Fall/Winter 2005 Table of Contents
Message from the Dean

Dean Michael C. Alfano
Dean Michael C. Alfano

If the cover art on this issue of Global Health Nexus gets under your skin, I am worried. Indeed, if you still don’t focus on soft tissue exams for oral cancer in your patients, you might be thinking, “Who do they think they are running this ad?" Well, you don’t need to worry about NYUCD running this hypothetical ad in the consumer media, because we do not want to embarrass the profession in any way. Indeed, the six-year focus on oral cancer by NYUCD is designed not only to help improve the health of the citizenry, but also to elevate the stature of the dental profession. Nevertheless, if this fictitious ad offended you, I respectfully suggest that you rethink your oral exam priorities and technique.

This is the third issue of Global Health Nexus that is dedicated to raising awareness of oral cancer and the importance of prevention and early detection. In two previous issues, we talked about the urgent need to change attitudes about oral cancer exams — both the public’s and the profession’s — in order to save many of the over 7,000 American lives that are lost annually to this disease. In this issue of Nexus, which we’ve dubbed “The Oral Cancer Scorecard,” we take a hard look at how far we’ve come and how far we still have to go.

Yes, progress has been made. Since 1999, the Oral Cancer Consortium, of which NYU College of Dentistry was the initial member, has played a leadership role in increasing access to free screenings, consumer information, and education into the causes and prevention of oral cancer. Notably, the Oral Cancer Consortium helped to catalyze similar outreach initiatives in other states and a pilot national oral cancer awareness campaign.

NYUCD has also reached out to alumni and other dentists across the nation, encouraging them to build an oral cancer examination into their routine dental exam regimens. We sent our alumni — over 10,000 dentists — a guide published by the National Institute of Dental and Craniofacial Research (NIDCR), which reviews the steps in a standardized oral cancer examination and helps the practitioner refresh the techniques necessary to ensure optimum patient health. We offered free continuing education courses focusing on the importance of performing oral cancer exams, and we developed a Web site on oral cancer, www.oral-cancer.org. We also coauthored a national supplement to the Journal of the American Dental Association, which focused entirely on oral cancer; developed an online course on oral cancer diagnosis; and paid for consumer ads on oral cancer in such publications as Time magazine, The New York Times, and the New York Daily News. Furthermore, we substantially increased our research on oral cancer; we partnered with the New York State Dental Association in providing continuing education on oral cancer throughout New York; and NYUCD faculty have written journal editorials and papers on the subject.

All this begs the question: Has oral cancer become a public health priority? The answer, sadly, is no. In the following pages, we ask why and also offer some thoughts on actions needed to bring about change.

In our lead editorial, Brian Hill, Founder and Executive Director of The Oral Cancer Foundation and a late-stage oral cancer survivor, asks tough, provocative questions about how well the profession and policymakers are fulfilling their responsibility to the public with regard to oral cancer awareness and screenings. His questions are especially timely in light of a recent study published in Lancet that provides solid evidence that nearly 40,000 lives could be saved worldwide every year through early detection of oral cancer.

On another front, an article about NYUCD’s $8.3 million NIH-funded Oral Cancer Research for Adolescent and Adult Health Promotion (RAAHP) Center provides an in-depth look at studies that are identifying factors contributing to oral cancer disparities, and developing and testing new strategies for eliminating them.

This project is an important part of NYUCD’s plan to become a national center for oral cancer research. In addition to RAAHP Center investigations, faculty are also contributing to a broader understanding of cancer’s progression and to the development of highly targeted prevention and treatment strategies. Projects include revealing novel targets in programmed cell death, testing the effect of chemoprevention on precancerous tissues, using anti-cancer immunotherapy, applying gene and mutation research to the prevention of oral cancer, and evaluating the feasibility of new oral cancer treatment approaches. It is noteworthy also that our colleague at UCLA, Dr. David Wong, is conducting some of the most exciting research around — on the use of saliva as a diagnostic test for oral cancer.

The path forward in oral cancer research is truly promising. In terms of empowering the public to ask their dentists for an oral cancer exam, however, we do not score very high.

In his article entitled “Taking Oral and Oropharyngeal Cancer Awareness and Action to the Next Level,” NYUCD faculty member and current Chairman of the Oral Cancer Consortium, Dr. Ross Kerr, focuses on this issue and also on why more dentists are not routinely doing the exam without being asked. And he proposes a plan of action for finally making an oral cancer exam a “must-have” healthcare procedure, like a pap smear for women or a prostate exam for men. Finally, Dr. Roger Levin, CEO and Founder of The Levin Group, discusses motivations for more private practitioners to do oral cancer exams, including the availability of new oral cancer detection technology, and he proposes the incorporation of a reimbursement system into private practices.

I hope that this issue of Global Health Nexus makes the compelling case that the defeat of oral cancer must be a collective effort. Please let me know how you feel about the issue by sending your comments to me at . I look forward to including your views in a future issue.