Oral cancer visual screening
A trained health worker looking inside the mouth with a light can find mouth cancer early; in India this cut deaths by a third among people who use tobacco or alcohol.
Overview
The Kerala cluster-randomised trial (Trivandrum Oral Cancer Screening Study, Lancet 2005) randomised 13 clusters with 191,873 people to three rounds of visual oral examination by trained health workers or to usual care; among tobacco or alcohol users, oral cancer mortality was reduced by about a third (rate ratio 0.66), a benefit sustained at 15 years, with no significant effect in people without those risk factors. It remains the only randomised evidence for any oral cancer screening and underpins India's national programme of opportunistic oral visual examination for people over 30 in the non-communicable disease clinics. The USPSTF (2013) found insufficient evidence for screening asymptomatic adults in the US, where incidence is lower and increasingly driven by HPV in the throat rather than tobacco in the mouth. Dentists' routine examination is the de facto screen in high-income countries.
How it works
Systematic inspection and palpation of the oral mucosa under good light for leukoplakia, erythroplakia, ulcers and masses, with referral for biopsy.
- No equipment, deliverable by community health workers
- Randomised evidence of mortality reduction in high-risk users
- Benefit confined to tobacco and alcohol users
- Compliance with referral for biopsy is the weak link
- Does not address HPV-related oropharyngeal cancer
Latest papers
topQuery for this technology: (TITLE:"Oral cancer visual screening" OR ABSTRACT:"Oral cancer visual screening") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Oral cancer visual screening, not a curated reading list.
Pages like this
not linked directly; found by shared links- Key paperEffect of screening on oral cancer mortality in Kerala, India
Shares Kerala oral cancer visual screening trial (Trivandrum), Head and neck squamous cell carcinoma.
- PersonRengaswamy Sankaranarayanan
Shares Kerala oral cancer visual screening trial (Trivandrum), Head and neck squamous cell carcinoma.