Early Detection Of Oral Cancer Research Articles

Efficacy of toluidine blue, lugol's iodine and acetic acid for detecting oral lesions of Leukoplakia and erosive lichen planus – A cross-sectional study

Background and Objectives: Early detection and treatment of oral cancer will significantly improve the survival rate and prognosis of the patients. Adjunctive diagnostic aids such as vital staining have been developed to supplement clinical examination and improve the diagnosis. The current study was conducted to evaluate the diagnostic efficacy of acetic acid (2%) (AA), lugol's iodine (3% dilution) (LIS), and toluidine blue (1%) (TBS) in oral leukoplakia (OL) and erosive variant of oral lichen planus (OLP). Materials and Methods: A hospital-based, cross-sectional study was conducted with 30 randomly selected subjects having clinically proven cases of OL and erosive OLP. Every patient underwent AA, LIS, and TBS application to their oral lesions in a sequential manner. Subsequently, clinical and histopathologic diagnosis was compared with staining results of each. Cases which were diagnosed as epithelial hyperplasia were considered as a control group. Data are presented in numbers and percentages. Chi-square test was used to compare between TBS, LIS and AA. Diagnostic efficiency and reliability was calculated by sensitivity and specificity test in terms of its utility in predicting the dysplastic nature of the lesion. Results: Sensitivity of both TBS and LIS staining was calculated as 90.48% whereas the specificity of the former test was 22.22% and latter was 11.11%. AA test showed a sensitivity of 57.14% and specificity of 33.33%. Multiple comparisons of staining with three agents and the histopathologic variants did not show any statistically significant difference. Conclusion: TBS and LIS staining showed high sensitivity in diagnosing OL and erosive OLP compared to AA. The specificity of all three modalities used was low.

Bibliometric analysis of the top-100 cited articles on oral potentially malignant disorders to guide research topic and direction

Background/purposeBibliometric analysis highlights the key topics and studies which have shaped the understanding and management of a concerned disease. Here the top-cited articles on oral potentially malignant disorders (OPMD) were characterized and analyzed. Materials and methodsA comprehensive search was performed and identified in the Scopus database from 1941 to 10 March 2019 for the 100 most-cited articles on OPMD. ResultsThe number of citations of the 100 selected articles varied from 131 to 1422, with a mean of 240.6 citations per article. Molecular markers/targets, chemoprevention, and early detection and diagnosis of oral cancer were the top-3 study topics, and the proportion of the number of the articles on the top-3 topics and that of the number of citations was 47% and 47.7%, respectively. Moreover, 20 (90.9%) of the 22 high-quality articles published in journals with high IF > 9 were the research of top-3 topics. Besides, the most contributing author, Hong WK (n = 11), was from the most contributing institution and country of origin, M.D. Anderson Cancer Center (n = 12), United States (n = 41). Systematic reviews (n = 7), randomized controlled trial (n = 5), cohort studies (n = 18) were study designs with higher evidence level, but the large majority (n = 70) were considered lower level. ConclusionThe results of this first citation analysis of the 100 most-cited articles on OPMD provide a historical perspective and key topics, and suggest a troika for the trends of further research and clinical practice in the field of OPMD.

Early detection and prevention of oral cancer: an appraisal

Oral cancers (OC) represent the majority of head and neck cancers with more than half million patients being affected each year worldwide. Oral squamous cell carcinoma is the sixth commonest cancer worldwide, accounting for approximately 4% of all cancers. Therefore, an improvement in the prevention and control of oral cancer is of critical importance. This may be achieved by reducing the risk through avoidance of tobacco and alcohol, recognizing and treating premalignant lesions and detecting developed OC at an early stage. Data search for the present review was done electronically. Electronic search was conducted using databases such as Pubmed and Medline, Cochrane library, articles published in peer-reviewed journals, text books, grey literature and from sites of World Health Organization, Centre For Diseases Control Report, Global Adult Tobacco Survey and Global Youth Tobacco Survey reports. This review ruled out web of causation and web of prevention including early detection and prevention to be an ideal strategy to reduce the prevalence of oral cancer and its impact on quality of life. Screening and early detection in population at risk have been proposed to decrease both morbidity and mortality associated with the oral cancer.

Laser Confocal Refractive Microscopy and Early Detection of Oral Cancer: A Narrative Review

Laser confocal refractive microscopy is a modern technique that aids in the detection of early malignancies in recent years. However, it is inappropriately explored in oral oncology. To date, the gold standard for diagnosis of oral malignancies is still a biopsy for histopathological examination as this is an invasive method, and it causes discomfort for the patients. In this concern, the focus of this present article is to understand how this laser confocal microscopy could be used in the diagnosis of oral malignancies without the actual need for biopsy. Thus, it can be an effective noninvasive diagnostic aid for detecting oral malignancies.

A smart tele-cytology point-of-care platform for oral cancer screening.

Early detection of oral cancer necessitates a minimally invasive, tissue-specific diagnostic tool that facilitates screening/surveillance. Brush biopsy, though minimally invasive, demands skilled cyto-pathologist expertise. In this study, we explored the clinical utility/efficacy of a tele-cytology system in combination with Artificial Neural Network (ANN) based risk-stratification model for early detection of oral potentially malignant (OPML)/malignant lesion. A portable, automated tablet-based tele-cytology platform capable of digitization of cytology slides was evaluated for its efficacy in the detection of OPML/malignant lesions (n = 82) in comparison with conventional cytology and histology. Then, an image pre-processing algorithm was established to segregate cells, ANN was trained with images (n = 11,981) and a risk-stratification model developed. The specificity, sensitivity and accuracy of platform/ stratification model were computed, and agreement was examined using Kappa statistics. The tele-cytology platform, Cellscope, showed an overall accuracy of 84-86% with no difference between tele-cytology and conventional cytology in detection of oral lesions (kappa, 0.67-0.72). However, OPML could be detected with low sensitivity (18%) in accordance with the limitations of conventional cytology. The integration of image processing and development of an ANN-based risk stratification model improved the detection sensitivity of malignant lesions (93%) and high grade OPML (73%), thereby increasing the overall accuracy by 30%. Tele-cytology integrated with the risk stratification model, a novel strategy established in this study, can be an invaluable Point-of-Care (PoC) tool for early detection/screening in oral cancer. This study hence establishes the applicability of tele-cytology for accurate, remote diagnosis and use of automated ANN-based analysis in improving its efficacy.

Accuracy, Sensitivity and Specificity of Oral Brush Cytology in the Diagnosis of Oral Epithelial Lesions

Background: Oral Squamous cell carcinoma (SCC) is highly prevalent in Pakistan than the rest of the world. Five-year survival rate is 80% if SCC is diagnosed at an early stage. The survival rate declines to 20% if diagnosed at a later stage. The objective of the present study was to find out the usefulness of oral brush cytology in detecting oral lesions.
 Material and Methods: In the present prospective observational study, 88 samples were collected from Maxillofacial Surgery Out-Patient Department (OPD), Liaquat University Hospital and ISRA University Hospital from July 2015 to December 2015. After taking written informed consent, oral brush cytology was performed and stained with standard Papanicolaou (PAP) staining protocol. The biopsy of the patients was performed by standard protocols of oral biopsy and specimen preserved in 10% buffered formalin. Cross tabulation between diagnosis of brush cytology and biopsy of same patients was done and accuracy, sensitivity and specificity were calculated.
 Results: According to the distribution of patients on brush cytology, 59.1% patients were diagnosed with malignant tumors, whereas 17.1% had benign tumors. On biopsy of the same patients, squamous cell carcinoma was confirmed in 72.7% and benign tumors were found in 17% of the patients. Comparison of brush cytology with biopsy of same patients revealed no significant difference. Accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of malignant tumor were calculated as 86.36%, 81.25% and 100% respectively. Whereas accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of benign and inflammatory conditions were 100%.
 Conclusion: Oral brush cytology has good accuracy, sensitivity and specificity for detection of oral epithelial lesions and can be useful in early detection of oral cancer as well as other lesions. Moreover, as an easy-to-do, painless and non-invasive procedure, it can be a good screening method for detection of oral lesions.

Efficacy of Fluorescence Technology vs Conventional Oral Examination for the Early Detection of Oral Pre-Malignant Lesions. A Clinical Comparative Study.

Oral cancer is one of the most common malignancies that affect human beings across the world and early detection of oral cancer is believed to reduce the morbidity significantly. Fluorescence diagnosis is emerging as a promising method in the differentiation of cancerous lesions and thus helping in the determination of resolution for the surgical resection of affected area of malignancy very accurately. The aim of this study was to evaluate the usefulness of an autofluorescence hand held device (OralID) to detect oral premalignant lesions. 98 potentially high-risk oral cancer patients were divided into two groups (n=49/group). Both the groups were first examined by conventional oral examination under white light and oral findings were noted. Subjects under group B were further examined under fluorescence light through hand held device, i.e. OralID. After the examinations, a surgical biopsy sample was taken from the suspected lesions under local anaesthesia from both the groups to confirm the diagnosis through histopathological analysis. The positive potential malignant lesions (PMLs) observed in Group A when compared with biopsy reporting was 89.47% true positive while in Group B was 95.24%. The sensitivity reported of Group A was 89.47% and Group B was 97.56%. We observed 8.09% more sensitivity and 11.36% more specificity when we incorporate adjunctive the fluorescence examination using OralID. Results from this study suggests that OralID is a true adjunct to conventional oral examination in detecting early potential malignant changes in subjects visiting for regular dental check-up.

Disparities in Oral Cancer Screening Among Dental Professionals: NHANES 2011–2016

As early detection of oral cancers is associated with better survival, oral cancer screening should be included in dental visits for adults. This study examines the rate and predictors of oral cancer screening exams among U.S. adults with a recent dental visit. Individuals aged ≥30 years who received a dental visit in the last 2 years, in the 2011-2016 National Health and Nutrition Examination Survey were analyzed in December 2018. Weighted multivariable logistic regression models examined the likelihood of intraoral and extraoral oral cancer screening exams, adjusting for age, sex, race/ethnicity, education, marital status, poverty income ratio, health insurance, tobacco smoking, and alcohol consumption. Subgroup analyses were conducted among races/ethnicities, smokers, and alcohol consumers. Statistical significance was set at p<0.01. A total of 37.6% and 31.3% reported receiving an intraoral and extraoral oral cancer screening exam, respectively. Minority racial/ethnic groups versus white, non-Hispanics, less-educated versus more-educated, uninsured and Medicaid-insured versus privately insured, and low-income versus high-income participants were less likely to have received intraoral or extraoral oral cancer screening exams. There was no difference in the likelihood of being screened based on smoking status. Alcohol consumers were more likely to be screened. Among subgroups, less-educated and low-income individuals were less likely to be screened. A significantly higher proportion of minority race/ethnicity and low SES individuals report not receiving an oral cancer screening exam, despite a recent dental visit. This selective screening by dental professionals is incompliant with guidelines and concerning because these groups are more likely to present with an advanced stage of oral cancer at diagnosis. An understanding of the reasons for discriminatory oral cancer screening practices could help develop effective interventions.

Dental students\u2019 awareness and attitudes toward HPV-related oral cancer: a cross sectional study at the University of Jordan

BackgroundThe incidence of human papilloma virus (HPV)-related oral cancer has recently increased worldwide. The role of dentists is of prime importance in the early detection of oral cancer which would result in a favourable outcome for the patients. The aim of the current study was to assess the knowledge, awareness and attitudes of dental students, interns and postgraduate maxillofacial residents at the University of Jordan (UJ) to different aspects of oral cancer, particularly those related to HPV.MethodsA paper-based survey was conducted at UJ among all pre-clinical dental students (pre-clinical group), clinical dental students, interns and postgraduate maxillofacial residents (clinical group). The survey included five sections comprising 29 items. The sections included questions investigating oral cancer knowledge, oral cancer screening, HPV knowledge and the ability to discuss personal topics with patients.ResultsA total of 376 respondents out of 1052 potential participants completed at least one item of the survey (study coverage of 35.7%). Among the study participants, the pre-clinical group represented 41.2% (n = 155) and the clinical group represented 58.8% (n = 221). The majority of participants in the clinical group showed better knowledge on oral cancer potential anatomic sites, clinical presentation and possible risk factors compared to the pre-clinical group. Most participants in the clinical group (n = 195, 88.2%) correctly identified HPV as a risk factor for oral cancer development. The majority of participants in the clinical group displayed suitable attitude towards oral cancer screening despite their desire for a reliable screening device and additional training in oral cancer screening. A number of limitations in basic knowledge about HPV was noticed among participants in the clinical group particularly related to unawareness of the vaccine availability. The majority of participants in the clinical group displayed hesitancy in discussing personal topics with the patients, including the history of previous sexually transmitted infections and sexual abuse.ConclusionsGaps in knowledge regarding HPV-related oral cancer has been detected which necessitate intervention measures including curricular changes, training workshops and awareness campaigns.

Missed opportunities for oral cancer screening in Australia.

Most patients with oral cancer lack early symptoms, therefore most present with advanced stage of disease. Early detection of oral cancer and oral potentially malignant disorders (OPMDs) in the asymptomatic phase via an opportunistic oral cancer screening examination is important as survival rates are significantly improved if the disease is treated at an earlier stage. The objective is to identify opportunities to achieve early stage diagnosis of oral cancer in Australian patients. A cohort of 103 patients newly diagnosed with oral cancer were surveyed at a tertiary hospital Head and Neck Clinic. Patient awareness, knowledge, risk factors and diagnostic delay in oral cancer diagnosis were investigated. The asymptomatic period before diagnosis was studied to identify opportunities for improving opportunistic screening rates in Australia. Australian patients have poor awareness of oral cancer with 46% having never heard of oral cancer, and poor knowledge of risk factors for oral cancer. Only 7% were diagnosed in the asymptomatic phase and all by dental practitioners. Once symptomatic, median diagnostic delay was 9weeks. In the asymptomatic phase before diagnosis, patients attended general medical practitioners far more often than general dental practitioners. Both groups rarely discussed risk factors for oral cancer (<10%) or performed opportunistic oral cancer screening examinations (<10%) with their patients. Asymptomatic diagnosis of oral cancer at an earlier stage of disease is possible in the primary medical setting but increased awareness and knowledge are required in both patients and health practitioners.

Evidence of genotoxicity and cytotoxicity of X-rays in the oral mucosa epithelium of adults subjected to cone beam computed tomography.

Evidence of genotoxicity and cytotoxicity of X-rays in the oral mucosa epithelium of adults subjected to cone beam computed tomography.

ANALYSIS OF SALIVARY GLUTATHIONE AND SELENIUM IN HIGH RISK AND ORAL CANCER PATIENTS SEEN AT LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA

Objectives To select three study groups consisting of 20 oral squamous cell carcinoma subjects(Group 1), 20 high risk for oral squamous cell carcinoma subjects (Group 2) and 20 healthy controls (Group 3). To collect saliva samples from each subject and analyze for salivary concentration level of glutathione using enzymatic recycling assay and salivary selenium concentration level using atomic absorption spectrophotometry. To analyze data on salivary glutathione and selenium levels in each group and compare findings within and between groups using statistical method of Analysis of Variance (ANOVA) Findings The mean salivary glutathione concentration in healthy control group (5.618±0.5213µM) was higher than the high risk group (5.273± 0.2340µM) and oral cancer group (5.047± 0.5115µM) The difference between groups was statistically significant (p = 0.001). However, the salivary selenium was higher in the oral cancer group (0.0167±0.0083 mg/dl) compared to the high risk (0.0148± 0.0071mg/dl) and healthy control (0.0138± 0.0093 mg/dl) but not statistically significant (p= 0.5414). Conclusion Salivary glutathione level could be a predictor of risk of oral cancer and could therefore serve as a non invasive modality in the early detection of oral cancer.

MINIMALLY-INVASIVE ORAL EXFOLIATED CELLS STUDY FOR PREMALIGNANT LESIONS USING RAMAN MICROSPECTROSCOPY

Squamous cell carcinoma of the oral cavity ranks as the 15th most common cancer in the world and the 10th most frequent cancer in males. The present study was undertaken for the development of new methods for early oral cancer detection based on Raman microspectroscopy of exfoliated cells. Exfoliated oral cells were collected by brush biopsy from patients attending Dublin Dental Hospital Dysplasia Clinic (25) and from healthy volunteers (25). Samples of exfoliated cells from normal mucosa and from pre-malignant lesions were collected using an endocervical cytobrush and placed in ThinPrep vials. Slides were prepared using the Thinprep2000 processor with the aim of forming a monolayer of cells for analysis. Raman spectra were acquired from the nucleus and cytoplasm of each cell using an XploRA confocal Raman instrument (HORIBA JobinYvon). As source, a 532 nm laser was focused by a 100X objective onto the sample and the resultant Raman signals were acquired in the 400 to 1800 cm−1 region. Glass spectral contamination was removed using extended multiplicative signal correction Following pre-processing, spectra were subjected to principal component analysis (PCA) and principal component-linear discriminant analysis (PC-LDA). The results show that Raman spectroscopy coupled with PCA could differentiate the nucleus and cytoplasm of the cell, the PC loadings showing that the cytoplasmic regions are dominated by protein bands while thenuclear regions are dominated by DNA bands. Furthermore, patient samples were discriminated from healthy volunteers based on DNA and lipids bands inthe PC loadings. Sensitivities of 91% and 97% and specificites of 98% and 89% were achieved for the cytoplasm and nucleus respectively, using PC-LDA. Thus, the findings of the study support the potential of Raman microspectroscopy for providing molecular level information from oral exfoliated cells and the future potential for screening of minimally invasive brush biopsy samples for oral pre-cancer and cancer.

M-Health for Early Detection of Oral Cancer in Low- and Middle-Income Countries.

Background: Up to 86% of oral cancer (OC) patients present at the late stage where survival is dismal. Limited access to specialist diagnosis is a significant factor for late presentation. The increasing use of smartphones presents an opportunity to use digital technology to facilitate early detection of OC. Aim: To evaluate the feasibility of using Mobile Mouth Screening Anywhere (MeMoSA®) to facilitate early detection of OC. Methods: A mobile phone app named MeMoSA was developed and the feasibility of integrating this for documentation of oral lesions, and communication between dentists and specialists for management decisions were evaluated. The experience of dentists and specialists in using MeMoSA was determined using qualitative questionnaires. Results: Communication between specialist and dentists using MeMoSA stratified cases and streamlined referral of patients. Twelve of 48 patients were found to have oral lesions or signs suspicious of cancer and 3 required referrals. The patient's compliance for referral was tracked with MeMoSA. All dentists agreed that MeMoSA could facilitate early detection of OC and believed that MeMoSA could assist in the identification of oral mucosal lesions through direct communication with specialists and continuous learning in the recognition of high-risk lesions. Conclusions: MeMoSA has the potential to be used to promote equitable health care and streamline patient management that could result in early detection of OC.

Oral Cancer Knowledge, Attitudes and Practices among Primary Oral Health Care Dentists in Kuwait

Background:Oral cancer signifies a public health concern of international importance. Early detection of oral cancer can improve the prognosis and the 5-year survival rate.Objective:The aim of this study was to assess the level of oral cancer knowledge, opinion, attitudes and practices among dentists working at the primary oral health care centers in Kuwait.Methods:In this cross-sectional study, self-reported questionnaire was distributed to the dentists working at the primary oral health care centers in Kuwait. A total of 289 dentists participated in the present study. The questionnaire included 23- questions on oral cancer knowledge, opinion, attitudes and practices.Results:The mean age of the dentists was 35.2 ± 10.9 years. Approximately, all dentists (99.7%) were aware of the major risk factors that were most likely associated with oral cancer. Overall, majority of the participants knew the most common form of oral cancer (80.6%), most common site (80.3%) and the likely lesions associated with oral cancer occurrence (87.9%). A large number of dental practitioners (81%) would routinely refer a patient with a suspicious lesion to a specialist. Nearly one-third (32%) reviewed their patients’ oral cancer risk factors. Approximately two-thirds (62%) assessed the use of tobacco in their practice. Almost, all (92.4%) were interested in attending continuing education courses on oral cancer.Conclusions:Majority of the participants presented good knowledge about various aspects of oral cancer. More continuing education programs on risk factors and diagnosis of oral cancer should be organized to train the dentists. Oral cancer screening should be a routine procedure for the high risk patients at the primary oral health care centers in Kuwait.

Identification of Novel MicroRNAs and Their Diagnostic and Prognostic Significance in Oral Cancer.

Background: Oral cancer is one of the most prevalent cancers worldwide. Despite that the oral cavity is easily accessible for clinical examinations, oral cancers are often not promptly diagnosed. Furthermore, to date no effective biomarkers are available for oral cancer. Therefore, there is an urgent need to identify novel biomarkers able to improve both diagnostic and prognostic strategies. In this context, the development of innovative high-throughput technologies for molecular and epigenetics analyses has generated a huge amount of data that may be used for the identification of new cancer biomarkers. Methods: In the present study, GEO DataSets and TCGA miRNA profiling datasets were analyzed in order to identify miRNAs with diagnostic and prognostic significance. Furthermore, several computational approaches were adopted to establish the functional roles of these miRNAs. Results: The analysis of datasets allowed for the identification of 11 miRNAs with a potential diagnostic role for oral cancer. Additionally, eight miRNAs associated with patients’ prognosis were also identified; six miRNAs predictive of patients’ overall survival (OS) and one, hsa-miR-let.7i-3p, associated with tumor recurrence. Conclusions: The integrated analysis of different miRNA expression datasets allows for the identification of a set of miRNAs that, after validation, may be used for the early detection of oral cancers.

Promoter Hypermethylation of Tumor-Suppressor Genes p16INK4a,RASSF1A,TIMP3, and PCQAP/MED15 in Salivary DNA as a Quadruple Biomarker Panel for Early Detection of Oral and Oropharyngeal Cancers.

Silencing of tumor-suppressor genes (TSGs) by DNA promoter hypermethylation is an early event in carcinogenesis; hence, TSGs may serve as early tumor biomarkers. We determined the promoter methylation levels of p16INK4a, RASSF1A, TIMP3, and PCQAP/MED15 TSGs in salivary DNA from oral cancer (OC) and oropharyngeal cancer (OPC) patients, using methylation-specific PCR coupled with densitometry analysis. We assessed the association between DNA methylation of individual TSGs with OC and OPC risk factors. The performance and the clinical validity of this quadruple-methylation marker panel were evaluated in discriminating OC and OPC patients from healthy controls using the CombiROC web tool. Our study reports that RASSF1A, TIMP3, and PCQAP/MED15 TSGs were significantly hypermethylated in OC and OPC cases compared to healthy controls. DNA methylation levels of TSGs were significantly augmented by smoking, alcohol use, and betel quid chewing, indicating the fact that frequent exposure to risk factors may drive oral and oropharyngeal carcinogenesis through TSG promoter hypermethylation. Also, this quadruple-methylation marker panel of p16INK4a, RASSF1A, TIMP3, and PCQAP/MED15 TSGs demonstrated excellent diagnostic accuracy in the early detection of OC at 91.7% sensitivity and 92.3% specificity and of OPC at 99.8% sensitivity and 92.1% specificity from healthy controls.

Role of the dentist in early detection of oral cancer

Aims: The aim of the study is to appraise the awareness levels among dentists of the Kingdom of Saudi Arabia (KSA) regarding oral cancer. Materials and Methods: A survey based on questionnaire was done to evaluate the acquaintance levels regarding oral cancer among the dentists working in the governmental and private dental clinic, Riyadh city, KSA. Results: Majority of the patients were male (57.9%, n = 117), most were working in private clinics (57.4%, n = 116), graduated within 15 years (2003–2018) (89.1%, n = 180), and general practitioners (78.7%, n = 159). The variation between knowledge and age, gender, year of graduation, and specialty (P > 0.05) among dentists was insignificant. Conclusion: For early detection of oral cancers, dentists have a vital role as they are the persons who see and observe oral cavity during routine dental checkups and can help identify suspicious lesions before having any symptoms.

Hybrid Framework using Data Mining Techniques for Early Detection and Prevention of Oral Cancer

This paper presents the usage of classification and association data mining techniques for early detection and prevention of oral cancer. The indigenous dataset of 1,025 patients who visited a tertiary care centre during 2004 to 2009 was used for the research. Ten classification data mining models are designed using varied types of data mining techniques like regression analysis, classification trees and neural networks. Regression analysis models are linear regression model and logistic regression model; classification tree models are decision tree model, decision tree forest model and TreeBoost model and artificial neural networks are multilayer perceptron model, radial basis function model, group method of data handling model, cascade correlation model and probabilistic - general regression neural network model. Association rules are generated using apriori algorithm. The classification models and association rules are evaluated using various estimation parameters. Finally, a hybrid oral cancer management system is designed using the classification model and the association rules.

A Novel Mobile App for Oral Cancer Awareness amongst General Population: Development, Implementation, and Evaluation

To develop a mobile app for education and screening regarding oral cancer in the general population. A mobile app titled Prayaas-Oral Cancer Prevention, Treatment, and Rehabilitation was designed and developed to be installed on a basic mobile handset with or without internet. It was aimed for the common public, patients as well as healthcare providers. The contents included all information in the pictorial format as well as videos regarding oral cancer awareness, tobacco de-addiction, self-oral examination, various surgeries, and rehabilitation options. It was pilot tested in 50 factory workers of rural set-up. Participants' feedback was recorded using a self- report questionnaire. Overall feedback was very positive, they found the app easy to operate, enhancing knowledge regarding oral cancer and they recommended this to be used for the general population. Within limitations of this pilot study, it can be inferred that mobile technology can be successfully used to reach out to bottom of the pyramid population residing in inaccessible rural population for creating public health issues such as oral cancer. Oral cancer is preventable through risk factor intervention especially tobacco de-addiction. The self- oral examination can be a very critical factor in early diagnosis of oral cancer. Access to care is a major issue in our country owing to low levels of education, lower income and exposure to risk factors such as tobacco. The fact that today there is widespread use of mobile technology by people belonging to all socioeconomic groups can be harnessed for this public health awareness initiative. This app can be used as a tool for patient education for prevention as well as early detection of oral cancer, both of which can be key to reduce oral cancer morbidity and mortality in India.