One person dies each hour from oral cancer, estimates the Oral Cancer Foundation. More than 34,000 Americans will be diagnosed with the disease each year, only half of whom will be alive in five years. The death rate for oral cancer is higher than that of cervical cancer, Hodgkin's lymphoma, thyroid cancer or skin cancer.

Oral cancer isn't just a disease that's affecting smokers and users of chewing tobacco. While a historical link has been seen between individuals who consume alcohol frequently and in high amounts, a new virus has also been named a culprit. Oral cancer, typically seen 6-to-1 in males, now has a 2-to-1 ratio. The cause? Human papillomavirus (HPV), the same virus that causes more than 90% of all cervical cancers.

Research from late 2007 and early 2008 suggests that the fastest-growing segment of oral cancer diagnoses is actually nonsmokers under age 50, the Oral Cancer Foundation states.

Even worse, "when oral cancer is diagnosed, it's usually too late," says Dr. Sami Beg, associate medical director for U.S. Preventive Medicine. More than 75% of oral cancer diagnoses are in the late stages, bringing low survival rates, high medical bills and costly operations that can leave patients disfigured or require months of physical therapy.

Which presents the question: Are your employees being screened for oral cancer? The sad answer: Probably not.

Regular dental care lacking

Beg estimates that only one in five Americans has a regular oral cancer screening, but new research suggests that the issue may be more deeply rooted than just not screening for oral cancer. Guardian Life Insurance's 2007 Spotlight on Dental survey suggests that only three out of four (73%) women and two out of three (66%) men who have dental coverage visit the dentist on a regular basis.

Seventy-three percent of infrequent dental visitors cite lack of insurance or inadequate coverage as the reason they do not visit the dentist more often.

Anecdotal evidence suggests that when dental patients were described the basic procedure for oral cancer screenings - which can include neck palpations, a tongue examination or a brush test, similar to a pap smear - only about one in five patients recalled having any of those tests done.

This is partly due to state laws, says Richard Goren, DDS, second vice president of group dental at Guardian Life Insurance. "There are a number of techniques for oral screening ... in some states, it's illegal to palpate below the neck. [Dentists should, however] let patients know exactly what they're doing."

Technological advancements

Over the past few years, great strides have been made in screening technologies. Most common is the "brush test," during which a dentist scrapes a small amount of cells from the cheek or tongue for examination.

In 2005, the American Dental Association approved a CDT code for an "adjunctive pre-diagnostic test that aids in the detection of mucosal abnormalities including pre-malignant and malignant lesions not to include cytology or biopsy procedures."

Screening tools such as ViziLite(r) Plus, from Zila Pharmaceuiticals, Inc., is covered under this code. VELscope, from Canadian manufacturer LED Dental Inc., may or may not be covered, depending on your insurance.

Guardian is the first insurer to offer the American Dental Association's recognized screening code, D-0431, as part of their PPO network plans. Delta Dental currently recognizes the code under their HMO plans. Several others plan to do so in the near future.

"There is benefit to both dental and medical carriers to provide coverage for oral cancer screening," Dr. Goren says. "While a company that [just offers dental coverage] is going to experience the cost of screening coverage, they're not necessarily going to get the savings on the medical side from having created a medical diagnosis ... but they will retain better people ... and save lives.

"Over time, you'll see more companies offering coverage," he predicts.

Raising awareness

Experts offer several tips for employers to educate employees about oral cancer and their risks for the disease.

· Since research clearly links oral cancer with smoking and high alcohol use, help fund employee smoking-cessation or alcohol-dependency programs.

• Diets low in fruit and vegetables may also be a factor. Encourage proper nutrition as part of employee wellness outreach efforts.
• With incidences of HPV on the rise, make sure your insurer covers the Gardasil vaccine for women. (Read more about HPV and Gardasil in EBN January.)
• Conduct meetings to make sure employees are aware of what dental coverage options are offered, and encourage health campaigns to raise awareness of oral cancer and other diseases.
• Promote awareness during this month's National Oral Cancer Awareness Week, April 21-27. Visit http://www.oralcancerfoundation.org/events for a calendar of awareness events across the country.
• The Yul Brenner Head and Neck Cancer Foundation sponsors free screenings nationwide. Visit http://www.headandneck.org/ for a complete list of locations.

Visit http://ebn.podhoster.com/ to download a "Five Minutes With ..." podcast with Dr. Jed Jacobson, senior vice president at Delta Dental, who offers information about oral cancer screening technology and an employer success story. Additionally, contact Robbins at mclean.robbins@sourcemedia.com if you have a particularly innovative program. We'll feature your stories in an upcoming Web exclusive.