A 62-year-old man presents to his primary care physician for a routine check-up. He is asymptomatic but on questioning mentions a “white patch” on the inside of his cheek that he first noticed several months ago. It is painless and has not changed significantly in size. His past medical history is significant for hypertension, managed with lisinopril, and gastroesophageal reflux disease, for which he takes omeprazole as needed. He has a 40-pack-year smoking history and currently smokes half a pack per day. He also reports drinking 2-3 alcoholic beverages daily. He denies any use of betel quid or other forms of smokeless tobacco. He has no history of oral cancer.