Case Western Reserve University School of Dental Medicine researchers unveiled a new test for oral cancer, including head and neck cancers, in the March 4 edition of Cell Reports Medicine.
Dr. Aaron Weinberg, the study's lead researcher, said the test, which involves swabbing the skin, has several benefits over a biopsy where doctors remove a tissue sample for testing.
“It's pretty costly to do a biopsy," he said. "It's stressful. It can lead to secondary infections.”
These swab tests also provide results more quickly and easily than going into a hospital to have a skin sample removed, Weinberg said. This new test, which determines if cancer is present using a scoring system known as the beta-defensin index, usually provides results within 30 minutes of a sample being taken, he said.
According to a 2023 National Institutes of Health report, head and neck cancer is the seventh-most prevalent type of cancer in the world, making up about 5% of all cancers worldwide and 3% in the United States. Instances of this cancer are on the rise, with about 640,000 cases per year, resulting in about 350,000 deaths worldwide, mainly in socioeconomically disadvantaged populations and underserved communities, the study found.
Weinberg said patients are generally resistant to getting a biopsy, in part, due to the invasive nature of having a piece of tissue removed for testing. This only gets worse if multiple biopsies are needed, he said.
"You can't do biopsy after biopsy after biopsy," Weinberg said. "That's not practical and no one's going to want to have their mouths cut up frequently."
Given that only 5% of biopsies ordered for this type of cancer result in a cancer diagnosis, this new test provides a way to determine if a biopsy is even necessary in the first place, Weinberg said.
The goal is to get as far out in front of any problems as possible by providing it to primary care doctors and dentists, he said.
"The purpose for this is not just for hospitals," Weinberg said. "It's too late for hospitals. You've got to get it into the clinics and where there are the clinicians, their primary care physicians who look into your mouth when you do an annual physical, and they are obviously primary care dentists who spend a lot of time looking at your mouth."
Weinberg said while this test will benefit patients in the U.S., providing a less expensive, less invasive test like this should have a larger impact internationally. This benefit will be seen particularly in countries like India and throughout Asia where this type of cancer is much more common with an estimated 7 million people expected to develop oral cancer, he said.
"I think a more important life saving perspective ... would be in India [with] low socioeconomic, environments, where pathology review is either not available or questionable as to outcomes," Weinberg said.
The CWRU researchers are planning to expand upon their initial study, which focused on approximately 100 patients in the region, to a much larger national and international study. Weinberg said he expects to submit a grant proposal to the National Institutes of Health by June. The study would not only focus on developing a tool to detect cancer that can be easily used in the field, but to explore the role of this test in helping detect pre-cancerous lesions.
The original study found instances where the test concluded there was cancer, only for this not to be the case, but further assessment of the information showed that these so-called false positives may have been caused by detecting pre-cancerous lesions in the skin.
This new study would delve more deeply into this to see whether the test could help doctors determine whether a biopsy should be taken to detect lesions that could turn cancerous, Weinberg said. He said this would allow doctors to work farther ahead, which is important given that pre-cancerous lesions have been shown to become cancerous in as little as 180 days of the pre-cancerous growths being detected.
