Dear Editor,

Head-and-neck cancer continues to be a major global health crisis, constituting 21.2% of the overall malignancies reported.[1] A high proportion of head-and-neck cancers are diagnosed very late, especially in developing countries. The COVID-19 pandemic has caused the suspension of elective outpatient services across many nations. This has affected screening programs for head-and-neck cancer all over the world, adding to the already-existing problem of late diagnosis. In this letter, we would like to highlight the possibility of detecting oral and oropharyngeal cancer among suspected cases of COVID-19 during the swab collection for its diagnosis.

Over a million people all over the world are being screened for COVID-19 daily. The World Health Organization has recommended tests that detect viral RNA as one of the initial diagnostic tests for COVID-19 infection. The nasopharynx and/or oropharynx is the most tested sampling site, with a higher preference for the oropharynx due to ease of the technique.[2] The oropharyngeal sample is collected by stroking the swab against the uvula, tonsils, and posterior wall of the pharynx. This means that the examination of the oral cavity by visual inspection is possible in this context. With this background, Halboub et al.[3] have suggested opportunistic screening of oral cancer and premalignant lesions.

We suggest that patients with known risk factors for the development of head-and-neck cancer presenting for COVID-19 testing may be questioned about the symptoms of head-and-neck cancer. These people can be subjected to careful examination of the oral cavity and oropharynx during the swabbing procedure. Any suspicious lesions may be further tested using a cytobrush for exfoliative cytology [4] to rule out a malignancy.

With minimal training, health-care professionals involved in sampling can be sensitized to identify various premalignant and malignant lesions of the oral and oropharyngeal region. They in turn can refer such patients for further testing and follow-up. The current pandemic has forced us to look at innovative solutions for the existing medical problems. One such example is the utilization of the COVID-19 testing for screening of oral cancer. This opportunistic screening will go a long way in the early detection and treatment of oral/oropharyngeal cancer.

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Conflicts of interest

There are no conflicts of interest.