Oral cancer and oral precancerous lesions in inflammatory bowel diseases, a systematic review
Oral cancer is historically linked to well-known behavioral risk factors such as tobacco smoking and alcohol consumption. Other risk factors include age over forty, male sex, several dietary factors, nutrition deficiencies, viruses, sexually transmitted infections, human papillomavirus, chronic irritation and possibly genetic predisposition. Precancerous lesions in the oral cavity include leukoplakia, erythroplakia and lichen planus. Histology of oral cancer varies largely but the great majority is squamous cell carcinomas.Epidemiological studies and cancer registries have shown a consistently increased risk of oral malignancies in kidney, bone marrow, heart or liver transplantation, in graft versus host disease and in patients with HIV infection. Because of the increasing use of immunosuppressive drugs in patients with inflammatory bowel disease it is useful to more accurately delineate the consequences of chronic immunosuppression to the oral cavity. Oral cancer and pre-cancerous oral lesions in patients with IBD have been scarcely reported and reviews on the topic are lacking.We conducted a literature search using the terms and variants of all cancerous and precancerous oral manifestations of inflammatory bowel diseases. By retrieving the existing literature it is evident that patients with IBD belong to the high-risk group of developing these lesions, a phenomenon strengthened also by the increasing HPV prevalence. Education on modifiable risk behaviors in patients with oral cancer is the cornerstone of prevention.Oral screening should be performed for all IBD patients, especially those who are about to start a immunosuppressant or a biologic
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