Ana Pucar

Oral Cancer and Oral Potentially Malignant Disorders: Advancing Diagnosis and the Relevance of Early Diagnosis

Oral potentially malignant disorders (OPMDs) are clinically suspicious conditions, a small percentage of which may transform into malignancies. OPMDs include leukoplakia, erythroplakia, nonhomogenious erythrolekuplakia, erosive atrophic form of lichen planus, oral submucous fibrosis and actinic cheilitis pose management complexities. Although only a fraction of OPMDs progress to cancer, determining individual cancer risk is critical for effective care. Unfortunately, the natural history of OPMDs is not fully understood, and precision approaches integrating predictive markers lack validation through prospective studies. Additionally, healthcare systems often neglect evidence-based health promotion, and most intervention studies face challenges such as non-uniform diagnostic criteria, inadequate outcome measures, and insufficient focus on quality of life or patient preferences. Global networks and well-designed trials using validated metrics are needed to refine OPMD management. Accurate diagnosis and management remain challenging under current standards of care. Dysplasia is a key marker for assessing cancer risk in OPMDs, with surgical biopsy serving as the diagnostic gold standard. However, biopsies are limited by morbidity, resource demands, and risks of underdiagnosis. While diagnostic adjuncts like toluidine blue and autofluorescence imaging exist, their poor accuracy limits their clinical utility. Emerging in vivo microscopy technologies—such as optical coherence tomography and confocal microscopy—offer promising alternatives by enabling real-time microscopic visualization at the point of care.Oral cancer (OC), common in developing countris such as Serbia, is a major health concern ofnthe orofacial region. Preventable through behavioral modifications—such as reducing tobacco, alcohol, and betel nut use—OC underscores the importance of early detection. Clinical recognition of suspicious oral lesions enables early intervention, with surgical biopsy as the diagnostic standard. Adjunctive tools and novel methods, including salivary marker identification, hold potential to enhance early diagnosis and reduce mortality rates. Integrating advanced diagnostic technologies and global research efforts is vital to improving patient outcomes.

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Prof dr Ana Pucar is full professor at the School of Dental Medicine, University of Belgrade. From the very beginning of her professional career, she is dedicated to lecturing, clinical and scientific work in the field of Oral Medicine. Prof. Pucar did her master's degree in the field of oral complications of chemotherapy, while her doctoral thesis was about the influence of periodontal bacteria on the onset and development of atherosclerosis. Current scientific work and projects deal with clinical features, diagnostics and molecular mechanisms of oral cancer formation and the biology and clinical behavior of oral potentially malignant disorders. Her prominent work as the author of numerous scientific papers and several important textbooks, but also her mentoring accomplishments in the clinical and scientific field, enabled progress in the diagnosis and treatment of oral diseases.