Oral Cancer Screening Research Articles

Validity and Reliability of Intraoral Camera with Fluorescent Aids for Oral Potentially Malignant Disorders Screening in Teledentistry.

There is limited documentation of using fluorescence images in oral potentially malignant disorders (OPMDs) and oral cancer screening through the field of teledentistry. This study aims to develop and evaluate the validity and reliability of the intraoral camera with the combination method of autofluorescence and LED white light used for OPMDs and oral cancer screening in teledentistry. The intraoral camera with fluorescent aids, which uses a combined method of both autofluorescence and LED white light, was developed before the device was evaluated for validity and reliability as a OPMDs screening tool for teledentistry. All lesions of thirty-four OPMD patients underwent biopsy for definitive diagnosis and were examined by an oral medicine specialist. Both images under autofluorescent and LED white light mode captured from the device were sent online and interpreted for the initial diagnosis and dysplastic features in addition to being compared to the direct clinical examination and histopathological findings. The combination method was also compared with autofluorescence method alone. The device provided good image quality, which was enough for initial diagnosis. Using the combination method, sensitivity, specificity, PPV, and NPV of the device via teledentistry were 87.5%, 84.6%, 63.6%, and 95.7%, respectively, which were higher than autofluorescence method alone in every parameter. The concordance of dysplastic lesion was 85.29% and 79.41% for category of lesion. The validity and reliability results of the combination method for the screening of dysplasia in OPMDs were higher than autofluorescent method alone. The intraoral camera with fluorescent aids for the OPMDs screening can be utilized for screening via teledentistry.

Level of oral cancer awareness among Indian rural population: A possible research model using knowledge, attitude and practice (KAP) intervention and its utilisation in low resource settings of LMICs

A study was conducted to establish levels of awareness of oral cancer and its causes among an Indian population.A pre-tested structured questionnaire on Knowledge, Attitude and Practice [KAP] (open and closed ended questionnaire) was used to estimate the KAP score, followed by clinical examination of the oral mucosal lesions. The subjects were counselled immediately after completion of KAP scoring using a structured protocol of regarding tobacco cession, and given advice about intake of natural sources of anti-oxidants in the diet, of tomato, carrot and green leafy vegetables (GLV).Subjects who had a KAP score 50% or less were counselled using a structured protocol. Subjects who had a KAP score greater than 50% were also counselled and given the correct information to their incorrect answers.In the group of people with a KAP score 50% or less, continual behavioural therapy was given to remain tobacco free for life. The subjects were monitored weekly for between 30 and 40 days. Clinically suspect lesions of hyperplasic candidiasis, lichen planus, and all varieties of Leucoplakia were confirmed histopathologically and routine treatment (conservative or surgical) was started without delay for the group. Those cases with dysplastic changes (of all different grades) were also counselled. Regular follow-up was maintained over several months and re-assessment carried out at intervals and any improvement noted. ConclusionThis is a cost-effective and simple method for estimation of the score on knowledge, attitude, and practice (KAP), and determinants of the ill-effect of tobacco habit(s) and engaging the popolation-in-need for their appropriate understanding about oral cancer screening and education for prevention and control.

Classification of imbalanced oral cancer image data from high-risk population.

.Significance: Early detection of oral cancer is vital for high-risk patients, and machine learning-based automatic classification is ideal for disease screening. However, current datasets collected from high-risk populations are unbalanced and often have detrimental effects on the performance of classification.Aim: To reduce the class bias caused by data imbalance.Approach: We collected 3851 polarized white light cheek mucosa images using our customized oral cancer screening device. We use weight balancing, data augmentation, undersampling, focal loss, and ensemble methods to improve the neural network performance of oral cancer image classification with the imbalanced multi-class datasets captured from high-risk populations during oral cancer screening in low-resource settings.Results: By applying both data-level and algorithm-level approaches to the deep learning training process, the performance of the minority classes, which were difficult to distinguish at the beginning, has been improved. The accuracy of “premalignancy” class is also increased, which is ideal for screening applications.Conclusions: Experimental results show that the class bias induced by imbalanced oral cancer image datasets could be reduced using both data- and algorithm-level methods. Our study may provide an important basis for helping understand the influence of unbalanced datasets on oral cancer deep learning classifiers and how to mitigate.

Perceptions and Practices of General Practitioners towards Oral Cancer and Emerging Risk Factors among Indian Immigrants in Australia: A Qualitative Study.

Background: In Australia, Indian immigrants are one of the fastest-growing communities. Since oral cancer is widespread in India, the indulgence of Indians in customs of areca (betel) nut use in Australia may be linked to the recent rise in oral cancer cases. Since GPs (general practitioners) are primary healthcare providers, it is pivotal to ensure the oral cancer awareness of GPs. This study aimed to explore oral cancer risk-related knowledge, beliefs, and clinical practices of GPs in Australia. Methods: Fourteen semi-structured interviews were conducted with GPs practicing across New South Wales and Victoria. Purposive and snowball sampling were used for recruitment. Data were analysed through a directed content analysis approach. Results: All GPs were knowledgeable of major oral cancer causative factors including tobacco and alcohol, but some had limited understanding about the risks associated with areca nut preparations. Positive attitudes were evident, with all participants acknowledging the importance of oral cancer risk assessment. Most GPs recalled not performing oral cancer routine check-ups. Conclusion: GPs presented good oral cancer knowledge except for emerging risk factors such as areca nut use. Varied beliefs and inconsistent clinical practices relating to oral cancer screening is concerning. Accessible oral cancer training around emerging risk factors may benefit GPs.

Pilot Model for Community Based Oral Cancer Screening Program: Outcome from 4 Northeastern Provinces in Thailand.

Management of advanced-stage oral cancer adds a great burden to individuals and health care systems. Community-based oral cancer screening can be beneficial in early detection and treatment. In this study, a novel oral cancer screening program was conducted utilizing an existing network of health care personnel, facilities, and digital database management for efficient coverage of a large population. The screening program considered 392,396 individuals aged ≥40 from four northeastern provinces in Thailand. Three levels of screening were performed: S1 by village healthcare volunteers to identify risk groups, S2 by dental auxiliaries to visually identify abnormal oral lesions, and S3 by dentists for final diagnosis and management. A total of 349,318 individuals were interviewed for S1, and 192,688 were identified as a risk group. For S2, 88,201 individuals appeared, and 2969 were further referred. Out of 1779 individuals who appeared for S3, oral potentially malignant disorders (OPMDs) were identified in 544, non-OPMDs in 1047, doubtful lesions in 52, and no results in 136 individuals. Final treatment was carried out in 704 individuals that included biopsies of 504 lesions, exhibiting 25 cancerous lesions and 298 OPMDs. This study is so far one of the largest oral cancer screening programs conducted in Thailand and showed effective implementation of community-based oral cancer screening.

Velscope guided oral cancer screening

Context:Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope.Aims:Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder.Settings and Design:A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India.Materials and Methods:Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed.Statistical Analysis Used:Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome.Results:The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity.Conclusions:The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.

1375Age-standardization to world population and under-estimation of oral cancer burden

Abstract Background Age-standardization is common for adjustment of unequal population in different ages as it can influence cancer incidence. However, for planning healthcare services (including screening), one needs absolute magnitude since everyone needs intervention. This study assessed the effect of age-standardization on understanding the global differentials in magnitude of oral cancer. Methods Data on cancer incidence rates of oral cancers for 2008-2012, was obtained from the website of international agency for research on cancer for all 334 population-based cancer registries. Scatter plots were prepared between age-standardized and crude incidence rates to assess the ratio between them according to proportion of old people for all countries. Areas with high occurrence of oral cancer were identified. Results The ratio between age-standardized and crude incidence rate was >1 in countries with high proportion of older population (high-development-index countries), indicating an artificial widening of gap between incidence rates between countries due to age-standardization. Six areas had higher crude incidence rate among men than India. Based on the published estimates, the per-unit-population burden in Europe was 6.3% higher than India, while in USA it was merely 12.5% lower than India. Conclusions The perception of low burden of oral cancer in high-economy countries is artificial, brought about by common practice of age-standardization. Key messages Organization of oral cancer screening activities by countries with resources and expertise will provide much needed knowledge on its natural history and efficacy of control strategies.

It's not just about the teeth: The importance of screening for oral cancer and raising awareness

It's not just about the teeth: The importance of screening for oral cancer and raising awareness

Leveraging Clinical Decision Support and Integrated Medical-Dental Electronic Health Records to Implementing Precision in Oral Cancer Risk Assessment and Preventive Intervention.

Introduction: Precision medicine is focused on serving the unique needs of individuals. Oral and oropharyngeal cancer risk assessment identifies individual risk factors while providing support to reduce risk. The objective is to examine potential current and future strategies to broadly implement evidence-based oral and oropharyngeal cancer risk assessment and screening in dental practices throughout the United States. Methods: Feasible and effective oral cancer risk assessment and risk reduction strategies, ripe for implementation in dental practice, were identified in the published literature. Results: The Screening, Brief Intervention, Referral for Treatment (SBIRT) model is a feasible approach to assessing individual oral cancer risk and providing risk reducing interventions in the dental setting. HPV is a more recently identified risk factor that dentistry is well positioned to address. Evidence supporting the utilization of specific risk assessment tools and risk reduction strategies is summarized and future opportunities discussed. Discussion: Current knowledge of risk factors for oral and oropharyngeal cancers support the recommendation for dental providers to routinely assess all patients for risk factors, educate them about their personal level of cancer risk, and recommend actions to reduce relevant risk factors. Individuals ages 9–26 should be asked about their HPV vaccination status, educated about HPV and oropharyngeal cancer and receive a recommendation to get the HPV vaccination.

Acceptability, Utility, and Cost of a Mobile Health Cancer Screening Education Application for Training Primary Care Physicians in India.

PurposeMobile health (mHealth)–based oncology education can be a powerful tool for providing cancer screening knowledge to physicians, as mobile technology is widely available and inexpensive. We developed a mobile application (M‐OncoED) to educate physicians on cancer screening and tested the acceptability, utility, and cost of two different approaches to recruit physicians.MethodsM‐OncoED was designed to perform pre‐ and postlearning assessments through the in‐built quizzes; present case studies and educational materials for cervical, breast, and oral cancer screening; collect responses to interactive queries; document module completion; send reminders and alerts; and track user metrics, including number of sessions to complete each module and time spent per session. We tested two recruitment approaches: a broad‐scale recruitment group, for which we relied on e‐mails, messaging apps (e.g., WhatsApp), and phone calls, and the targeted recruitment group, for which we conducted a face‐to‐face meeting for the initial invitation.ResultsOverall, about 35% of those invited in the targeted group completed the course compared with about 3% in the broad‐based recruitment group. The targeted recruitment approach was more cost‐efficient ($55.33 vs. $109.43 per person). Cervical cancer screening knowledge increased by about 30 percentage points, and breast cancer screening knowledge increased by 10 percentage points. There was no change in knowledge for oral cancer scorings.ConclusionThis study has demonstrated the feasibility and utility of using an mHealth app to educate physicians. A more intensive hands‐on recruitment approach is likely required to engage physicians to download and complete the app. Future studies should assess the impact of mHealth tools on physician behavior and patient outcomes.Implications for PracticeMobile health (mHealth)–based oncology education can be a powerful tool for providing cancer screening knowledge to physicians, as mobile technology is widely available and inexpensive. This study has demonstrated the feasibility and utility of using an mHealth app to educate physicians and illustrates the type of recruitment approach (face‐to‐face) that is likely required to incentivize physicians to download the app and complete the training.

Package of Essential Noncommunicable Disease Services at Peri-Urban Community Setting in Chandigarh, India- An Implementation Research Study

Background: The National Programme for prevention and control of cancer, diabetes, cardiovasculardisease,and stroke (NPCDCS) has been launched since 2011-2012 but there is paucity of information on progressand implementation of this program.Method: The objective was to do situational analysis for assessing the current implementation of NCDprograms in peri-urban area and to implement the package of essential NCD services by capacity buildingof existing staff through routine health care delivery for effective coverage. After training of ANMsimplementation was started. Baseline assessment was performed through pre-tested questionnaire amongsubjects (n=1026) who were aged> 30 years and residing in that area for >6 months.Result: About 37% (n= 406) of the people were screened for hypertension, 34% (n=352) were screened fordiabetes in the last one year. Post intervention screening coverage was increased to 96.9%, 97.5% for bloodsugar and blood pressure respectively and 95.4%, 93.4% and 54.8% for oral, breast and cervical cancer.After implementation 23(2.4%) new cases of diabetes and 132 (13.2%) new cases of hypertension werediagnosed.Conclusion: Screening coverage at baseline analysis was found to be 37.1% and 34% for blood pressure andblood sugar measurement respectively and 0.5%, 0.2%, 0.3% for oral, breast and cervical cancer screening,respectively. This highlights the poor implementation of the programme. After implementation, screeningcoverage for measurement of blood pressure and blood sugar improved by about 60% and by about 90% forthree common cancers.

Validation of a Point-of-Care Optical Coherence Tomography Device with Machine Learning Algorithm for Detection of Oral Potentially Malignant and Malignant Lesions.

Simple SummaryEarly detection is crucial towards improving survival in patients diagnosed with oral cancer. Non-invasive strategies equivalent to histology diagnosis are extremely valuable in oral cancer screening and early detection in resource-constrained settings. Optical coherence tomography (OCT), an optical biopsy technique enables real-time imaging with periodic surveillance and capability to image architectural features of the tissues. We report that while OCT system delineates oral pre-cancer and cancer with more than 90% sensitivity, integration, with artificial neural network-based analysis efficiently identifies high-risk, oral pre-cancer (83%). This study provides evidence that the robust, low-cost system was effective as a point-of-care device in resource-constrained settings. The high accuracy and portability signify widespread clinical application in oral cancer screening and/or surveillance.Non-invasive strategies that can identify oral malignant and dysplastic oral potentially-malignant lesions (OPML) are necessary in cancer screening and long-term surveillance. Optical coherence tomography (OCT) can be a rapid, real time and non-invasive imaging method for frequent patient surveillance. Here, we report the validation of a portable, robust OCT device in 232 patients (lesions: 347) in different clinical settings. The device deployed with algorithm-based automated diagnosis, showed efficacy in delineation of oral benign and normal (n = 151), OPML (n = 121), and malignant lesions (n = 75) in community and tertiary care settings. This study showed that OCT images analyzed by automated image processing algorithm could distinguish the dysplastic-OPML and malignant lesions with a sensitivity of 95% and 93%, respectively. Furthermore, we explored the ability of multiple (n = 14) artificial neural network (ANN) based feature extraction techniques for delineation high grade-OPML (moderate/severe dysplasia). The support vector machine (SVM) model built over ANN, delineated high-grade dysplasia with sensitivity of 83%, which in turn, can be employed to triage patients for tertiary care. The study provides evidence towards the utility of the robust and low-cost OCT instrument as a point-of-care device in resource-constrained settings and the potential clinical application of device in screening and surveillance of oral cancer.

Cost-effectiveness of oral cancer screening approaches by visual examination: Systematic review.

The present study is the first systematic review of papers that have performed a full economic evaluation on oral cancer screening strategies using visual oral examination. The review questions were (1) Is screening a cost-effective strategy in oral cancer? (2) What is the most cost-effective strategy among the different screening approaches in oral cancer? The main outcome measure was the incremental cost-effectiveness ratio. The study identifies and reviews seven full economic evaluations. The included studies scored 75%-100% on the methodological appraisal. Majority of the studies reports that oral cancer screening is a cost-effective strategy, especially in an opportunistic setting and high-risk subset of patients. The results were sensitive to cost and effectiveness parameters. Oral cancer screening, though found cost-effective, the uncertainty around these parameters necessitates additional studies that include better estimates in the modeling assessments. The heterogeneity in studies limited comparison and generalization.

EVALUATION OF AWARENESS, KNOWLEDGE, ATTITUDE AND SCREENING OF ORAL CANCER AMONG DENTAL PRACTITIONERS AND DENTAL STUDENTS- AN ONLINE QUESTIONAIRE BASED CROSS-SECTIONAL STUDY

Background: Oral cancer is a silent invasive disease with poor prognosis and more than 60 % of these cases were diagnosed in later stages. Early diagnosis of the malignancy greatly increased survival rates as the mouth is easily accessible for self or clinical examination. Lack of awareness among dental practitioners and health care providers is the most significant factor in delaying diagnosis and treatment of oral cancer.
 Aim & Objective: 1) To assess the level of knowledge and awareness regarding oral cancer, its clinical presentation and associated risk factors among dental practitioners and dental students.2) To explore dentists’ attitude regarding their role in screening, detection and prevention of oral cancer.
 Material & Methods: A cross sectional online survey was conducted on 300 dental practitioners and dental students, who are working and studying in recognized dental institutes and dental clinics receptively in the area around tri-city. A validated questionnaire survey comprised of 29 questions regarding a basic knowledge and awareness, and attitude and screening of oral cancer was distributed randomly among the participants. The Performa was distributed through electronic media and all the participants filled the questionnaire Performa. Performa was based on the demographic data and to raise the awareness, knowledge, attitude and screening of oral cancer among dental practitioners and dental students. All the data were collected, tabulated and analysed using SPSS software 20.
 Results: A total of 300 dental practitioners and dental students were approached, of which 273 participated in the study. The response rate of the study was 91%. Among the various risk factors for causing oral cancer, the use of alcohol was identified as a major risk factor by 267 (97.8%) dentists. The high-risk age group for oral cancer was identified in between 40-60 years by 246 (90.1%) dentists. Two hundred and forty-four (89.4%) dentists strongly agreed that patients should be referred to specialists if they suspected oral cancer in any lesion. Majority 97.8% of the dentists routinely practiced complete oral cavity examination on all patients who attended their practice.
 Conclusion: It can be concluded that though the mean knowledge and awareness, attitude, practice and screening about oral cancer among specialized dentists was good but there is a need to improve the knowledge and practices of risk factors for oral cancer among general dental practitioners by either collaborative approach by various specialties or by arranging continuous educational programs for them.
 Keywords: Oral cancer, oral cancer awareness, Poor oral hygiene, screening, Risk factors, Dental professionals

Abstract 87: Virtual Mentoring of Dentists in Oral Cancer Screening and Tobacco Cessation: An Advanced Level Program

Abstract Purpose: Oral cancer is the third common cancer in India, the mortality of which can be reduced by early detection. Dentists are ideal for this task and tobacco cessation owing to their forte of work. This paper discusses findings of a Project ECHO (Extension for Community Health Outcome)-based advanced telementoring program in these areas for dentists across India. Methods: The 14-week long training program in 2018, with weekly, hour-long sessions conducted by our Organization (hub) on Zoom app, had 52 participants (spokes) from across India. Each session comprised of an expert-led didactic, and case discussions by spokes. Participants were evaluated through online, pre- and post-training, and weekly post-session quizzes, along with weekly and post-one-year feedback. Successful spokes attended a hands-on workshop at our organization subsequently. Results: A notable increase in the overall and per-session mean knowledge score, and confidence in oral cancer screening was seen among the spokes. Many started such services at their respective clinics (and continued till even a year later) and reduced referrals to other healthcare facilities for confirmation of their diagnosis. They also felt motivated to spread community awareness about oral cancer prevention. Conclusion: The ECHO telementoring model comprising of expert didactics, case discussions by spokes, along with significant interaction between the spokes and experts, is a promising best-practice tool to reduce knowledge and skills disparity regarding oral cancer prevention among dentists situated across different locations. This in turn would enable these most appropriate healthcare providers to contribute towards the overall goal of oral cancer prevention. Citation Format: Suzanne Nethan, Amrita John, Priyanka Ravi, Vipin Kumar, Kavitha Dhanasekaran, Roshni Babu, Roopa Hariprasad. Virtual Mentoring of Dentists in Oral Cancer Screening and Tobacco Cessation: An Advanced Level Program [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 87.

Abstract 66: Screening and Risk Factor Analysis for Oral, Breast and Cervical Cancer amongst Garbage Cleaners of Bangalore, India; An Underserved Community.

Abstract Purpose: According to GLOBOCON 2018, in India oral cancer is the most common cancer among men while breast and cervical cancers are the most common cancers in women. Tobacco is a common and significant risk factor. This study was conducted amongst garbage cleaners of Bangalore, India. This population represents one of the lowest socio-economic classes in India due to poor health literacy and financial poverty. The objectives of this study were to identify the risk factors for oral, breast, and cervical cancer in this population and to identify premalignant and malignant lesions. Methods: A cross-sectional descriptive study was conducted in Bangalore, India. Validated questionnaires were used to assess risk factors. Over a period of one year, screening programs were conducted once a week in the municipality clinics. The screening included a visual exam of the oral cavity and exfoliative cytology of lesions, clinical breast exam (CBE), and pap smears. Follow up of suspected lesions were referred to higher centers for further management. Results: Of the 1123 attendees, 81.5% were women, 85% were illiterate. 68 oral premalignant lesions were identified on clinical exam and all of them underwent tobacco cessation counselling. 913/915 women underwent CBE, of which 23 were abnormal and were referred for mammogram. 28 abnormal pap smears were detected; 16 underwent biopsy:1 SCC (treated), 3 HSIL (1 treated/1 refused/1 under follow up), 2 LSIL (under follow up), 10 normal. Multiple logistic regression was done to assess the impact of risk factors on the oral pre-malignant cases. The intercept/constant was statistically significant with tobacco having a positive relationship while gender and age had a marginally positive relationship. Conclusion: Garbage cleaners represent a high-risk population due to poor health literacy, limited access to health care and hazardous working conditions. This program not only helped to create awareness about these cancers and the implications of tobacco use but also provided opportunity for screening. Imparting knowledge about oral and self-breast exams will help to create a sustainable model. Implementation of tobacco cessation programs would be beneficial. Citation Format: Chethana T, Punith Shetty, Radhika Kulkarni. Screening and Risk Factor Analysis for Oral, Breast and Cervical Cancer amongst Garbage Cleaners of Bangalore, India; An Underserved Community. [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 66.

Evaluation of Role of Visual Inspection Using Acetic Acid (VIA) and Exfoliative Cytology in Screening and Early Detection of Oral Premalignant Lesions and Oral Cancer.

Objective:Oral cancer accounts for 50–70% of total cancer mortality. VIA screening has drastically changed the morbidity and mortality related to cervical cancer. In present study, we assessed the role of 5% Acetic Acid as a vital stain in oral mucosa of chronic tobacco chewers, to know if it can help in early diagnosis and improved prognosis of oral malignancies and to assess the sensitivity and specificity of VIA and exfoliative cytology for screening of Oral premalignant and malignant lesions in high risk population with limited health care infrastructure.Methods:This was an outpatient department based prospective study done in a tertiary hospital over a period of two years. 150 cases with a history of chronic tobacco use were evaluated. Visual inspection (VI) followed by VIA using 5% Acetic acid was done. Oral scrapes were taken for cytological examination followed by biopsy for histopathological evaluation, wherever possible. Results:Sensitivity, specificity, PPV, NPV and accuracy of VIA and Exfoliative cytology was 71%, 65%, 83%, 48%, 69% and 98%, 65%, 89%, 92%, 88% respectively keeping histology as gold standard. Conclusion:Acetic acid along with exfoliative cytology can be used as simple, cost effective and convenient methods for mass screening of OPMDs and OSCC in high risk population where biopsy is not possible.

Early Diagnosis and Screening of Oral Cancers

Early Diagnosis and Screening of Oral Cancers

The College of American Pathologists Foundation's See, Test & Treat Program®: an Evaluation of a One-Day Cancer Screening Program Implemented in Mississippi.

Women in Mississippi experience significant barriers to healthcare that results in high incidence rates of late-stage breast, cervical, and oropharyngeal cancer. We implemented See, Test, & Treat, a cancer screening and education program, that was aimed at increasing access to cancer screening for underserved women in the Jackson Metropolitan Area. During the event, 103 women between the ages of 21 and 69years old received breast, cervical, and/or oral cancer screenings. Quantitative and qualitative data were collected to evaluate the effect of the program on the participants' cancer screening knowledge, self-efficacy to obtain medical check-ups, and intentions to engage in health-enhancing behaviors. Of the 57 women who received a mammogram, 18 had abnormal results that required follow-up care. None of the women who received a Pap test had abnormal results, but 8 women were diagnosed with trichomoniasis. One woman was diagnosed with stage 4 oral cancer. The evaluation data indicated that participants found that free cancer screenings and receipt of results on the same day were primary benefits of the program.

Mobile-based oral cancer classification for point-of-care screening.

.Significance: Oral cancer is among the most common cancers globally, especially in low- and middle-income countries. Early detection is the most effective way to reduce the mortality rate. Deep learning-based cancer image classification models usually need to be hosted on a computing server. However, internet connection is unreliable for screening in low-resource settings.Aim: To develop a mobile-based dual-mode image classification method and customized Android application for point-of-care oral cancer detection.Approach: The dataset used in our study was captured among 5025 patients with our customized dual-modality mobile oral screening devices. We trained an efficient network MobileNet with focal loss and converted the model into TensorFlow Lite format. The finalized lite format model is and ideal for smartphone platform operation. We have developed an Android smartphone application in an easy-to-use format that implements the mobile-based dual-modality image classification approach to distinguish oral potentially malignant and malignant images from normal/benign images.Results: We investigated the accuracy and running speed on a cost-effective smartphone computing platform. It takes to process one image pair with the Moto G5 Android smartphone. We tested the proposed method on a standalone dataset and achieved 81% accuracy for distinguishing normal/benign lesions from clinically suspicious lesions, using a gold standard of clinical impression based on the review of images by oral specialists.Conclusions: Our study demonstrates the effectiveness of a mobile-based approach for oral cancer screening in low-resource settings.