Despite the profession placing great emphasis on oral potentially malignant disorders (OPMDs) as a gateway for early recognition and consequently better outcomes for oral cancer, the death rates for lip and oral cavity cancer have remained stagnant for three decades. Evidence shows that only a small fraction of oral cancers are in fact preceded by OPMDs, and that most OPMDs have an annual transformation rate of less than 1%. As OPMDs encompass a very heterogeneous group of oral conditions, it could be argued that only patients with oral mucosal diseases bearing a substantial risk of malignant transformation warrant close surveillance and treatment, these include proliferative leukoplakia, erythroplakia, non-homogeneous leukoplakia, as well as diseases presenting with severe dysplasia at biopsy. In this narrative review, I discuss the intricate epidemiology of the malignancies that we colloquially refer to as oral cancer, explore the limitations of focusing on OPMDs to reduce the incidence and mortality of oral cavity cancer, and argue that amay-becancer label represents overdiagnosis for most OPMDs.
尽管医学界高度重视口腔潜在恶性病变（OPMDs），将其视为早期识别口腔癌并改善预后的关键途径，但唇癌和口腔癌的死亡率在过去三十年间始终未见下降。证据表明，实际上仅有少数口腔癌病例由OPMDs发展而来，且绝大多数OPMDs的年恶变率低于1%。由于OPMDs涵盖了一组高度异质性的口腔病变，有观点认为仅对具有显著恶变风险的口腔黏膜疾病患者需要进行密切监测和治疗，这类病变包括增殖性白斑、红斑、非均质性白斑以及活检显示重度异型增生的疾病。在本篇叙述性综述中，我将探讨被通俗称为"口腔癌"的恶性肿瘤复杂的流行病学特征，分析以OPMDs为重点来降低口腔癌发病率和死亡率的局限性，并论证"可能癌变"的标签对大多数OPMDs而言实属过度诊断。
Precursor Lesions, Overdiagnosis, and Oral Cancer: A Critical Review
肿瘤(癌症)患者之家