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 ¹.
• 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 ¹.
• 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 ¹.
• Persistent and unexplained neck lumps in adults, which may represent metastatic spread from oral cancer, also necessitate urgent referral ¹.
• 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 and Estefan, 2002; Neville and 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 ¹ (Weinberg and Estefan, 2002; Neville and Day, 2002; Abati et al., 2020).