rate still close to 50%. The poor prognosis of oral cancer is mainly related to its late diagnosis in advanced stages (stage III/IV), in which treatment is not effective. Therefore, reducing the delay in the diagnosis of oral cancer is an essential step in order to improve the outcomes and outlooks of patients affected by this disease. In this article, the diagnostic delay of oral patients is critically reviewed, jointly with their main reasons, difficulties, and future strategies for improvement. ABSTRACT: Oral and oropharyngeal cancers are a growing problem, accounting for 377,713 and 98,412 new cases per year all over the world and 177,757 and 48,143 deaths annually, respectively. Despite the substantial improvement in diagnostic procedures and treatment techniques in recent years, the mortality rate has not decreased substantially in the last 40 years, which is still close to 50% of cases. The major cause responsible for this high mortality is associated with the high percentage of oral cancers diagnosed in advanced stages (stages III and IV) where the treatment harbors poor efficacy, resulting in challenges, mutilations, or disability. The main reason for cancer to be diagnosed at an advanced stage is a diagnostic delay, so it is critical to reduce this delay in order to improve the prognosis of patients suffering from oral cancer. The causes of oral cancer diagnostic delay are complex and concern patients, healthcare professionals, and healthcare services. In this manuscript, oral cancer diagnostic delay is critically reviewed based on current evidence, as well as their major causes, main problems, and potential improvement strategies.