Oral Cancer Screening Research Articles

Promoting oral cancer screening by general practitioners in Australia: Strengthening primary healthcare.

Oral cancer remains a significant public health issue. General practitioners (GPs) can play an important role in raising awareness of oral cancer. This paper explores why providing advice relating to modifiable risk behaviours associated with oral cancer and undertaking routine oral cancer screening are important for GPs in clinical practice. To support GPs, an e-learning module on oral cancer screening, prevention and early detection was established as part of the Oral Cancer Screening and Prevention Program (funded by the Victorian Department of Health). The development of the e-learning module was led by Dental Health Services Victoria in partnership with The Royal Australian College of General Practitioners (RACGP), and the content was developed in consultation with experts from the University of Melbourne, Cancer Council Victoria and the Victorian Comprehensive Cancer Centre. The Oral Cancer: Prevention, early detection and referral e-learning module was launched on the RACGP training website in November 2023.

Can oral cancer screening reduce late-stage diagnosis, treatment delay and mortality? A population-based study in Taiwan

ObjectiveThis study evaluates the effectiveness of Taiwan’s nationwide oral cancer screening programme in reducing late-stage diagnosis, treatment delays and mortality.DesignA retrospective cohort study was conducted.SettingThe study utilized Nationally representative datasets,...

Oral pathology in a population observed within an oral cancer screening developed in Portugal.

Oral cancer is a global public health problem. Late diagnosis leads to treatment delays, which consequently result in a worse prognosis and a decrease in the 5-year survival rate. The purpose of this study is to evaluate the oral pathology in a population observed within an oral cancer screening developed in Portugal. Oral cancer opportunistic screening activities were conducted by the non-profit organization Liga Portuguesa Contra o Cancro ‑ Núcleo Regional do Sul (LPCC-NRS) and data collection occurred between March and December 2022. Participants completed an anonymous questionnaire to collect sociodemographic data and lifestyle habits, followed by a clinical examination of the oral cavity. All individuals classified with oral potentially malignant disorders (OPMD), or suspected lesions of malignant neoplasia were subsequently contacted between January and February 2023 and were questioned about undergoing a biopsy and its respective pathological examination result. Descriptive and analytical statistics were applied. A total of 2674 participants with a mean age of 57 years were screened. Fordyce granules (16.30%) were the most common non-pathological condition, and hairy tongue (11.04%) was the most frequently observed benign lesion. Leukoplakia (43.58%) was the most common oral potentially malignant disorder. Additionally, histological confirmation was obtained for the presence of 4 oral squamous cell carcinomas (OSCC), representing 0.15% of all population screened. Although benign pathology is the most frequently found, oral potentially malignant disorders and suspected malignant lesions were identified in 6.3% of participants in these oral cancer screenings. In this regard, we conclude that the oral cancer screening actions developed by LPCC-NRS were effective in identifying positive cases of OPMDs and oral cancer, using an intraoral visual examination of the oral cavity.

Effect of socioeconomic status and women empowerment status on coverage of oral cancer screening among Indian women within reproductive age group

Oral cancer is the second most prevalent cancer in India and 5% of all cancers in women is contributed by oral cancer. In spite of being a part of national programme, the screening coverage rates remain low. Studies have indicated that the societal status of women and their empowerment plays a role in screening coverage for cancer. The objective of the current study is to estimate the coverage of oral cancer screening among Indian women within reproductive age-group across Indian states and union territories (UTs), to explore the relationship of socioeconomic status (SES) and women empower status (WES) with oral cancer screening coverage across Indian states and union territories (UT). Data from the fifth round of the nationally representative cross-sectional survey (National Family Health Survey, NFHS-2019–2021) was used in the present study with 3,48,882 individuals being included in the final analysis. We have cross-tabulated SES and WES composite scores with the Dimension Index (DI) of screening and categorised states and UTs into low, middle and high. We have represented these values over the Indian map. The interaction among these was graphically represented by a bubble plot. Further, we estimated the association of each indicator of SES and WES with screening coverage using multivariable logistic regression. The national coverage of oral cancer screening among women of reproductive age was 0.77% with Andhra Pradesh (7%) and Andaman and Nicobar Islands (10%) recording the highest screening coverage. Despite having high SES and WES scores, Madhya Pradesh and Uttar Pradesh, the screening (DI) was low. States with both high women empowerment status and high socioeconomic status showed high oral cancer screening uptake but the trend was not universal. Still, there were variations in the association among the states. The increased screening was significantly associated with higher access to improved sanitary facility (76%) and clean fuel for cooking (44%). Socio-economic status is an important precursor for better oral cancer screening coverage but women empowerment status did not always translate into good cancer screening uptake. Deep-rooted socio-cultural constructs and stigma associated with cancer and its implications may play a role. Implementation research for better uptake of oral cancer screening coverage is required.

Oral cancer perceptions amongst adult attendees of a Dental Hospital in the Republic of Ireland: A cross-sectional pilot study

Objectives This study aimed to assess (i) awareness of the signs and symptoms of oral cancer and its risk factors and (ii) awareness and attitudes towards oral cancer screening, in an Irish cohort. Methods A cross-sectional self-administered survey was used in a convenience sample of patients > 18 years with no cancer history attending the Dublin Dental University Hospital. The data were analysed using descriptive statistics, Pearson’s Chi-squared and Fisher’s exact tests. Results 124 responses were received. 83.7% reported knowing little/nothing about oral cancer risk factors. 12.8% did not identify smoking, 35.3% alcohol consumption, 90.5% betel nut, 35.3% age and 80.2% male gender, as risk factors. 46% were unaware that a dentist is trained to check for oral cancer. Participants were more likely to seek advice regarding a persistent oral white or red patch from their doctor than their dentist but were more likely to attend their dentist in relation to a persistent ulcer, swelling or pain. The study did not find any statistically significant relationship between gender, age, educational level and either awareness of the signs and symptoms of oral cancer and its risk factors, or with experiences and attitudes towards oral cancer screening. Conclusions The study demonstrated a lack of knowledge of the risk factors, signs and symptoms of oral cancer, and of awareness of the role of dentists in screening for oral cancer. It should be repeated in a larger cohort in non-dental settings to inform the development of oral cancer awareness programmes that address those areas where awareness is lacking.

The Types and Effectiveness of Mobile Health Applications Used in Improving Oral Cancer Knowledge: A Mixed Methods Systematic Review

ABSTRACTBackground and AimsThe global burden of oral cancer (OC) is enormous. Mobile health applications have been found to play a promising role in cancer prevention; however, no known systematic review evidence exists on whether the use of mobile health applications is effective in increasing public knowledge of OC or not. Therefore, this systematic review aimed to synthesize evidence on the types and effectiveness of mobile health applications used for improving OC knowledge.MethodsThis study adopted a mixed methods systematic review design. The review methodology was informed by Joanna Brigg's Institute's PRISMA checklist and the AMSTAR‐2 guidelines. The literature used for this review were obtained through the search of multiple sources, including 12 electronic databases, web sources, and manual searching of the reference lists and citations of the included articles. Quality appraisal of the included articles was done using the Mixed Methods Appraisal Tool, after which relevant data were collected, synthesized, and configured.ResultsA total of three high‐quality articles, from two studies conducted in India, were included in this review. The studies investigated 574 participants, who are predominantly doctors and community members, on two Android‐based mobile health applications (M‐OncoED and Prayaas). Only Prayaas was found to significantly increase OC knowledge among its users (p < 0.05). Only M‐OncoED was found to significantly increase the practice of OC screening advice provision among a selected group of users. No other significant finding was reported on the effect of OC knowledge obtained from the use of these applications on clinical, behavioral, and epidemiological outcomes.ConclusionMobile health application‐based education is a highly underutilised but very promising strategy that can be used to improve public knowledge of OC. This strategy needs to be adopted in public education programmes on OC.

Innovative Progress: Artificial Intelligence in the Realm of Oral Cancer

: In recent years, there has been a notable increase in the global incidence of oral cancer, leading to significant morbidity and mortality, especially when diagnosed at advanced stages. The integration of technology holds great promise for early detection and diagnosis, facilitating improved patient management for clinicians. The emergence of artificial intelligence (AI) presents a potential breakthrough in oral cancer screening, as it can meticulously analyze vast datasets from various imaging modalities, offering valuable support in the field of oncology. This review focuses on a spectrum of AI techniques utilized for early detection and diagnosis of oral cancer. Additionally, AI techniques may be employed for the effective treatment of oral cancer. Using the abundance of information acquired, this article provides an in-depth overview and discussion of AI's value and benefits in oral cancer screening, early detection, disease prediction, and therapy, among other areas. Furthermore, it identifies present limits and forecasts the hopeful future of AI in oral cancer research.

Utilizing laser therapy to manage oral potentially malignant disorders in older adults at the primary care level.

Oral lesions are a significant concern among older adults because they can progress to oral cancer if not diagnosed and treated promptly and effectively. Transportation to the hospital is a major barrier to oral healthcare for many older adults. The purpose of this editorial is to address the challenges of managing oral potentially malignant disorders in the older population, highlighting the barriers they face in accessing healthcare services, the potential use of laser therapy for management, and the direction of research in this area. Due to the limited access of the older to healthcare services, primary healthcare facilities within communities serve as their primary providers. Laser therapy is recommended for the management of oral potentially malignant disorders due to its favorable outcomes. This approach has been tested in several primary healthcare centers in Thailand. In our project, laser therapy was used to treat oral potentially malignant disorders in primary and secondary healthcare services. This includes photodynamic therapy for older patients with extensive lesions, as well as individuals with oral leukoplakia and erythroplakia who have declined curative surgery. It has also been used in cases of recalcitrant lichen planus to steroid or photobiomodulation therapy. This approach has been well accepted by both oral healthcare providers and patients. To expand access to these treatment options in such settings, it is critical to empower healthcare professionals, particularly dentists and dental nurses, to integrate laser techniques into geriatric care and oral cancer screening. Establishing a network foundation for orofacial laserology would also enhance the potential of such settings.

Evaluating different samples & techniques for hr-HPV DNA genotyping to improve the efficiency of risk profiling for oral & cervical cancers in Sikkim, India.

Background & objectives Oral and genital HPV infection in men may be a source of cervical diseases in their women partners as well as disease in themselves. This study aimed to evaluate and compare the performance of Hybrid Capture 2 (HC2) in physician-collected cervical samples and qPCR in self-collected urine and oral gargle samples of women and men, respectively, for hr-HPV infection status and genotyping. Methods One thousand and two hundred biological samples were collected from 200 women (urine, oral gargle, and cervical smear) and 200 men (urine and oral gargle) visiting a referral hospital in the remote Himalayan State of Sikkim. The extracted genomic DNA from urine and gargle samples were profiled for hr-HPV genotypes using quantitative polymerase chain reaction (qPCR) and HC2 for cervical samples. Results In women, hr-HPV was detected in 17.5 per cent of cervical samples by HC2, 25.5 per cent of urine, and 7 per cent of gargle samples by qPCR. For men, hr-HPV was detected in 8 per cent urine and 5 per cent gargle samples by qPCR. Among the HPV-positive women, 56 per cent of urine samples and 20 per cent of oral samples showed single-genotype infection, while the remaining had multiple genotypes. Amongst the HPV-positive men, 62.7 per cent of urine samples and 85.7 per cent of oral samples showed single-genotype infection while the remaining had multiple genotypes. Compared to Pap, the area under ROC was good for HC2 (AUC=0.89) and for qPCR (AUC= 0.852). Interpretation & conclusions HC2 for cervical and qPCR-based HPV DNA assay for urine and gargle sample is suitable for risk profiling for cervical cancer (CC) and oral cancer (OC) screening programmes.

Assessing Oral Cancer Knowledge and Awareness among Dental Patients of Bengaluru City, India

Abstract Background Oral cancer (OC) is prevalent in India, with serious social and economic ramifications on the public, often resulting in poverty and societal imbalance. Knowledge of the risk factors and signs and symptoms may reduce the OC burden on the society. Objectives To assess the knowledge regarding risk factors and clinical indicators in early detection and prevention of OC among dental patients. Methods A hospital-based cross-sectional study, interviewer-administered questionnaire was conducted among 540 adult patients attending the outpatient department of dental hospital. The questionnaire contained items about participants' characteristics, including demographics, education level, and knowledge about major risk factors: use of tobacco products, alcohol, diet/nutrition, family cancer history, oral hygiene habits and dental aspects, and clinical presentation of OC. The SPSS software was used to analyze the data, and the significance threshold was set at p = 0.05. The subjects were counseled immediately after completion of the questionnaire regarding tobacco cessation, and was given advice on diet, oral hygiene maintenance, and other lifestyle modifications. Results A solid understanding of signs and symptoms was demonstrated by 72%. However, two-thirds of this group were unaware of the symptoms associated with OC. As for OC risk factors such as tobacco use and heavy alcohol consumption, 61.6% expressed good knowledge. Of the total, 38.3% reported visiting a dentist at least once a year for dental issues in the past 3 years, yet none of them had undergone OC screening. Additionally, less than 10% of the patients received OC counseling or tobacco cessation intervention from a dentist. Conclusion Knowledge of OC risk factors and signs and symptoms were average, which may adversely affect the practices regarding prevention and early detection.

Salivary cysteine levels as a potential biochemical indicator of oral cancer risk in tobacco consumers.

Aim: Oral cancer is the leading cause of mortality, with a survival rate of less than 5 years, and is predominantly influenced by tobacco mutagens. Invasive diagnostic methods hinder early detection of oral cancer biomarkers. The present study performed salivary biochemical analysis for early oral cancer screening in tobacco consumers.Materials & methods: Three study groups included healthy controls (n=25), tobacco users (n=25) and oral cancer patients (n=25). Salivary total protein, amylase, TNF-α and amino acid levels were evaluated using enzymatic tests, Enzyme linked Immunosorbent Assay (ELISA) and High-Performance Liquid Chromatography (HPLC).Results: Compared with healthy controls, salivary total protein and TNF-αlevels were significantly (p=0.04) higher in oral cancer patients. Salivary amylase levels were significantly lower in tobacco smokers (p=0.02) and higher in oral cancer patients (p=0.01). Interestingly, the amino acid cysteine concentration was significantly higher (p=0.02) in tobacco consumers (62.5±10) than in healthy controls (116.1±28).Conclusion: In high-risk populations, such as tobacco users, salivary biochemical analysis can serve as a promising noninvasive diagnostic method for early oral cancer screening. As a salivary biomarker, the amino acid cysteine exhibits potential as a means of detecting the progression of oral cancer in individuals who consume tobacco.

An Examination of Oral Cancer Screening Among Men in India

An Examination of Oral Cancer Screening Among Men in India

Dental education in nursing schools: A pan-Canadian study

ObjectivesThe aim of this study was to gather data on Canadian nursing programs regarding oral health curriculum and attitudes towards oral health curriculum to evaluate the level of oral health education in nursing programs and provide a reference for understanding dental and oral health in the nursing field. MethodsData to inform models for oral health curriculum in nursing were collected through an online survey using a secured google form. The web-based questionnaire examined main aspects of dental and oral health in nursing educational institutions. Eligibility criteria for this study included faculty members of an accredited nursing program in Canada. ResultsOf the 76 institutions approached, a total of 47 nursing faculty members from 35 nursing programs responded to the online survey. The vast majority (85.1 %) of the participants stated they believe oral health should be taught within nursing programs. Relating to the current curriculum, 70.2 % of the respondents stated their institution currently teaches anatomy relating to the oral cavity, but only 38.3 % reported their institution implemented oral diseases and pathology into the curriculum. Moreover, 48.9 % of the participants noted that dental screening was not covered in the nursing curriculum; 27.7 % of the respondents stated that their institution implemented education regarding gum disease, 25.5 % noted implementing education regarding oral cancer and oral lesions screening. Overall, 80.9 % of the participants noted that future nurses should be educated about oral cancer and disease prevention. However, in order to implement dental and oral health curriculums, participants noted certain needs such as time to implement curriculum (87.2 %) and more knowledge about the topic (83 %). ConclusionsThere is a current lack of content regarding dental and oral health in the curriculum of nursing programs throughout Canada. Due to this deficiency, many nursing graduates lack general knowledge about various aspects of dental and oral health.

Learning from the Indian National Family Health Survey to assess population based oral, cervix and breast cancer screening in low-and-middle income countries

Learning from the Indian National Family Health Survey to assess population based oral, cervix and breast cancer screening in low-and-middle income countries

Consideration of Dentistry and Oral Cancer Screening in Complete Medical Checkup

Consideration of Dentistry and Oral Cancer Screening in Complete Medical Checkup

French Dentists’ knowledge, attitudes and practices toward oral cancer detection: A national survey

BackgroundFrance is ranked 6th in Europe in terms of oral cancer incidence. Dental surgeons are on the front line in examining the oral mucosa, but little is known about the knowledge, attitudes and practices of French dental surgeons with respect to lesions suspected of malignancy. MethodsAn online survey including 18 self-administered questions was widely shared on social media using major networks of French dentists. Items included socio-demographic characteristics of the respondents, their self-assessed knowledge, screening practices and training on oral cancer detection and care. ResultsA total of 676 dental surgeons participated in this survey. The vast majority, 92.8 %, were general dental surgeons, 83.9 % had a private practice and 49.1 % had less than 5 years of dental experience. Almost 55 % declared that they did not conduct systematic examinations of the oral mucosa and 45 % reported that they did conduct such examinations. In-hospital practice, lower patient age, dental surgeon experience, and specialty were all positively associated with systematic examination of the oral mucosa. Conversely, absence of a patient complaint, absence of an obvious lesion, lack of time, and lack of training/skills were all negatively associated. DiscussionThis is the first survey to analyze the practices of French dental surgeons in oral cancer screening. Only half of the respondents, the best trained, performed systematic oral mucosa examinations which objectively help to early detect mucosal cancer lesions. To improve oral cancer early detection, we recommend mandatory screening training programs for all dental students and dental surgeons.

Physical Health Checks and Follow-Up Care in Deprived and Ethnically Diverse People With Severe Mental Illness: Co-Designed Recommendations for Better Care.

There is wide variation in premature mortality rates in adults with severe mental illness (SMI) across London, with Tower Hamlets (a highly deprived and ethnically diverse area) scoring the highest. To identify examples of best practice and co-design recommendations for improving physical health checks and follow-up care amongst people with SMI in Tower Hamlets. Data were collected through online questionnaires (using SMI physical health best practice checklists), one-on-one interviews (n = 7) and focus groups (n = 3) with general practices, secondary mental health services, commissioners and leads of community services and public health programmes, experts by experience and community, voluntary and social enterprise organisations in Tower Hamlets. Data were analysed using deductive and inductive thematic analysis. Twenty-two participants representing 15 general practices (out of 32), secondary mental health services, commissioners and public health leads completed the online questionnaires. Twenty-one participants took part in interviews and focus groups. Examples of best practice included cleaning and validating the SMI register regularly by general practices, knowing the number of patients who had been offered and/or received physical health checks, having clear pathways to community and specialist care services, using various communication methodsand having a key performance indicator (KPI) for tailored smoking cessation services for people with SMI. Recommendations included adopting evidence-informed frameworks for risk stratification and utilising the wider primary care workforce with specific training to follow up on results, offer interventionsand support navigating pathways and taking up follow-up care. Incentivising schemes were needed to deliver additional physical health check components such as oral health, cancer screening, Covid-19 vaccination and sexual health checks. Including KPIs in other community services' specifications with reference to SMI people was warranted. Further engagement with experts by experience and staff training were needed. The present initiative identified best practice examples and co-designed recommendations for improving physical health checks and follow-up care in deprived and ethnically diverse people with SMI. This initiative was supported by three experts with experience, and two community organisations, who were involved in data curation and interpretation, development of recommendationsand/or dissemination activities including writing this manuscript.

Precise Identification of Oral Cancer Lesions Using Artificial Intelligence.

Dentists, especially those who are not oral lesion specialists and live in rural areas, need an artificial intelligence (AI) system for accurately assisting them in screening for oral cancer that may appear in smartphone images. Not many literatures present a viable model that addresses the needs, especially in the context of oral lesion segmentation in smartphone images. This study demonstrates the use of a deep learning-based AI for simultaneously identifying types of oral cancer lesions as well as precisely outlining the boundary of the lesions in the images for the first time. The lesions of interest were oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) lesions. The model could successfully (1) detect if the images contained the oral lesions, (2) determine types of the lesions, and (3) precisely outline the boundary of the lesions. With future success of our project, patients will be diagnosed and treated early before the pre-cancer lesions can progress into deadly cancerous ones.

Oral cancer screening using cytopathology: An advanced proposal with the Bethesda classification.

Oral cancer screening requires analysis capable of detecting changes preceding the clinical manifestation. Oral cytopathology studies as an oral cancer screening have shown promising results. This study aims to evaluate the use of cytopathology in a quali-quantitative analysis using Papanicoloau staining. Four experimental groups were evaluated: control (CG), exposed to carcinogens (EG), potentially malignant disorder with and without epithelial dysplasia (D-OPMDG and ND-OPMDG) and oral squamous cell carcinoma (OSCCG). Oral smears were collected using a Cytobrush® and conventional exfoliative cytology. Oral Papanicolaou smears from 143 individuals were analysed in 8100 images. Qualitatively, non-lesional groups exhibited minimal suspected cases (20% in CG and 5% in EG), in the OPMD groups the ability to identify altered cells was low (40% in D-OPMDG and 0% in ND-OPMDG). Conversely, a notable100% accuracy was achieved in the OSCCG. Quantitatively, a higher percentage of anucleated and a lower percentage of intermediate cells were observed in the OPMDG; a higher proportion of parabasal/suspicious cells was observed in OSCCG. The optimal threshold for improved accuracy in detecting suspected malignancies occurs when the count of parabasal/suspicious cells exceeds 8/100 cells examined. Cytomorphometric analysis revealed a higher nucleus/cytoplasm ratio (N/C) in OSCCG, with a best cutoff point indicating enhanced accuracy in discerning suspected malignancies when exceeding 17% of cells exhibiting this elevated ratio. It is possible to suggest updates in cytomorphometric and quantitative analysis in the modified Bethesda system for the oral cavity including objective criteria in the risk classification, therefore improving oral cancer screening.

A systematic review on the early detection of oral cancer using artificial intelligence and electronic tongue technology

This systematic review examines the role of artificial intelligence (AI) and electronic tongue (e-tongue) technology in the early detection of oral cancer. A comprehensive search of PubMed, Scopus, and Web of Science databases identified 500 articles, of which 20 met the inclusion criteria and were included in the review. The included studies encompassed diverse methodologies, AI models, and e-tongue technologies, with a total of 5,000 participants across various populations. AI-driven models, particularly those utilizing deep learning algorithms, demonstrated high sensitivity (>85%) and specificity (>80%) in detecting oral cancer biomarkers. E-tongue technologies, such as mass spectrometry and optical sensors, contributed to enhanced diagnostic accuracy, with area under the curve (AUC) values exceeding 0.85 in several studies. While promising, challenges such as study heterogeneity, validation in large-scale trials, and implementation barriers require further attention. The findings highlight the transformative potential of AI and e-tongue technology in revolutionizing oral cancer screening and management, with implications for improving patient outcomes and reducing healthcare costs. Future research should focus on standardization, validation, and real-world implementation to harness the full benefits of these innovative approaches in clinical practice.