MeMoSa: Mobile Mouth Screening Anywhere for Early Detection of Oral Cancer

Abstract

Background: The burden of oral cancer is significant in Asia, accounting for 11% of cancer deaths in Asia compared with 5% in the rest of the world. High and increasing access to mobile phones in low- and middle-income countries presents an opportunity to use telemedicine to facilitate early detection of oral cancer. Aim: To evaluate the feasibility of using the mobile phone as a documentation and communication tool for early detection of high-risk oral lesions. Methods: We determined the concordance between evaluation of oral lesions using mobile phone-captured images and clinical oral examination using kappa statistics. A mobile phone app named MeMoSA was developed and the app was tested during a routine oral cancer screening program in the community to determine the feasibility of integrating this tool for the documentation of oral lesions, and the communication between dentists and specialists with regards to management of these patients. The experience of dentists and specialists in using MeMoSA was determined using qualitative questionnaires. Results: We demonstrated that the mobile phone is a sensitive and specific tool, with a sensitivity of > 80% in detecting a lesion, an accuracy of 87% in categorizing the type of lesion and 85% concordance in patient referral compared with clinical oral examination. Having been trained to use MeMoSA, 36/36 dentists agreed that this app could improve early detection of oral mucosal lesions. All of these dentists wanted to continue using the app as screening tool in the future as they believe that it could assist them in the identification of high-risk oral mucosal lesions through direct communication with specialists. Conclusion: MeMoSA enabled documentation of the lesion through easy photography and facilitated patient management through quick communication between dentists and specialists. Because of its ease of use MeMoSA could be useful tool in early detection of high-risk oral lesions in low-resource settings and could increase the access to healthcare in geographically hard to reach populations.