Nomenclature and classification of potentially malignant disorders of the oral mucosa

Authors

  • S. Warnakulasuriya,

    1. Department of Oral Medicine, King’s College London Dental Institute at Guy’s, King’s and St Thomas’ Hospitals, and the WHO Collaborating Centre for Oral Cancer and Precancer, Denmark Hill Campus, Caldecot Road, London, UK
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  • Newell. W. Johnson,

    1. School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, Queensland, Australia
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  • I. Van Der Waal

    1. Department of Oral and Maxillofacial Surgery/Pathology, ACTA/VU University Medical Centre, Amsterdam, The Netherlands
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Professor Saman Warnakulasuriya, Department of Oral Medicine, King’s College London Dental Institute, Denmark Hill Campus, Caldecot Road, London SE5 9RW, UK. Tel: +44 20 7 346 3608, Fax: +44 20 7 346 3624, E-mail: s.warne@kcl.ac.uk

Abstract

At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Precancer in the UK issues related to terminology, definitions and classification of oral precancer were discussed by an expert group. The consensus views of the Working Group are presented here. The term, ‘potentially malignant disorders’, was recommended to refer to precancer as it conveys that not all disorders described under this term may transform into cancer. Critically evaluating all definitions proposed so far for oral leukoplakia, the Working Group agreed that the term leukoplakia should be used to recognize ‘white plaques of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer’. An outline was proposed for diagnosing oral leukoplakia that will prevent other oral white disorders being misclassified as leukoplakia. The Working Group discussed the caveats involved in the current use of terminology and classification of oral potentially malignant disorders, deficiencies of these complex systems, and how they have evolved over the past several decades. The terminology presented in this report reflects our best understanding of multi-step carcinogenesis in the oral mucosa, and aspires to engender consistency in use.

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