Mouth cancer (oral cancer) kills thousands annually—yet early detection dramatically improves survival rates from 50% to 80-90%. At Tooronga Family Dentistry, Dr. Kaufman performs mouth cancer screening at every checkup, knowing that recognizing mouth cancer symptoms early saves lives. Mouth cancer can develop in the different parts of the mouth—from lips to tongue to throat—and understanding the signs and symptoms of mouth cancer empowers Glen Iris patients to seek evaluation promptly. Learning the 11 warning signs (including sores lasting 2+ weeks, white/red patches, loose teeth, jaw pain, swallowing difficulty), knowing when you have one of these signs, please make an appointment with us, and understanding that Dr. Kaufman will investigate other more common causes first—ruling out infections before escalating concerns—provides reassurance while ensuring potentially life-threatening conditions don’t go undetected.

Quick Facts: Mouth Cancer Statistics

Oral cancer prevalence and survival:

• 📊 54,540 new oral cancer cases annually (US—2023 statistics)
• 📊 11,580 deaths annually from oral cancer (21% mortality—serious disease)
• 📊 66% five-year survival rate (all stages combined)
• 📊 84% five-year survival if caught early (localized stage)
• 📊 38% five-year survival if caught late (distant metastasis)
• 📊 2x increase in oral cancer (past 20 years—HPV-related cases rising)
• 📊 Median age: 64 years (but 25% occur under age 55)
• 📊 Men 2x more likely than women (historically—gap narrowing with HPV cancers)

The critical truth: Early detection transforms prognosis—84% vs 38% survival. Recognizing mouth cancer symptoms early is life-saving.

Where Mouth Cancer Develops: Locations in the Oral Cavity

Mouth Cancer Can Develop in Different Parts of the Mouth

Common oral cancer sites:

1. Lips (Lip Cancer)

Like on the lips:

Lip cancer characteristics:

⚠ Lower lip most common (90% of lip cancers—sun exposure highest) ⚠ Squamous cell carcinoma (most common type—arising from surface cells) ⚠ Highly visible (easier self-detection—better prognosis) ⚠ Sun exposure link (UV radiation—outdoor workers, fair skin highest risk)

Lip cancer symptoms:

• Persistent sore, scab (not healing 2+ weeks)
• White or red patch (on lip surface)
• Lump or thickening (palpable mass)
• Bleeding (spontaneous or with minimal trauma)

2. Gums (Gingival Cancer)

Gums:

Gum cancer characteristics:

⚠ Can mimic gum disease (appearing as red, swollen tissue—delaying diagnosis) ⚠ May cause tooth loosening (tumor invading bone—periodontal attachment lost) ⚠ Upper/lower gums (any location—most commonly lower gums)

Gum cancer symptoms:

• Red or white patch (on gum tissue)
• Non-healing ulcer (appearing like canker sore but persisting)
• Swelling or mass (palpable growth)
• Loose teeth (unexplained mobility)
• Bleeding (spontaneous or excessive with brushing)

3. Tongue (Tongue Cancer)

Tongue:

Tongue cancer characteristics:

⚠ Most common oral cancer site (25-30% of oral cancers—high incidence) ⚠ Sides/undersurface most affected (lateral borders, ventral surface—high-risk areas) ⚠ HPV association (base of tongue cancers—often HPV-related) ⚠ Highly symptomatic (tongue movement essential—pain, dysfunction early)

Tongue cancer symptoms:

• Persistent sore or ulcer (not healing 2+ weeks)
• Red or white patch (on tongue surface)
• Lump or thickening (palpable mass—often painless initially)
• Tongue pain, especially when it moves (specific symptom—speaking, eating, swallowing causing pain)
• Numbness (tumor affecting nerves)
• Difficulty moving tongue (advanced—restricted mobility)

4. Inside Lining of Cheeks (Buccal Mucosa Cancer)

Inside lining of the cheeks:

Buccal mucosa cancer characteristics:

⚠ Associated with tobacco use (especially chewing tobacco—direct contact prolonged) ⚠ Betel nut link (certain cultures—chewing habit dramatically increasing risk) ⚠ Often detected late (inside cheek—less visible, patients unaware)

Buccal mucosa cancer symptoms:

• White or red patch (leukoplakia, erythroplakia—pre-cancerous often)
• Non-healing ulcer (persisting 2+ weeks)
• Lump or thickening (cheek feeling thicker—asymmetry)
• Difficulty opening mouth (trismus—tumor restricting)
• Pain or burning (especially with spicy/acidic foods)

5. Roof of Mouth (Palate Cancer)

Roof of the mouth:

Palate cancer characteristics:

⚠ Hard palate (front bony portion—squamous cell carcinoma most common) ⚠ Soft palate (back soft tissue—higher risk area) ⚠ Smoking/alcohol link (strong association—synergistic risk)

Palate cancer symptoms:

• Lump or swelling (on roof of mouth—visible, palpable)
• Ulcer or sore (not healing)
• Denture that used to fit well and now it does not (tumor changing palate shape—denture no longer fitting)
• Pain (localized—especially when eating)
• Numbness (tumor affecting palatal nerves)

6. Floor of Mouth (Floor of Mouth Cancer)

Floor of the mouth:

Floor of mouth cancer characteristics:

⚠ Second most common oral cancer site (after tongue—15-20% of cases) ⚠ Under tongue (horseshoe-shaped area—between tongue and lower jaw) ⚠ Tobacco/alcohol strong link (pooling of carcinogens—concentrated exposure) ⚠ Aggressive (proximity to major vessels, nerves—spreads quickly)

Floor of mouth cancer symptoms:

• Lump or swelling (under tongue—visible when tongue lifted)
• Ulcer or red patch (persistent)
• Pain (especially when moving tongue)
• Loose teeth (tumor invading mandible—lower front teeth mobility)
• Difficulty moving tongue (restricted—tumor tethering)
• Swelling under jaw (lymph node involvement—metastasis)

The 11 Warning Signs and Symptoms of Mouth Cancer

Critical Mouth Cancer Symptoms Requiring Evaluation

The signs and symptoms of mouth cancer can be:

Symptom 1: Non-Healing Sore (Most Important)

✗ A sore that doesn’t heal for more than 2 weeks:

Why this is #1 warning sign:

✓ Normal mouth sores (canker sores, bite trauma—healing within 7-14 days) ⚠ Cancer sores persist (beyond 2 weeks—abnormal tissue, not healing)

Characteristics of cancer sore:

• Location: Any oral site (tongue, cheek, gum, floor of mouth)
• Appearance: Ulcer (crater-like), may have rolled/raised borders
• Texture: Firm to touch (not soft like normal sore)
• Pain: Variable (may be painless initially, then painful; or constantly painful)
• Duration: Key feature—persisting >2 weeks despite good hygiene

THE 2-WEEK RULE: Any mouth sore lasting more than 2 weeks requires professional evaluation—no exceptions.

Symptom 2: Lump or Thickening

✗ A lump or thickening of the skin or lining of your mouth:

What to feel for:

⚠ New lump (mass—wasn’t present before) ⚠ Thickened tissue (area feeling firmer, thicker—compared to other side) ⚠ Asymmetry (one cheek, side of tongue thicker than opposite—comparison helpful) ⚠ Hard texture (unlike soft normal tissue—firm, immobile)

Where lumps occur:

• Tongue (sides, underneath—most common)
• Floor of mouth (under tongue—visible when tongue lifted)
• Cheeks (inside lining—palpable when pressing)
• Gums (swelling—appearing like gum overgrowth)
• Lips (usually lower—visible, palpable)

Self-examination: Monthly oral self-exam—feeling for lumps, comparing sides.

Symptom 3: White or Red Patches

✗ A white or reddish patch or areas where the mouth lining is peeling or rough:

The patch types:

Leukoplakia (white patch): ⚠ White, thick (cannot be scraped off—unlike thrush) ⚠ Pre-cancerous potential (5-10% become cancer—monitoring essential) ⚠ Locations: Cheeks, gums, tongue, floor of mouth ⚠ Appearance: Smooth or rough texture, flat or slightly raised

Erythroplakia (red patch): ⚠ Red, velvety (bright or dark red—alarming appearance) ⚠ Higher cancer risk (50%+ are cancer or severe dysplasia—very concerning) ⚠ Often asymptomatic (no pain—insidious) ⚠ Urgent evaluation needed (high malignant potential)

Erythroleukoplakia (mixed red-white): ⚠ Combination (red areas with white spots—”speckled leukoplakia”) ⚠ High-risk (intermediate cancer potential—significant concern)

Peeling or rough areas: ⚠ Texture change (normally smooth mucosa—becoming rough, irregular) ⚠ Keratosis (thickened tissue—pre-cancerous changes)

IMPORTANT: Any persistent white or red patch (>2 weeks) requires biopsy—determining if pre-cancerous or cancerous.

Symptom 4: Loose Teeth

✗ Loose teeth:

Why teeth loosen with mouth cancer:

⚠ Tumor invading bone (cancer growing into mandible/maxilla—destroying bone, loosening teeth) ⚠ No gum disease present (healthy-appearing gums—yet teeth mobile, suspicious) ⚠ Localized loosening (one or few teeth—not generalized, unlike periodontal disease)

When to suspect cancer:

• Unexplained mobility (no trauma, no gum disease—yet tooth/teeth loose)
• Progressive loosening (worsening over weeks—not stable)
• Associated symptoms (gum swelling, numbness, pain—in area of loose teeth)

Loose teeth differential: Could be gum disease (most common), but if gums healthy and unexplained loosening—cancer must be ruled out.

Symptom 5: Ill-Fitting Denture

✗ A denture that used to fit well and now it does not:

Why denture stops fitting:

Normal causes:

• Bone resorption (gradual over years—slow, symmetric)
• Weight change (affecting tissue—gradual)

Cancer cause: ⚠ Tumor growth (changing ridge shape—rapid, asymmetric) ⚠ Unilateral (one side not fitting—opposite side still good) ⚠ Rapid change (weeks to months—not years) ⚠ Associated symptoms (sore under denture not healing, swelling—red flags)

When to suspect cancer:

• Sudden denture fit change (within weeks-months—was fine, now loose/tight)
• One-sided change (denture rocking to one side—asymmetric)
• Non-healing sore (under denture—persisting despite denture adjustment)

ACTION: Don’t just adjust denture—examine tissue underneath for masses, ulcers, patches.

Symptom 6: Tongue Pain, Especially with Movement

✗ Tongue pain, especially when it moves:

Why tongue pain concerning:

⚠ Tongue constantly moving (speaking, eating, swallowing—cancer causing pain with normal function) ⚠ Specific to movement (resting may be pain-free—movement stretching tumor, causing pain) ⚠ Progressive (worsening over time—tumor growing)

Tongue cancer pain characteristics:

• Location: Typically side or undersurface of tongue (most common cancer sites)
• Quality: Sharp, burning, or dull ache
• Triggers: Talking, eating (especially acidic, spicy foods), swallowing
• Associated: Often with visible sore, lump, or patch

Differential: Tongue pain could be glossitis (inflammation), geographic tongue (benign), traumatic ulcer—but if persistent >2 weeks or with visible abnormality—cancer evaluation essential.

Symptom 7: Jaw Pain or Stiffness

✗ Jaw pain or stiffness for an extended period of time:

Why jaw symptoms occur:

⚠ Tumor invading jaw bone (mandibular/maxillary cancer—causing pain) ⚠ Trismus (tumor affecting chewing muscles or joints—restricting opening) ⚠ Nerve involvement (tumor compressing inferior alveolar nerve—causing pain, numbness)

Jaw pain/stiffness characteristics:

• Persistent (daily—not intermittent TMJ)
• Progressive (worsening—not fluctuating)
• Unilateral (one side—asymmetric)
• Associated: Numbness (lower lip/chin—concerning sign of nerve involvement)

Differential: TMJ disorder most common (clicking, fluctuating symptoms), but persistent, progressive, one-sided—warrants cancer evaluation.

Symptom 8: Difficult or Painful Chewing

✗ Difficult or painful chewing without reason for more than 2 weeks:

Why chewing becomes difficult:

⚠ Tongue/cheek tumor (movement painful—avoiding certain motions) ⚠ Jaw involvement (limited opening—cannot chew effectively) ⚠ Tooth pain (tumor near teeth—pressure during chewing)

“Without reason” key phrase:

• No obvious cause (no new cavity, no cracked tooth, no TMJ clicking—yet chewing painful)
• Persistent (>2 weeks—not transient sensitivity)
• Progressive (worsening—not stable, improving)

ACTION: If chewing difficult/painful >2 weeks and no obvious dental cause—oral cancer screening essential.

Symptom 9: Difficult or Painful Swallowing

✗ Difficult or painful swallowing for more than 2 weeks:

Medical term: Dysphagia (difficult swallowing) or odynophagia (painful swallowing)

Why swallowing affected:

⚠ Tongue base cancer (posterior tongue—swallowing mechanism disrupted) ⚠ Soft palate/throat cancer (oropharyngeal—passageway obstructed) ⚠ Tumor mass (mechanically blocking—food sticking) ⚠ Pain with swallowing (tumor stretch, inflammation—avoiding swallowing)

Swallowing difficulty characteristics:

• Progressive (starting with solids—advancing to liquids, severe)
• Location-specific feeling (knowing where food “sticks”—tumor location)
• Associated: Weight loss (avoiding eating—painful), voice changes (if larynx involved)

URGENT: Swallowing difficulty can be throat cancer (oropharyngeal)—requires immediate evaluation (ENT referral often needed).

Symptom 10: Persistent Sore Throat

✗ Sore throat for more than 2 weeks:

Why sore throat persists:

Normal causes (resolving <2 weeks):

• Viral infection (cold, flu—self-limiting)
• Bacterial infection (strep throat—antibiotic-responsive)

Cancer cause: ⚠ Oropharyngeal cancer (throat, tonsil, base of tongue—causing chronic irritation) ⚠ One-sided sore throat (unilateral—more concerning than bilateral) ⚠ Persistent despite treatment (antibiotics not helping—red flag)

When to suspect cancer:

• >2 weeks duration (despite treatment attempts)
• One-sided (right or left throat pain—asymmetric)
• Associated: Ear pain (referred pain—same nerve), lump in neck (lymph node metastasis), difficulty swallowing

ACTION: Sore throat >2 weeks, especially one-sided or with neck lump—requires examination (possibly ENT referral—visualizing throat).

Symptom 11: Foreign Body Sensation

✗ Feeling that something is irritating or caught in your throat:

Medical term: Globus sensation (“lump in throat” feeling)

Why sensation occurs:

Benign causes:

• Anxiety (most common—stress-related)
• GERD (acid reflux—chronic irritation)
• Post-nasal drip (mucus—throat irritation)

Cancer cause: ⚠ Throat tumor (mass—creating obstruction sensation) ⚠ Persistent (constant or frequent—not just during anxiety) ⚠ Progressive (worsening—actual obstruction developing)

When to suspect cancer:

• Persistent (daily, constant—not intermittent)
• Associated symptoms (sore throat, difficulty swallowing, voice changes—multiple symptoms together)
• Not anxiety-related (no clear stress trigger—organic cause)

When to Seek Evaluation: The 2-Week Rule

Critical Timeframe for Mouth Cancer Symptoms

THE UNIVERSAL RULE: Any mouth abnormality persisting more than 2 weeks requires professional evaluation.

When you have one of these signs, please make an appointment with us:

Immediate appointment needed if experiencing:

🚨 Non-healing sore (>2 weeks) 🚨 White or red patch (persistent) 🚨 Lump or thickening (new mass) 🚨 Loose teeth (unexplained) 🚨 Denture fit change (sudden, unilateral) 🚨 Tongue pain with movement (persistent) 🚨 Jaw pain/stiffness (extended period) 🚨 Difficult/painful chewing (>2 weeks, no cause) 🚨 Difficult/painful swallowing (>2 weeks) 🚨 Sore throat (>2 weeks) 🚨 Throat foreign body sensation (persistent)

Additional urgent symptoms:

🚨 Numbness (lip, chin, tongue—nerve involvement) 🚨 Bleeding (spontaneous oral bleeding—no trauma) 🚨 Neck lump (lymph node swelling—potential metastasis) 🚨 Unexplained weight loss (10+ pounds—systemic cancer effect) 🚨 Voice changes (hoarseness >2 weeks—laryngeal involvement)

Dr. Kaufman’s Evaluation Process: Thorough Yet Reassuring

What to Expect at Your Mouth Cancer Screening

I will investigate other more common causes for your signs and symptoms first, such as an infection and see if there is a reason for concern:

Dr. Kaufman’s systematic approach:

Step 1: Comprehensive History

✓ Symptom details (duration, location, changes—thorough understanding) ✓ Risk factor assessment (smoking, alcohol, HPV—evaluating likelihood) ✓ Medical history (immune status, previous cancers—context)

Step 2: Visual Examination

✓ Lips (external, internal—looking for sores, patches, lumps) ✓ Buccal mucosa (cheeks inside—checking for leukoplakia, masses) ✓ Gums (upper, lower—assessing for swelling, patches, loose teeth) ✓ Tongue (top, sides, underneath—most common cancer site, thorough) ✓ Floor of mouth (lifting tongue—examining horseshoe area) ✓ Palate (hard, soft—checking for masses, asymmetry) ✓ Throat (oropharynx—visible portion, ENT referral if deeper concern)

Step 3: Palpation (Feeling)

✓ Bimanual palpation (feeling with fingers inside and outside—detecting deep masses) ✓ Tongue (grasping with gauze—feeling entire tongue, base) ✓ Floor of mouth (under tongue—common tumor site) ✓ Cheeks (between fingers—assessing thickness) ✓ Lymph nodes (neck—checking for metastasis, swelling)

Step 4: Ruling Out Common Causes First

“Investigate other more common causes first, such as an infection”:

Common benign causes evaluated:

✓ Traumatic ulcer (bite, denture rub—should heal after trauma removed) ✓ Aphthous ulcer (canker sore—typically heals 7-14 days) ✓ Fungal infection (oral thrush—white patches that scrape off) ✓ Viral infection (herpes simplex—clustered vesicles, heals) ✓ Bacterial infection (abscess—usually associated with tooth, responds to antibiotics)

Dr. Kaufman’s approach:

• If obvious benign cause: Treat (antibiotics for infection, adjust denture for trauma)—recheck 2 weeks
• If cause unclear or concerning features: Proceed to biopsy referral immediately—no delay

Step 5: Determining if “Reason for Concern”

“And see if there is a reason for concern”:

Factors increasing cancer concern:

⚠ High-risk appearance (red patch, firm mass, indurated ulcer—suspicious features) ⚠ High-risk location (tongue side/undersurface, floor of mouth—common cancer sites) ⚠ High-risk patient (smoker, heavy drinker, HPV history—predisposed) ⚠ Persistent despite treatment (infection treatment failed, trauma removed but sore persists—very suspicious)

Dr. Kaufman’s decision:

• No concern: Benign diagnosis clear, resolving—reassurance, monitoring
• Concern present: Biopsy referral to oral surgeon/ENT—definitive diagnosis

Step 6: Biopsy Referral (If Needed)

When biopsy indicated:

✓ Suspicious lesion (appearance, location, persistence—concerning features) ✓ Unexplained symptoms (no benign cause found—cancer must be ruled out) ✓ High-risk patient (even borderline lesions—low threshold for biopsy)

Biopsy procedure:

• Incisional biopsy (removing portion of lesion—for large lesions)
• Excisional biopsy (removing entire lesion—for small lesions)
• Pathology examination (microscope analysis—definitive cancer diagnosis or benign confirmation)

Result timeline: 7-14 days (pathology report—determining if cancer present)

Mouth Cancer Risk Factors

Who Is at Highest Risk?

Major risk factors:

⚠ Tobacco use (cigarettes, cigars, pipes, chewing tobacco—#1 risk factor, 6x increased risk) ⚠ Heavy alcohol use (>2 drinks daily—3x increased risk; tobacco + alcohol = 15x risk) ⚠ HPV infection (human papillomavirus—especially HPV16, causing throat/tongue base cancers) ⚠ Age >45 (risk increasing with age—median diagnosis 64) ⚠ Male gender (2x risk vs. women—though gap narrowing) ⚠ Sun exposure (lips—outdoor workers, fair skin) ⚠ Previous oral cancer (20% develop second primary cancer—lifelong monitoring) ⚠ Weakened immune system (HIV, immunosuppressants—increased risk) ⚠ Poor diet (low fruits/vegetables—nutritional deficiency) ⚠ Betel nut chewing (cultural practice—dramatically increasing risk)

Genetic predisposition: Some individuals higher risk (family history, genetic syndromes).

Mouth Cancer Prevention

Reducing Your Oral Cancer Risk

Actionable prevention strategies:

✅ Stop tobacco (all forms—single most important prevention) ✅ Limit alcohol (≤1 drink daily women, ≤2 men—reducing risk) ✅ HPV vaccination (Gardasil—preventing HPV-related throat cancers, ages 9-45) ✅ Healthy diet (fruits, vegetables—antioxidants protecting) ✅ Sun protection (lip balm SPF 30+—preventing lip cancer) ✅ Regular dental visits (every 6 months—oral cancer screening) ✅ Self-examination (monthly—early detection)

Early detection = best “prevention”: Catching cancer early (stage I) = 84% survival vs. late (stage IV) = 38%.

Expert Mouth Cancer Screening in Glen Iris

Comprehensive Oral Cancer Evaluation at Tooronga Family Dentistry

Dr. Kaufman provides:

✓ Routine oral cancer screening (every checkup—visual, palpation examination) ✓ Symptom evaluation (if concerning signs—thorough assessment) ✓ Common cause investigation (ruling out infection, trauma—systematic approach) ✓ Risk factor counseling (tobacco cessation, alcohol reduction—prevention education) ✓ Biopsy coordination (if needed—referring to oral surgeon/ENT) ✓ Follow-up care (monitoring healing, biopsy results—ongoing support) ✓ Early detection focus (catching cancer early—improving survival)

Why choose Tooronga Family Dentistry for screening:

• Thorough examination (every visit—not just when symptomatic)
• Systematic approach (ruling out common causes—not jumping to worst conclusion)
• Experienced evaluation (Dr. Kaufman—distinguishing benign from concerning)
• Prompt referral (when indicated—no delay in diagnosis)
• Patient education (risk factors, symptoms—empowering awareness)
• Glen Iris location (convenient—serving local community)

Schedule Your Mouth Cancer Screening

Early Detection Saves Lives

Don’t ignore mouth cancer symptoms.

Call Tooronga Family Dentistry: 9822 7006

What to Expect at Screening Appointment

1. Symptom discussion (describing concerns—duration, changes, pain)
2. Risk factor assessment (tobacco, alcohol, HPV—evaluating likelihood)
3. Comprehensive oral examination (visual, palpation—all oral sites)
4. Neck examination (lymph nodes—checking for spread)
5. Common cause investigation (infection, trauma—ruling out benign)
6. Diagnosis/plan (benign reassurance or biopsy referral—clear pathway)
7. Follow-up scheduling (recheck in 2 weeks if treating infection, or coordinating biopsy)

Contact Information

• Phone: 9822 7006
• Services: Oral cancer screening, mouth lesion evaluation, biopsy coordination
• Location: Glen Iris, serving Malvern, Ashburton, Camberwell, surrounding Melbourne

Take Action: Know the Signs, Get Screened

The Bottom Line on Mouth Cancer Symptoms

Mouth cancer develops in:

• Lips, gums, tongue, cheek lining, palate, floor of mouth

11 warning signs:

1. ⚠ Sore lasting >2 weeks (most important sign)
2. ⚠ Lump or thickening (new mass)
3. ⚠ White or red patch (leukoplakia, erythroplakia)
4. ⚠ Loose teeth (unexplained)
5. ⚠ Ill-fitting denture (sudden change)
6. ⚠ Tongue pain with movement (persistent)
7. ⚠ Jaw pain/stiffness (extended period)
8. ⚠ Difficult/painful chewing (>2 weeks, no cause)
9. ⚠ Difficult/painful swallowing (>2 weeks)
10. ⚠ Sore throat (>2 weeks)
11. ⚠ Foreign body sensation (throat—persistent)

The 2-week rule: Any oral abnormality >2 weeks = professional evaluation required

Dr. Kaufman’s approach:

✅ Investigates common causes first (infection, trauma—reassuring systematic) ✅ Determines if reason for concern (appearance, location, risk factors—evidence-based) ✅ Refers for biopsy if needed (prompt—no delay in diagnosis)

Early detection transforms survival:

• Early stage: 84% five-year survival
• Late stage: 38% five-year survival

Don’t wait. Don’t ignore symptoms.

Call or book online Tooronga Family Dentistry on (03) 9822 7006  for oral cancer screening.

Dr. Kaufman will thoroughly examine mouth, investigate symptoms, rule out common causes, and coordinate biopsy if concerning features present.

Serving Glen Iris with life-saving oral cancer detection.

Your life may depend on this appointment. Schedule screening today.