Brush biopsy could enable early detection of oral cancer without surgery

early detection of oral cancer

A new test invented by US researchers allows dentists to screen for the most common form of oral cancer with a simple and familiar tool: the brush.

The diagnostic kit, created and patented by a team at the University of Illinois Chicago uses a small brush to collect cells from potentially cancerous lesions inside the mouth. The sample is then analysed for genetic signals of oral squamous cell carcinoma, the ninth most prevalent cancer globally.

This new screening method, which is currently seeking commercialisation partnerships, improves upon the current diagnostic standard of surgical biopsies—an extra referral step that risks losing patients who sometimes don’t return until the cancer progresses to more advanced, hard-to-treat stages.

The detection system works by looking for small segments of genetic material called microRNA that regulate the expression of genes.

Previous research by the team found an expression signature of 40 microRNA sequences that can distinguish between a tumour and normal tissue with over 90 per cent accuracy.

Importantly, their test also worked using epithelial cells, the outermost layer of cells in a patient’s mouth. These cells can be easily collected in less than a minute of gentle brushing—no numbing required—by a dentist or nurse, who then places the brush in a tube of solution and sends it to a lab for microRNA analysis. Results can be returned to the clinic in days with the current version of the diagnostic test.

“We were the first to observe that brush biopsy samples actually work quite well when you use microRNA,” inventor Guy Adami said. “All you need is a good light and the brushes.”

In addition to the convenience of the collection method, the brush biopsy also provides several other advantages. Surgical biopsies often collect a mixture of cell types, making subsequent analysis more complicated, and risk spreading cancerous cells to other areas of the mouth. And unlike blood tests that survey generally for genetic signals of cancer, the brush method only collects cells from a single site where treatment can be focused if a malignancy is detected.

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