What are the key clinical features that should raise suspicion for oral cancer in a patient presenting with oral lesions?

Key clinical features that should raise suspicion for oral cancer in a patient presenting with oral lesions include:

• Unexplained ulceration in the oral cavity lasting more than 3 weeks, which warrants urgent referral for suspected cancer pathway assessment NICE NG12.
• A lump on the lip or in the oral cavity that is persistent and unexplained, especially if increasing in size, should prompt urgent referral to a dentist for assessment and possible suspected cancer pathway referral NICE NG12.
• Red or red and white patches in the oral cavity consistent with erythroplakia or erythroleukoplakia are important clinical signs that require urgent referral for specialist assessment NICE NG12.
• Persistent and unexplained neck lumps in adults, which may represent metastatic spread from oral cancer, also necessitate urgent referral NICE NG12.
• Other suspicious features include lesions that do not heal, indurated or firm areas, and lesions associated with pain, bleeding, or difficulty in swallowing or speaking, which are commonly reported in oral cancer presentations Weinberg & Estefan 2002Neville & Day 2002.
• Early diagnosis is critical as oral cancer often arises from premalignant lesions such as erythroplakia and leukoplakia, and clinical vigilance for these changes improves outcomes Abati et al. 2020.

In summary, persistent oral ulceration, unexplained lumps, and red or red and white patches in the oral cavity are key clinical features that should raise suspicion for oral cancer and prompt urgent referral for specialist assessment NICE NG12 Weinberg & Estefan 2002Neville & Day 2002Abati et al. 2020.