Tiresias looks at oral screenin

My friends

Tiresias was contemplating discussing what more needs to be done to achieve the rapid penetration of Optiscan’s in-vivo confocal endomicroscopy into the clinic; specifically initially into neurosurgery, oral surgery and breast surgery. How does one market to these groups? Tiresias has some different ideas which may seem unconventional to those who do not understand just what needs to be done, and the lack of understanding of this up till now has held back Optiscan’s commercialization for so long. Tiresias promises he will address this in future missives, but for today, he would like to just briefly revisit oral cancer, or more correctly pre-cancer and its screening. Just how big is this market?

You know that there were 55,000 oral cancers diagnosed and operated on in the United States last year. Approximately the same number were reported from China last year too. The China estimate is undoubtedly underestimated, given that China has a fourfold greater population and the incidence of oral cancer, per head of population of oral cancer in China is far greater than in the United States.. Optiscan’s in-vivo intra-operative confocal endomicromicroscopy for oral cancer margin detection, is by itself a huge market. But this is just the tip of the iceberg for Optiscan. The really big market, the one that will bring home the bacon for Optiscan’s is screening of pre-cancerous lesions in the mouth.

Oral pre-cancer, leukoplakia , is very very common, and depending on populations, their smoking, alcohol and diet, varies between 2% and 5% of the population. In the United States, if we take the lower figure of 2%, this approximates to 6 million people who need regular, at least 6 monthly screening. In China, which has the much higher figure it is somewhere it is in the order of 50 million people who need regular screening. This involves at least 6 monthly oral examination, which at present involves traumatic, inaccurate, and expensive biopsy of any suspicious looking changes on visual inspection. It leads to delay in diagnosis, delay in surgery, and as often, unnecessary surgery, and then inadequate incomplete or excessive surgery to great detriment of patient care, morbidity and mortality. Optiscan confocal in-vivo endomicroscopy will revolutionise oral cancer screening. Tiresias recoils from financial calculations and will leave this to others, but he is sure that current Optiscan valuation will be related by many orders of magnitude. The other point is that all medical technology, especial optical fibre based has a limited life span, and will need regular replacement, at relatively frequent intervals. There will be constant upgrades and repeat sales. As Tiresias has also indicated previously, there are many developments and improvements in the pipeline for confocal microscopy leading to new models and ongoing sales. As Teresa says and keeps saying, the oral cancer and particularly the pre-cancer screening market is a company maker and it will come quickly. And the incidence of oral cancer is increasing everywhere. After 20 years or so on in the market those who have not heard of Optiscan will think this was an overnight success.