Mouth Cancer Action Month November 2015 Oral Health Education Community Dental Service Room 131, Alsager Clinic Sandbach Road South ALSAGER ST7 2LU Tel 01270 275555

Aim – Increase awareness about mouth cancer and support healthcare professionals to signpost to treatment and preventative services. Objectives  Outline the incidence of Head and Neck cancer Identify early warning signs of mouth cancer State how to access mouth checks and signpost to health improvement services

Head and neck cancer in Merseyside and Cheshire During 2008 – 2010 53% of Head and neck cancers were in people aged under 65 15th Most common cancer in UK Areas of Crewe have a particularly high incidence – see slide 4 Females incidence in East Cheshire Local Authority is higher than England – see slide 5

Local figures N.B. Statistically high incidence in areas of Crewe

Incidence N.B – Female incidence in Cheshire East LA is higher than England

Key UK facts ref. Mouth Cancer Foundation In 2011, there were 6,767 people diagnosed with mouth cancer in the UK Mouth cancer cases have increased by a third in the last decade…… it is one of few cancers that experts predict will continue to increase in the coming years The lifetime risk of developing mouth cancer is 1 in 84 for men and 1 in 160 for women Cancer of the tongue and oral cavity are the most common forms of mouth cancer.

Who does it effect? Rates are much higher in white males, however those in Asian males are similar More than 90% of mouth cancers in men and 85% in women are linked to lifestyle and environmental factors

Risk factors Smoking Alcohol Poor diet Human Papilloma Virus (HPV) Gum disease and tooth loss

Smoking Two thirds of mouth cancer cases are linked to smoking tobacco Smokers put themselves at almost three times higher risk…..but cigars and pipe smokers put themselves at greater risk Ex-smokers reduce their risk by a third

Stop smoking contact details Phone:  0800 085 8818 Email:  ecn-tr.kickstartstopsmoking@nhs.net Website:  kickstartcheshire.co.uk

Alcohol Drinking alcohol to excess is linked to around a third of all cases Those who smoke and drink to excess put themselves at risk by up to 30 times

Alcohol metabolises to a product called Acetaldehyde This is mutagenic. This is metabolised in the liver but also in the oral cavity and accumulates in the soft tissues. Metabolism is enhanced by oral streptococci - linking poor oral hygiene to increased risk of mouth cancer.  Alcohol enhances the penetration of tobacco carcinogens into the oral mucosa. It has the capacity to eliminate the fatty barrier that protects the oral mucosa and tongue from penetration by tobacco carcinogens.  This disrupts the normal orderly arrangement of fat molecules opening up inter cellular pathways.

Cheshire East Drug and Alcohol service 01625 422100

Other risk factors More than half of cases in the UK are linked to a poor diet Solar radiation from the sun has been linked to cancer of the lip The Human Papilloma Virus (HPV) is estimated to overtake smoking as the number one cause of mouth cancers in the future Mouth cancer is 2.5 times higher in those with gum disease…and is 60 times higher in people with six or more missing teeth Mouth cancer is 70% more common in those whose family have a history of the disease

Silent killer More than 2,000 people lose their life to mouth cancer in the UK every year There are more deaths from mouth cancer than there are through road traffic accidents Mouth cancer also claims more lives per year than cervical and testicular cancer combined

Survival Although the number of mouth cancer cases have increased steadily over the last decade, more people are being treated successfully and living for longer Early detection for mouth cancer results in a survival outcome of 90%

How to check for mouth cancer:- Self examination At the dentist Free mouth checks

Self examination Free leaflets/posters are available from: info@mouthcancerfoundation.org 01924 950 950

At the dentist As part of a regular check-up a dentist is required to carry out a visual examination and look for early signs of mouth cancer. For urgent dental care 9am to 9.30pm every day including weekends and bank holidays telephone 0161 476 9651 If someone is having difficulty finding an NHS dentist call NHS England on 0300 311 2233 or visit NHS choices at www.nhs.uk

Useful resources/references www.mouthcancer.org www.dentalhealth.org www.ons.gov.uk www.nice.org.uk www.orderline.dh.gov.uk www.smokefree.nhs.uk

Evaluation Objectives Outline the incidence of Head and Neck cancer Identify early warning signs of mouth cancer State how to access mouth checks and signpost to health improvement services

Questions Contact Lynn McCutcheon 01270 275555 lynnmccutcheon@nhs.net Please complete evaluation form