Laboratory News

Saliva Test Being Developed to Detect Head and Neck Cancer

How about diagnosing cancer from a mouth rinse specimen? That's the goal of scientists at the Johns Hopkins Kimmel Cancer Center in Baltimore. They are developing a new way to screen for head and neck cancers in heavy smokers, heavy drinkers, and other high-risk populations.  The test is inexpensive, easy-to-perform, and painless.  The test focuses on finding cells with genetic signatures suggesting the presence of head and neck cancers.

Patients who undergo the test are asked to brush the inside of their mouths, then rinse and gargle with a salt solution.  Scientists then filter out cells in the saliva that might contain one or more of 21 bits of chemically-altered genes associated with head and neck cancers.  "It would be nice to have an easy way to identify people at risk for head and neck cancer that can be done by anybody-a nurse, a doctor, a PA (physician assistant)," stated Joseph Califano, M.D., one of the researchers and an Associate Professor, Otolaryngology, Head & Neck Surgery at Johns Hopkins Medicine in Baltimore, Maryland.

A study of the saliva test appears in the Journal of Clinical Cancer Research.  The mouth-rinse test was given to 211 people with head and neck cancers and 527 people who did not have these diseases.  It correctly identified more than half of the people with cancer as having the disease.  The test has since been improved.  "I think it's actually going to be really fairly impressive in terms of its ability to detect stuff," said Dr. Califano, who noted that it could be years before the test is widely used. Because there is no existing screening test for head and neck cancers, this test could work wonders for the 13,000 people who die of head and neck cancers and the 55,000 that develop these cancers each year. 

One noteworthy aspect of this research effort is the use of saliva as the specimen.  It shows how different molecular technologies are capable of providing diagnostic information from a variety of specimen types.  Researchers are also aware that most people find venipuncture to be an unpleasant way to collect a needed specimen.  Not only does a mouth rinse specimen avoid the need for venipuncture, but it also makes it easier to collect a specimen using healthcare workers who are not phlebotomists.

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• Study:  Evaluation of Promoter Hypermethylation Detection in Body Fluids as a Screening/Diagnosis Tool for Head and Neck Squamous Cell Carcinoma