The incidence of malignant transformation in leukoplakias ranges from 3% to 33% over 10 years.[61]Waldron CA, Shafer WG. Leukoplakia revisited. A clinicopathologic study 3256 oral leukoplakias. Cancer. 1975 Oct;36(4):1386-92.
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One 2021 systematic review of observational studies over the last 5 years estimated malignant transformation to be 9.8%.[159]Aguirre-Urizar JM, Lafuente-Ibáñez de Mendoza I, Warnakulasuriya S. Malignant transformation of oral leukoplakia: systematic review and meta-analysis of the last 5 years. Oral Dis. 2021 Nov;27(8):1881-95.
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Rates of transformation to carcinoma vary with the clinical type of leukoplakia (presence of candidal infection and grade of dysplasia reported in a biopsy).
Progression to oral squamous cell carcinoma is as high as 36% when moderate or severe epithelial dysplasia is present and occurs in up to 50% in lesions with severe dysplasia. However, the histological findings of dysplasia indicate no more than that a lesion has a statistically increased risk of malignant change and cannot be used for confident prediction of malignant change in any individual case.
Oropharyngeal cancer