Recent advances in molecular biology have established not only that the sequential progression of the -multipath, mul-tifocal and multicLonal oral carcinogeneic continuum may extend over periods up to two or more decades in duration prior to the initial clinical presentation of occult oral squa-mous cell carcinomas (OSCC), but also that the differential capacity to form distant metastases is already established at the initial precancerous (intraepithelial neoplastic [IEN]) stage. As preventive, especially chemopreventive, measures offer the potential to delay, arrest or even reverse the development of the IEN stages of this continuum, the most rational strategy to reduce the burden of the more than 300,000 new cases of OSCC detected annually worldwide on patients and their families together with the associated economic costs for the provision of healthcare and loss of human capital from their high morbidity and premature mortality rates, centers on the development of techniques for the early detection of individuals at high-risk for oral carcinoeenesis.
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