Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.
These recommendations were finalized by the Task Force in June 1993
| MANEUVER | EFFECTIVENESS | LEVEL OF EVIDENCE <REF> | RECOMMENDATION |
| Smoking cessation counselling. | Use of multiple intervention and re-enforcement strategies increased 6-month and 1-year cessation rates. | Randomized controlled trials <17> (I) | Good evidence to include in periodic health
exam. (A)
*Although the recommendation has not changed, the evidence review has been updated for this recommendation. Click here for 1999 update: Prevention of oral cancer mortality |
| Screening by oral physical examination. | Low prevalence of oral cancers and poor positive predictive value of physical exam (even in conjunction with use of tolonium chloride testing) limit usefulness. Potential for labelling, cost of follow-up and marginal benefits demonstrated for therapy are additional considerations. | Cohort and case-control studies <2-6> (II-2) | Insufficient evidence to include
or exclude from periodic health exam (C);
annual examination by physician and/or dentist should be considered for
men and women over age 60 years with risk factors for oral cancers and
precancers; individual judgement should be exercised regarding the use
of tolonium chloride for those identified as positive by oral physical
exam.
*Note: This recommendation has been updated. Click here for 1999 update: Prevention of oral cancer mortality |
| Use of 13-cis-retinoic acid (13cRA) reverses or stabilizes premalignant lesions and reduces the rate of second primary malignancies. Side effects, potential teratogenicity and relapse after discontinuation limit usefulness. b -carotene reduces occurrence of oral leukoplakia and mucosal dysplasia to a lesser degree than 13cRA, without side effects. | Randomized controlled trials <22-27> (I) | ||
| Survival of patients with invasive cancer appears comparable for surgical and radiation therapy; earlier stage of disease is an important prognostic factor. | Cohort studies <23,28> (II-2) and case series <29-33,36> (III) |
Link to Full Text of this review
Link to Structured Abstract of this review
Link to Selected References list of this review
Link to 1999 Update: Prevention of oral cancer mortality
Reprinted in modified format by the Canadian
Task Force on Preventive Health Care
with permission.
Original Copyright
© 1994 Minister of Supply and Services Canada.
For any technical issues please contact: webmaster@ctfphc.org
Last modified March 27, 1998.
