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Gurushanth K, Sunny SP, Kuriakose MA, Birur PN. Feasibility, Reliability, and Effectiveness of Oral cancer screening in South Asia and Southeast Asian countries: A systematic review and Meta-analysis. Oral Dis 2024. [PMID: 38817091 DOI: 10.1111/odi.15001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES The incidence of oral cancer is significantly high in South Asia and Southeast Asia. Organized screening is an effective approach to early detection. The aim of this systematic review and meta-analysis was to evaluate the reliability, diagnostic accuracy, and effectiveness of visual oral screening by community health workers (CHWs) in identifying oral cancer/oral potentially malignant disorders (OPMDs) in this region. MATERIALS AND METHODS We conducted a bibliographic search in PubMed, Scopus, the gray literature of Google Scholar, ProQuest dissertations, and additional manual searches. Twelve articles were included for qualitative synthesis and six for meta-analysis. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and forest plot analysis were performed. RESULTS Meta-analysis showed CHWs identified 8% (n = 6365) as suspicious and 92% (n = 74,140) as normal. The diagnostic accuracy of visual oral screening by CHWs showed a sensitivity of 75% (CI: 74-76) and specificity of 97% (CI: 97-97) in the detection of OPMDs/oral cancer. Forest plots were obtained using a random effects model (DOR: 24.52 (CI: 22.65-26.55)) and SAUC: 0.96 (SE = 0.05). CONCLUSIONS Oral visual examination by trained CHWs can be utilized for community screenings to detect oral cancer early. This approach can be used in primary healthcare to triage patients for further referral and management.
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Affiliation(s)
| | - Sumsum P Sunny
- Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Bengaluru, Karnataka, India
| | | | - Praveen N Birur
- KLE Society's Institute of Dental Sciences, Bengaluru, Karnataka, India
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2
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Gupta S, Singh B, Abhishek R, Gupta S, Sachan M. The emerging role of liquid biopsy in oral squamous cell carcinoma detection: advantages and challenges. Expert Rev Mol Diagn 2024; 24:311-331. [PMID: 38607339 DOI: 10.1080/14737159.2024.2340997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Oral Squamous Cell Carcinoma (OSCC), the sixth most widespread malignancy in the world, accounts for 90% of all cases of oral cancer. The primary risk factors are tobacco chewing, alcohol consumption, viral infection, and genetic modifications. OSCC has a high morbidity rate due to the lack of early diagnostic methods. Nowadays, liquid biopsy plays a vital role in the initial diagnosis of oral cancer. ctNAs extracted from saliva and serum/plasma offer meaningful insights into tumor genetics and dynamics. The interplay of these elements in saliva and serum/plasma showcases their significance in advancing noninvasive, effective OSCC detection and monitoring. AREAS COVERED This review mainly focused on the role of liquid biopsy as an emerging point in the diagnosis and prognosis of OSCC and the current advancements and challenges associated with liquid biopsy. EXPERT OPINION Liquid biopsy is regarded as a new, minimally invasive, real-time monitoring tool for cancer diagnosis and prognosis. Many biomolecules found in bodily fluids, including ctDNA, ctRNA, CTCs, and EVs, are significant biomarkers to identify cancer in its early stages. Despite these groundbreaking strides, challenges persist. Standardization of sample collection, isolation, processing, and detection methods is imperative for ensuring result reproducibility across diverse studies.
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Affiliation(s)
- Sudha Gupta
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, India
| | - Brijesh Singh
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, India
| | - Rajul Abhishek
- Department of Surgical Oncology, Motilal Nehru Medical College, Prayagraj, India
| | - Sameer Gupta
- Department of Surgical Oncology, King George Medical University, Lucknow, India
| | - Manisha Sachan
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, India
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3
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Rich BJ, Samuels SE, Azzam GA, Kubicek G, Freedman L. Oral Cavity Squamous Cell Carcinoma: Review of Pathology, Diagnosis, and Management. Crit Rev Oncog 2024; 29:5-24. [PMID: 38683151 DOI: 10.1615/critrevoncog.2023050055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Squamous cell carcinoma of the oral cavity presents a significant global health burden, primarily due to risk factors such as tobacco smoking, smokeless tobacco use, heavy alcohol consumption, and betel quid chewing. Common clinical manifestations of oral cavity cancer include visible lesions and sores, often accompanied by pain in advanced stages. Diagnosis relies on a comprehensive assessment involving detailed history, physical examination, and biopsy. Ancillary imaging studies and functional evaluations aid in accurate staging and facilitate treatment planning. Prognostic information is obtained from histopathological factors, such as tumor grade, depth of invasion, lymphovascular invasion, and perineural invasion. Notably, lymph node metastasis, found in approximately half of the patients, carries significant prognostic implications. Effective management necessitates a multidisciplinary approach to optimize patient outcomes. Surgical resection is the backbone of treatment, aimed at complete tumor removal while preserving functional outcomes. Adjuvant therapies, including radiation and chemotherapy, are tailored according to pathological factors. Further work in risk stratification and treatment is necessary to optimize outcomes in squamous cell carcinoma of the oral cavity.
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Affiliation(s)
| | | | - Gregory A Azzam
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine
| | - Gregory Kubicek
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine
| | - Laura Freedman
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine
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4
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Lan R, Galieri AC, Catherine JH, Tardivo D. Oral cancer: Current status and public health perspectives. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:93-105. [PMID: 38040651 DOI: 10.3917/spub.hs1.2023.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Despite advances in surgical and oncological treatments, the incidence and five-year survival rates (~50 percent) of oral cancers (OC) have not improved over the last decades and remain a major public health problem. Seventy percent are still diagnosed at a late stage (T3 or T4), with an average delay in diagnosis of two to five months. As the cure and survival of patients are directly related to the development stage of the tumor at the time of diagnosis, the objective of this work was to analyze all the determinants related to oral cancer and to propose new clinical approaches for diagnosis and screening. A proposal for new models of screening, training, and concrete action to improve public awareness of the major global problem of OC is made. The strengths and weaknesses of OC screening studies need to be objectively understood to effectively guide and energize testing in primary care settings, with the prospect of using new and emerging technologies that can help improve the discriminatory accuracy of case detection. Most national organizations have not, to date, recommended population-based mass screening, due to a lack of sufficient scientific evidence of associated mortality reduction. Where health care resources are high, opportunistic individual screening is recommended, although the low diagnostic capacity of front-line clinicians is alarming.
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5
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Mavedatnia D, Cuddy K, Klieb H, Blanas N, Goodman J, Gilbert M, Eskander A. Oral cancer screening knowledge and practices among dental professionals at the University of Toronto. BMC Oral Health 2023; 23:343. [PMID: 37254183 DOI: 10.1186/s12903-023-03062-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 05/19/2023] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Opportunistic oral cancer screening during visits to the dentist is a non-invasive and accessible option for detection of pre-malignant lesions and early-stage malignancies. The objective of this study was to investigate the knowledge, practices, and attitudes towards oral cancer screening among dentists. METHODS A 42-item survey was sent to 650 dental professionals affiliated with the University of Toronto. Data regarding training/practice characteristics, knowledge of oral cavity cancer, current screening practices, attitudes towards screening, and remuneration were collected. RESULTS Ninety-one dentists responded. Most obtained their dental degree from Canada (71.4%) and were practicing in large urban centers (87.9%). Most dentists correctly identified the oral tongue (87.8%) and floor of mouth (80%) as the two of most common sites of oral cavity cancer but only 56% correctly identified the most common presentation. 91% performed intra/extra oral examinations at every patient visit. Only 9.9% of dentists discussed the risk factors of oral cancer and 33% were not familiar with resources for smoking cessation and alcohol abuse. International medical graduates were more likely to discuss risk factor management than Canadian medical graduates (p < 0.01). Over 80% of dentists referred to a specialist when a suspected lesion was found. The greatest barrier for oral cancer screening was lack of time. Almost all dentists (98.8%) reported that their screening practices do not differ depending on the patient's insurance status and 63.8% reported compensation would not influence their decision to perform oral examinations. CONCLUSION Most dentists have a good knowledge of the presentation and risk factors associated with oral cavity cancer. Most dentists perform screening with every patient, with no influence from compensation and insurance status. Dentists are therefore an excellent first contact for oral cavity cancer screening for the general public and for high-risk populations.
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Affiliation(s)
| | - Karl Cuddy
- Division of Oral and Maxillofacial Surgery, University of Toronto, Mount Sinai, Princess Margaret and Humber River Hospitals, Toronto, ON, Canada
| | - Hagen Klieb
- Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Nick Blanas
- Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Jade Goodman
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Melanie Gilbert
- Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Antoine Eskander
- Department of Otolaryngology - Head & Neck Surgery, Surgical Oncology, University of Toronto, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, ON, Canada.
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
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6
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Haron N, Rajendran S, Kallarakkal TG, Zain RB, Ramanathan A, Abraham MT, Lau SH, Cheng LC, Chong SMY, Mohamed Azahar FA, Mohamad Zaini Z, Chan SW, Goh YC, Lim D, Khairi J, Abidin MZ, Abdul Rahman ZA, Liew CS, Fong SC, Yang YH, Ismail SM, Cheong SC. High referral accuracy for oral cancers and oral potentially malignant disorders using telemedicine. Oral Dis 2023; 29:380-389. [PMID: 33914993 DOI: 10.1111/odi.13892] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/02/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the accuracy of MeMoSA®, a mobile phone application to review images of oral lesions in identifying oral cancers and oral potentially malignant disorders requiring referral. SUBJECTS AND METHODS A prospective study of 355 participants, including 280 with oral lesions/variants was conducted. Adults aged ≥18 treated at tertiary referral centres were included. Images of the oral cavity were taken using MeMoSA®. The identification of the presence of lesion/variant and referral decision made using MeMoSA® were compared to clinical oral examination, using kappa statistics for intra-rater agreement. Sensitivity, specificity, concordance and F1 score were computed. Images were reviewed by an off-site specialist and inter-rater agreement was evaluated. Images from sequential clinical visits were compared to evaluate observable changes in the lesions. RESULTS Kappa values comparing MeMoSA® with clinical oral examination in detecting a lesion and referral decision was 0.604 and 0.892, respectively. Sensitivity and specificity for referral decision were 94.0% and 95.5%. Concordance and F1 score were 94.9% and 93.3%, respectively. Inter-rater agreement for a referral decision was 0.825. Progression or regression of lesions were systematically documented using MeMoSA®. CONCLUSION Referral decisions made through MeMoSA® is highly comparable to clinical examination demonstrating it is a reliable telemedicine tool to facilitate the identification of high-risk lesions for early management.
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Affiliation(s)
| | | | - Thomas George Kallarakkal
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Rosnah Binti Zain
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Faculty of Dentistry, Saujana Putra Campus, MAHSA University, Selangor, Malaysia
| | - Anand Ramanathan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Oral Cancer Research & Coordinating Centre (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Mannil Thomas Abraham
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Shin Hin Lau
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Lai Choo Cheng
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Sherrie Mei Yee Chong
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Farah Aliya Mohamed Azahar
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia.,Oral Surgery Clinic, Hospital Serdang, Ministry of Health, Serdang, Malaysia
| | - Zuraiza Mohamad Zaini
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Siew Wui Chan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Yet Ching Goh
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Daniel Lim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Juliana Khairi
- Department of Oral and Maxillofacial Surgery, Hospital Tengku Ampuan Rahimah, Ministry of Health, Selangor, Malaysia.,Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Marzuki Zainal Abidin
- Oral Health Program, Ministry of Health Malaysia, Putrajaya, Malaysia.,Oral Surgery Clinic, Hospital Serdang, Ministry of Health, Serdang, Malaysia
| | - Zainal Ariff Abdul Rahman
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Sun Liew
- Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, Kuala Lumpur, Malaysia.,Data Intensive Computing Centre, Research Management & Innovation Complex, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Data Science, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Yi-Hsin Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Malaysia
| | - Siti Mazlipah Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Sok Ching Cheong
- Cancer Research Malaysia, Selangor, Malaysia.,Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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7
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Sulaiman D, Lohiya A, Rizwan SA, Singh A, Dwivedi P, Bahuguna P, Dixit J, Verma A, Kumar V. Diagnostic Accuracy of Screening of Lip and Oral Cavity Cancers or Potentially Malignant Disorders (PMD) by Frontline Workers: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2022; 23:3983-3991. [PMID: 36579978 PMCID: PMC9971487 DOI: 10.31557/apjcp.2022.23.12.3983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Oral cancer screening strategies help reduce associated mortality and could be performed by a trained frontline health worker (FHW). The present review aims to assess the diagnostic accuracy of commonly used screening modalities for oral cancer performed by FHW in apparently healthy individuals. METHODS Electronic databases PubMed, Scopus, Embase, Cochrane Library, and Google Scholar, were searched. The review included studies conducted where apparently healthy adult individuals were screened by the FHW for cancer or PMD of the lip and oral cavity by any of the four commonly used techniques - Conventional Oral Examination (COE), toluidine blue staining (TBS), Oral Cytology (OC), and Chemiluminescent Illumination (CLI). FINDINGS A total of 2,413 potentially relevant articles were retrieved from the search, among which five studies for COE were included in the review. Four out of those five studies were done before the year 2000. None of the studies fitted the inclusion criteria for TBS, OC, and CLI. Pooled sensitivity of oral screening by COE performed by an FHW (n=5) was 88.8% (95% CI: 71.6-96.1), whereas pooled specificity was 91.9% (95% CI: 78.3-97.3). On subgroup analysis, the pooled sensitivity and specificity of studies where the prevalence of disease was <50% (n=4) was 84.5% (95% CI: 62.6 - 94.7) and 94.1% (95% CI: 82.2 - 98.2), respectively. INTERPRETATION COE by trained FHW had high pooled sensitivity and specificity for screening of oral cancer and PMDs. The screening techniques TBS, OC, and CLI, were not studied for mass screening by trained FHW. COE by trained FHW could be utilized for oral screening in limited-resource settings. However, the FHW should be sufficiently trained to get the desired benefits of early detection. FUNDING Department of Health Research, Ministry of Health & Family Welfare, Government of India.
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Affiliation(s)
- Dahy Sulaiman
- Kalyan Singh Super Specialty Cancer Institute, Lucknow, India
| | - Ayush Lohiya
- Kalyan Singh Super Specialty Cancer Institute, Lucknow, India
| | - S A Rizwan
- ICMR-National Institute of Epidemiology, Chennai, India
| | - Ankita Singh
- Kalyan Singh Super Specialty Cancer Institute, Lucknow, India
| | - Pooja Dwivedi
- Kalyan Singh Super Specialty Cancer Institute, Lucknow, India
| | - Pankaj Bahuguna
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jyoti Dixit
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur Verma
- Kalyan Singh Super Specialty Cancer Institute, Lucknow, India
| | - Vijendra Kumar
- Kalyan Singh Super Specialty Cancer Institute, Lucknow, India
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8
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Guida A, Warnakulasuriya S. Stomatognathic Diseases: State of the Art and Future Perspectives. J Clin Med 2022; 11:jcm11216525. [PMID: 36362753 PMCID: PMC9655770 DOI: 10.3390/jcm11216525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Agostino Guida
- U.O.C. Odontostomatologia, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy
- Correspondence:
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 9RT, UK
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9
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Using machine learning and an electronic tongue for discriminating saliva samples from oral cavity cancer patients and healthy individuals. Talanta 2022; 243:123327. [DOI: 10.1016/j.talanta.2022.123327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/20/2022]
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10
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Ahuja NA, Kedia SK, Ward KD, Pichon LC, Chen W, Dillon PJ, Navaparia H. Effectiveness of Interventions to Improve Oral Cancer Knowledge: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:479-498. [PMID: 33506408 DOI: 10.1007/s13187-021-01963-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
Oral cancer is prone to late-stage diagnosis, and subsequent low five-year survival rates. A small number of interventions or campaigns designed to enhance knowledge of risk factors and symptoms associated with oral cancer have been attempted in the UK, US, and some other countries. The purpose of this systematic review is to assess the effectiveness of interventions designed to improve oral cancer knowledge. We searched five databases to identify randomized controlled trials (RCTs) and non-randomized/quasi-experimental (NR/QE) studies targeting the general population or high-risk groups (tobacco users or alcohol consumers), aged ≥15 years, and reporting the outcomes of individual and/or community level interventions. Two co-authors independently identified relevant studies, extracted data, and assessed the risk of bias. Adhering to PRISMA guidelines, 27 (eight RCTs and 19 NR/QE studies) of the 551 studies identified from the five databases met the inclusion criteria. All RCTs and nine NR/QE studies used either printed materials, health education sessions, multimedia aids, or some combinations of these tools. The other ten NR/QE studies were community-based and used mass media campaigns to increase oral cancer awareness. Overall, the majority of studies significantly improved oral cancer knowledge; however, heterogeneity in study design and variation in measurement tools made it difficult to compare outcomes. Findings suggest that individual and/or community level interventions are generally effective in increasing knowledge of oral cancer risk factors, signs and symptoms, and/or its early diagnosis and prevention strategies among the general population or high-risk groups. However, the long-term benefits of these interventions are understudied.
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Affiliation(s)
- Nikhil A Ahuja
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA.
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Weiyu Chen
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| | - Hitesh Navaparia
- Department of Oral and Maxillofacial Surgery, Vaidik Dental College and Research Center, Daman, India
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11
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Mendonca P, Sunny SP, Mohan U, Birur N P, Suresh A, Kuriakose MA. Non-invasive imaging of oral potentially malignant and malignant lesions: A systematic review and meta-analysis. Oral Oncol 2022; 130:105877. [PMID: 35617750 DOI: 10.1016/j.oraloncology.2022.105877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/09/2022] [Accepted: 04/18/2022] [Indexed: 12/19/2022]
Abstract
Non-invasive (NI) imaging techniques have been developed to overcome the limitations of invasive biopsy procedures, which is the gold standard in diagnosis of oral dysplasia and Oral Squamous Cell Carcinoma (OSCC). This systematic review and meta- analysis was carried out with an aim to investigate the efficacy of the NI-imaging techniques in the detection of dysplastic oral potentially malignant disorders (OPMDs) and OSCC. Records concerned in the detection of OPMDs, Oral Cancer were identified through search in PubMed, Science direct, Cochrane Library electronic database (January 2000 to October 2020) and additional manual searches. Out of 529 articles evaluated for eligibility, 56 satisfied the pre-determined inclusion criteria, including 13 varying NI-imaging techniques. Meta-analysis consisted 44 articles, wherein majority of the studies reported Autofluorescence (AFI-38.6%) followed by Chemiluminescence (CHEM), Narrow Band Imaging (NBI) (CHEM, NBI-15.9%), Fluorescence Spectroscopy (FS), Diffuse Reflectance Spectroscopy (DRS), (FS, DRS-13.6%) and 5aminolevulinic acid induced protoporphyrin IX fluorescence (5ALA induced PPIX- 6.8%). Higher sensitivities (Sen) and specificities (Spe) were obtained using FS (Sen:74%, Spe:96%, SAUC=0.98), DRS (Sen:79%, Spe:86%, SAUC = 0.91) and 5 ALA induced PPIX (Sen:91%, Spe:78%, SAUC = 0.98) in the detection of dysplastic OPMDs from non-dysplastic lesions(NDLs). AFI, FS, DRS, NBI showed higher sensitivities and SAUC (>90%) in differentiating OSCC from NDLs. Analysed NI-imaging techniques suggests the higher accuracy levels in the diagnosis of OSCC when compared to dysplastic OPMDs. 5 ALA induced PPIX, DRS and FS showed evidence of superior accuracy levels in differentiation of dysplastic OPMDs from NDLs, however results need to be validated in a larger number of studies.
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Affiliation(s)
- Pramila Mendonca
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Sumsum P Sunny
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Uma Mohan
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Praveen Birur N
- KLE Society's Institute of Dental Sciences, #20, Yeshwanthpur Suburb, II Stage, Tumkur Road, Bangalore 22, India.
| | - Amritha Suresh
- Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Moni A Kuriakose
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
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12
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Bouaoud J, Bossi P, Elkabets M, Schmitz S, van Kempen LC, Martinez P, Jagadeeshan S, Breuskin I, Puppels GJ, Hoffmann C, Hunter KD, Simon C, Machiels JP, Grégoire V, Bertolus C, Brakenhoff RH, Koljenović S, Saintigny P. Unmet Needs and Perspectives in Oral Cancer Prevention. Cancers (Basel) 2022; 14:cancers14071815. [PMID: 35406587 PMCID: PMC8997728 DOI: 10.3390/cancers14071815] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022] Open
Abstract
Oral potentially malignant disorders (OPMD) may precede oral squamous cell carcinoma (OSCC). Reported rates of malignant transformation of OPMD range from 3 to 50%. While some clinical, histological, and molecular factors have been associated with a high-risk OPMD, they are, to date, insufficiently accurate for treatment decision-making. Moreover, this range highlights differences in the clinical definition of OPMD, variation in follow-up periods, and molecular and biological heterogeneity of OPMD. Finally, while treatment of OPMD may improve outcome, standard therapy has been shown to be ineffective to prevent OSCC development in patients with OPMD. In this perspective paper, several experts discuss the main challenges in oral cancer prevention, in particular the need to (i) to define an OPMD classification system by integrating new pathological and molecular characteristics, aiming (ii) to better identify OPMD at high risk of malignant transformation, and (iii) to develop treatment strategies to eradicate OPMD or prevent malignant transformation.
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Affiliation(s)
- Jebrane Bouaoud
- Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, CNRS 5286, INSERM 1052, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France;
- Department of Translational Research and Innovation, Centre Léon Bérard, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France; (V.G.); (C.B.)
- Department of Maxillo-Facial Surgery, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
- Correspondence: (J.B.); (P.S.)
| | - Paolo Bossi
- Medical Oncology, ASST Spedali Civili Brescia, I-25064 Brescia, Italy;
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, I-25123 Brescia, Italy
| | - Moshe Elkabets
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (M.E.); (S.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Sandra Schmitz
- Department of Medical Oncology and Head and Neck Surgery, Institut Roi Albert II, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (Pole MIRO), UCLouvain, 1200 Brussels, Belgium; (S.S.); (J.-P.M.)
| | - Léon C. van Kempen
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands;
| | - Pierre Martinez
- Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, CNRS 5286, INSERM 1052, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France;
- Department of Translational Research and Innovation, Centre Léon Bérard, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France; (V.G.); (C.B.)
| | - Sankar Jagadeeshan
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (M.E.); (S.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, F-94805 Villejuif, France;
| | - Gerwin J. Puppels
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Room Ee-1691, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands;
| | - Caroline Hoffmann
- INSERM U932 Research Unit, Department of Surgery, Institut Curie, PSL Research University, F-75006 Paris, France;
| | - Keith D. Hunter
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK;
| | - Christian Simon
- Department of Otolaryngology and Head and Neck Surgery, Lausanne University Hospital, 1011 Lausanne, Switzerland;
| | - Jean-Pascal Machiels
- Department of Medical Oncology and Head and Neck Surgery, Institut Roi Albert II, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (Pole MIRO), UCLouvain, 1200 Brussels, Belgium; (S.S.); (J.-P.M.)
| | - Vincent Grégoire
- Department of Translational Research and Innovation, Centre Léon Bérard, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France; (V.G.); (C.B.)
- Radiation Oncology Department, Centre Léon Bérard, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France
| | - Chloé Bertolus
- Department of Translational Research and Innovation, Centre Léon Bérard, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France; (V.G.); (C.B.)
- Department of Maxillo-Facial Surgery, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| | - Ruud H. Brakenhoff
- Cancer Center Amsterdam, Section Head and Neck Cancer Biology & Immunology, Otolaryngology and Head and Neck Surgery, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands;
| | - Senada Koljenović
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands;
| | - Pierre Saintigny
- Centre de Recherche en Cancérologie de Lyon, Centre Léon Bérard, CNRS 5286, INSERM 1052, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France;
- Department of Translational Research and Innovation, Centre Léon Bérard, Université Claude Bernard Lyon 1, University Lyon, F-69008 Lyon, France; (V.G.); (C.B.)
- Department of Medical Oncology, Centre Léon Bérard, Université Claude Bernard Lyon 1, University Lyon, 28 Promenade Léa et Napoléon Bullukian, F-69008 Lyon, France
- Correspondence: (J.B.); (P.S.)
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Eccles K, Carey B, Cook R, Escudier M, Diniz-Freitas M, Limeres-Posse J, Monteiro L, Silva L, Fricain JC, Catros S, Lodi G, Lombardi N, Brailo V, Brzak BL, Ariyaratnam R, Albuquerque R. Oral potentially malignant disorders: advice on management in primary care. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2022. [DOI: 10.1051/mbcb/2022017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: The diagnosis of and risks associated with oral potentially malignant disorders (OPMD) have been widely reported, but little has been published on the management of OPMDs in a primary dental care setting. Hospital services face ongoing pressures due to long-term follow-up, with a need for surveillance to be jointly undertaken with primary dental care clinicians. In a primary care setting, identification and surveillance of OPMDs can be challenging as no universal guidance exists on recommended recall intervals. Corpus: In this article, an update on OPMDs is provided and, based on the practices of six Oral Medicine units in Europe (London (United Kingdom), Milan (Italy), Bordeaux (France), Porto (Portugal), Zagreb (Croatia) and Santiago de Compostela (Spain)), aiming to provide guidance on monitoring in a primary care setting in Europe. Conclusion: Oral medicine clinicians can provide guidance to general dental practitioners (GDPs) on recommended recall intervals. It is important that they feel confident in monitoring these conditions and, when concerned, to arrange referral to a hospital or appropriate specialist. GDPs should document descriptions of lesions and, if possible, take clinical photographs. Patients should be counselled on modifiable lifestyle factors and directed to oral medicine society websites to access patient information leaflets.
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14
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Walsh T, Warnakulasuriya S, Lingen MW, Kerr AR, Ogden GR, Glenny AM, Macey R. Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults. Cochrane Database Syst Rev 2021; 12:CD010173. [PMID: 34891214 PMCID: PMC8664456 DOI: 10.1002/14651858.cd010173.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The early detection of oral cavity squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD), followed by appropriate treatment, may improve survival and reduce the risk for malignant transformation respectively. This is an update of a Cochrane Review first published in 2013. OBJECTIVES To estimate the diagnostic test accuracy of conventional oral examination, vital rinsing, light-based detection, mouth self-examination, remote screening, and biomarkers, used singly or in combination, for the early detection of OPMD or OSCC in apparently healthy adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 October 2020), MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the test accuracy of any of the aforementioned tests in detecting OPMD or OSCC during a screening procedure. Diagnosis of OPMD or OSCC was provided by specialist clinicians or pathologists, or alternatively through follow-up. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction, and quality assessment were carried out by at least two authors independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). We reported the sensitivity and specificity of the included studies. We provided judgement of the certainty of the evidence using a GRADE assessment. MAIN RESULTS We included 18 studies, recruiting 72,202 participants, published between 1986 and 2019. These studies evaluated the diagnostic test accuracy of conventional oral examination (10 studies, none new to this update), mouth self-examination (four studies, two new to this update), and remote screening (three studies, all new to this update). One randomised controlled trial of test accuracy directly evaluated conventional oral examination plus vital rinsing versus conventional oral examination alone. There were no eligible studies evaluating light-based detection or blood or salivary sample analysis (which tests for the presence of biomarkers for OPMD and OSCC). Only one study of conventional oral examination was judged as at overall low risk of bias and overall low concern regarding applicability. Given the clinical heterogeneity of the included studies in terms of the participants recruited, setting, prevalence of the target condition, the application of the index test and reference standard, and the flow and timing of the process, the data could not be pooled within the broader categories of index test. For conventional oral examination (10 studies, 25,568 participants), prevalence in the test accuracy sample ranged from 1% to 51%. For the seven studies with prevalence of 10% or lower, a prevalence more comparable to the general population, the sensitivity estimates were variable, and ranged from 0.50 (95% confidence interval (CI) 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00); the specificity estimates were more consistent and ranged from 0.94 (95% CI 0.88 to 0.97) to 0.99 (95% CI 0.98 to 1.00). We judged the overall certainty of the evidence to be low, and downgraded for inconsistency and indirectness. Evidence for mouth self-examination and remote screening was more limited. We judged the overall certainty of the evidence for these index tests to be very low, and downgraded for imprecision, inconsistency, and indirectness. We judged the evidence for vital rinsing (toluidine blue) as an adjunct to conventional oral examination compared to conventional oral examination to be moderate, and downgraded for indirectness as the trial was undertaken in a high-risk population. AUTHORS' CONCLUSIONS There is a lack of high-certainty evidence to support the use of screening programmes for oral cavity cancer and OPMD in the general population. Frontline screeners such as general dentists, dental hygienists, other allied professionals, and community healthcare workers should remain vigilant for signs of OPMD and OSCC.
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Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Mark W Lingen
- Pritzker School of Medicine, Division of Biological Sciences, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, USA
| | - Graham R Ogden
- Division of Oral and Maxillofacial Clinical Sciences, School of Dentistry, University of Dundee, Dundee, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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15
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Banavar G, Ogundijo O, Toma R, Rajagopal S, Lim YK, Tang K, Camacho F, Torres PJ, Gline S, Parks M, Kenny L, Perlina A, Tily H, Dimitrova N, Amar S, Vuyisich M, Punyadeera C. The salivary metatranscriptome as an accurate diagnostic indicator of oral cancer. NPJ Genom Med 2021; 6:105. [PMID: 34880265 PMCID: PMC8654845 DOI: 10.1038/s41525-021-00257-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/21/2021] [Indexed: 12/11/2022] Open
Abstract
Despite advances in cancer treatment, the 5-year mortality rate for oral cancers (OC) is 40%, mainly due to the lack of early diagnostics. To advance early diagnostics for high-risk and average-risk populations, we developed and evaluated machine-learning (ML) classifiers using metatranscriptomic data from saliva samples (n = 433) collected from oral premalignant disorders (OPMD), OC patients (n = 71) and normal controls (n = 171). Our diagnostic classifiers yielded a receiver operating characteristics (ROC) area under the curve (AUC) up to 0.9, sensitivity up to 83% (92.3% for stage 1 cancer) and specificity up to 97.9%. Our metatranscriptomic signature incorporates both taxonomic and functional microbiome features, and reveals a number of taxa and functional pathways associated with OC. We demonstrate the potential clinical utility of an AI/ML model for diagnosing OC early, opening a new era of non-invasive diagnostics, enabling early intervention and improved patient outcomes.
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Affiliation(s)
- Guruduth Banavar
- Viome Research Institute, Viome Life Sciences, Inc., New York City, USA.
| | - Oyetunji Ogundijo
- Viome Research Institute, Viome Life Sciences, Inc., New York City, USA
| | - Ryan Toma
- Viome Research Institute, Viome Life Sciences, Inc., Seattle, USA
| | | | - Yen Kai Lim
- The Saliva and Liquid Biopsy Translational Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- The Translational Research Institute, Woolloongabba, Brisbane, QLD, Australia
| | - Kai Tang
- The Saliva and Liquid Biopsy Translational Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- The Translational Research Institute, Woolloongabba, Brisbane, QLD, Australia
| | - Francine Camacho
- Viome Research Institute, Viome Life Sciences, Inc., New York City, USA
| | - Pedro J Torres
- Viome Research Institute, Viome Life Sciences, Inc., New York City, USA
| | - Stephanie Gline
- Viome Research Institute, Viome Life Sciences, Inc., New York City, USA
| | - Matthew Parks
- Viome Research Institute, Viome Life Sciences, Inc., New York City, USA
| | - Liz Kenny
- The School of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Ally Perlina
- Viome Research Institute, Viome Life Sciences, Inc., Seattle, USA
| | - Hal Tily
- Viome Research Institute, Viome Life Sciences, Inc., New York City, USA
| | | | | | | | - Chamindie Punyadeera
- The Saliva and Liquid Biopsy Translational Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia.
- The Translational Research Institute, Woolloongabba, Brisbane, QLD, Australia.
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16
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Olugbeje H, Bosco J, Lescaille G, Baaroun V, Rochefort J. Clinical photography: attitudes of practitioners specialized in oral mucosal diseases. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Clinical photography is an important tool for clinical practice, training and research frequently used across medical specialties. It may provide snapshot images of evolving clinical situations. The aim of this work was to record its contribution in the management of oral mucosal diseases and, to identify the methods of using this tool by carrying out a survey with practitioners specialized in oral pathologies. This allowed us to make recommendations for appropriate use of this tool. Material and methods: An online anonymous questionnaire was sent via email, to practitioners who were member of two associations of French specialists. Results: 51 oral medicine specialists completed the survey. Among them, 48 (94%) used photography in their daily practice. Lack of time or interest was the reasons given by the 3 practitioners who did not use photography. Pictures were mostly taken with smartphones, which provide precise and accurate images, and stored on personal or professional computers. Sharing of images was performed mostly by secured professional or personal email addresses. Consent was obtained verbally in most cases. Conclusion: Photography could be a valuable asset in the practice of oral medicine. However, recommendations for the safety of patient personal data are not always followed.
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Bramati C, Abati S, Bondi S, Lissoni A, Arrigoni G, Filipello F, Trimarchi M. Early diagnosis of oral squamous cell carcinoma may ensure better prognosis: A case series. Clin Case Rep 2021; 9:e05004. [PMID: 34721865 PMCID: PMC8543051 DOI: 10.1002/ccr3.5004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
Oral squamous cell carcinoma is an extremely malignant tumour: in order to reduce mortality and morbidity, early diagnosis and treatment is the clinician's best weapon.
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Affiliation(s)
- Chiara Bramati
- Otorhinolaryngology – Head & Neck Surgery DepartmentSan Raffaele HospitalUniversity Vita‐SaluteMilanoItaly
- School of MedicineVita‐Salute San Raffaele UniversityMilanoItaly
| | - Silvio Abati
- School of MedicineVita‐Salute San Raffaele UniversityMilanoItaly
- Department of Dentistry and Stomatology IRCCS San Raffaele HospitalUniversity Vita‐SaluteMilanoItaly
| | - Stefano Bondi
- Otorhinolaryngology – Head & Neck Surgery DepartmentSan Raffaele HospitalUniversity Vita‐SaluteMilanoItaly
| | - Alessandra Lissoni
- Department of Dentistry and Stomatology IRCCS San Raffaele HospitalUniversity Vita‐SaluteMilanoItaly
| | - Gianluigi Arrigoni
- Pathology UnitSan Raffaele HospitalVita‐Salute San Raffaele UniversityMilanItaly
| | - Federica Filipello
- School of MedicineVita‐Salute San Raffaele UniversityMilanoItaly
- Pathology UnitSan Raffaele HospitalVita‐Salute San Raffaele UniversityMilanItaly
| | - Matteo Trimarchi
- Otorhinolaryngology – Head & Neck Surgery DepartmentSan Raffaele HospitalUniversity Vita‐SaluteMilanoItaly
- School of MedicineVita‐Salute San Raffaele UniversityMilanoItaly
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Virgone A, Badreh S. The 4P: Preventing Preneoplasia through Patients Partnership. Cancers (Basel) 2021; 13:cancers13174408. [PMID: 34503221 PMCID: PMC8430674 DOI: 10.3390/cancers13174408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022] Open
Abstract
The early diagnosis and management of oral potentially malignant disorders (OPMD) represent a unique opportunity to develop strategies that will prevent malignant transformation. Despite a high prevalence, awareness remains low, patient outcomes poor, and quality of life highly affected. How can patient advocacy groups (PAGs) bring more awareness to preneoplasia preceding oral cancers and help patients after the identification of a suspicious oral leukoplakia presented as white patches in the mouth? PAGs are today involved with awareness campaigns, lobbying, and education of both health care systems as well as the survivor and the newly diagnosed. PAGs are a link between the clinician and the patient, making sure that the medical terminology used is explained in layman language and that psychological support is available during and after treatment. This review outlines the actions that could be deployed by PAGs to successfully complete OPMD prevention challenge. The added value of researchers and patient representatives working together is the increased awareness of the problem. To know at which angle to best approach it for encouraging early diagnosis, improved education of disease signs and symptoms will condition effective prevention from the beginning.
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Affiliation(s)
- Angélique Virgone
- Tumor Escape, Resistance and Immunity Department, Université Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre De Recherche En Cancérologie De Lyon, 69008 Lyon, France
- Centre Léon Bérard, Department of Translational Medicine, 69008 Lyon, France
- Correspondence:
| | - Sara Badreh
- Secretariat Department of the European Cancer Patient Coalition (ECPC), 1000 Bruxelles, Belgium;
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19
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The future of private dentistry. BDJ IN PRACTICE 2021. [PMCID: PMC8350930 DOI: 10.1038/s41404-021-0834-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Overview of Oral Potentially Malignant Disorders: From Risk Factors to Specific Therapies. Cancers (Basel) 2021; 13:cancers13153696. [PMID: 34359597 PMCID: PMC8345150 DOI: 10.3390/cancers13153696] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a very aggressive cancer, representing one of the most common malignancies worldwide. Oral potentially malignant disorders (OPMDs) regroup a variegate set of different histological lesions, characterized by the potential capacity to transform in OSCC. Most of the risk factors associated with OSCC are present also in OPMDs' development; however, the molecular mechanisms and steps of malignant transformation are still unknown. Treatment of OSCC, including surgery, systemic therapy and radiotherapy (alone or in combination), has suffered a dramatic change in last years, especially with the introduction of immunotherapy. However, most cases are diagnosed during the advanced stage of the disease, decreasing drastically the survival rate of the patients. Hence, early diagnosis of premalignant conditions (OPMDs) is a priority in oral cancer, as well as a massive education about risk factors, the understanding of mechanisms involved in malignant progression and the development of specific and more efficient therapies. The aim of this article is to review epidemiological, clinical, morphological and molecular features of OPMDs, with the purpose to lay the foundation for an exhaustive comprehension of these lesions and their ability of malignant transformation and for the development of more effective and personalized treatments.
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21
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Walsh T, Macey R, Kerr AR, Lingen MW, Ogden GR, Warnakulasuriya S. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Syst Rev 2021; 7:CD010276. [PMID: 34282854 PMCID: PMC8407012 DOI: 10.1002/14651858.cd010276.pub3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015. OBJECTIVES Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions. SECONDARY OBJECTIVE to estimate the relative accuracy of the different index tests. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence. AUTHORS' CONCLUSIONS At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted.
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Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, USA
| | - Mark W Lingen
- Pritzker School of Medicine, Division of Biological Sciences, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Graham R Ogden
- Division of Oral and Maxillofacial Clinical Sciences, School of Dentistry, University of Dundee, Dundee, UK
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Di Cosola M, Cazzolla AP, Charitos IA, Ballini A, Inchingolo F, Santacroce L. Candida albicans and Oral Carcinogenesis. A Brief Review. J Fungi (Basel) 2021; 7:jof7060476. [PMID: 34204731 PMCID: PMC8231483 DOI: 10.3390/jof7060476] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 12/14/2022] Open
Abstract
Current medical knowledge and research on patients’ management are still evolving, and several protocols on minimizing risk of infection by Candida spp. among the population have developed. The aim of this work is to review the epidemiological and biomolecular characteristics and the various histopathological carcinogenesis hypothesis mechanisms that can occur during Candida albicans infections. Current evidence from the literature on the role of C. albicans during potentially malignant oral disorders and oral cancer has been sought. Thus, these biomolecular processes can give or contribute to benign lesions, also in precancerous or cancerous situations. Alongside this, the physiological microorganism oral flora (microbiota) can play a crucial role in maintaining oral health during those infections and therefore avoid carcinogenesis.
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Affiliation(s)
- Michele Di Cosola
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy; (M.D.C.); (A.P.C.)
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, 71122 Foggia, Italy; (M.D.C.); (A.P.C.)
| | - Ioannis Alexandros Charitos
- Department of Emergency and Urgency, National Poisoning Centre, Riuniti University Hospital of Foggia, 71122 Foggia, Italy
- Correspondence: (I.A.C.); (A.B.)
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario Ernesto Quagliariello, University of Bari “Aldo Moro”, 70125 Bari, Italy
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro” School of Medicine, 70124 Bari, Italy; (F.I.); (L.S.)
- Correspondence: (I.A.C.); (A.B.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro” School of Medicine, 70124 Bari, Italy; (F.I.); (L.S.)
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro” School of Medicine, 70124 Bari, Italy; (F.I.); (L.S.)
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Shanmugam A, Hariharan AK, Hasina R, Nair JR, Katragadda S, Irusappan S, Ravichandran A, Veeramachaneni V, Bettadapura R, Bhati M, Ramaswamy V, Rao VUS, Bagadia RK, Manjunath A, NML M, Solomon MC, Maji S, Bahadur U, Bettegowda C, Papadopoulos N, Lingen MW, Hariharan R, Gupta V, Agrawal N, Izumchenko E. Ultrasensitive detection of tumor-specific mutations in saliva of patients with oral cavity squamous cell carcinoma. Cancer 2021; 127:1576-1589. [PMID: 33405231 PMCID: PMC8084899 DOI: 10.1002/cncr.33393] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/16/2020] [Accepted: 11/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oral cavity squamous cell carcinoma (OCSCC) is the most common head and neck malignancy. Although the survival rate of patients with advanced-stage disease remains approximately 20% to 60%, when detected at an early stage, the survival rate approaches 80%, posing a pressing need for a well validated profiling method to assess patients who have a high risk of developing OCSCC. Tumor DNA detection in saliva may provide a robust biomarker platform that overcomes the limitations of current diagnostic tests. However, there is no routine saliva-based screening method for patients with OCSCC. METHODS The authors designed a custom next-generation sequencing panel with unique molecular identifiers that covers coding regions of 7 frequently mutated genes in OCSCC and applied it on DNA extracted from 121 treatment-naive OCSCC tumors and matched preoperative saliva specimens. RESULTS By using stringent variant-calling criteria, mutations were detected in 106 tumors, consistent with a predicted detection rate ≥88%. Moreover, mutations identified in primary malignancies were also detected in 93% of saliva samples. To ensure that variants are not errors resulting in false-positive calls, a multistep analytical validation of this approach was performed: 1) re-sequencing of 46 saliva samples confirmed 88% of somatic variants; 2) no functionally relevant mutations were detected in saliva samples from 11 healthy individuals without a history of tobacco or alcohol; and 3) using a panel of 7 synthetic loci across 8 sequencing runs, it was confirmed that the platform developed is reproducible and provides sensitivity on par with droplet digital polymerase chain reaction. CONCLUSIONS The current data highlight the feasibility of somatic mutation identification in driver genes in saliva collected at the time of OCSCC diagnosis.
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Affiliation(s)
| | | | - Rifat Hasina
- University of Chicago, Section of Otolaryngology-Head and Neck Surgery, Chicago, USA
| | | | | | | | | | | | | | | | | | - Vishal US Rao
- HealthCare Global (HCG) Cancer Centre, Bangalore, India
| | | | | | - Manjunath NML
- HealthCare Global (HCG) Cancer Centre, Bangalore, India
| | | | | | | | - Chetan Bettegowda
- Ludwig Center for Cancer Genetics and Therapeutics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Nickolas Papadopoulos
- Ludwig Center for Cancer Genetics and Therapeutics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Mark W. Lingen
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | | | | | - Nishant Agrawal
- University of Chicago, Section of Otolaryngology-Head and Neck Surgery, Chicago, USA
| | - Evgeny Izumchenko
- Department of Medicine, Section of Hematology and Oncology, University of Chicago, Chicago, IL, USA
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Chaturvedi AK, Udaltsova N, Engels EA, Katzel JA, Yanik EL, Katki HA, Lingen MW, Silverberg MJ. Oral Leukoplakia and Risk of Progression to Oral Cancer: A Population-Based Cohort Study. J Natl Cancer Inst 2021; 112:1047-1054. [PMID: 31860085 DOI: 10.1093/jnci/djz238] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/18/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The optimal clinical management of oral precancer remains uncertain. We investigated the natural history of oral leukoplakia, the most common oral precancerous lesion, to estimate the relative and absolute risks of progression to cancer, the predictive accuracy of a clinician's decision to biopsy a leukoplakia vis-à-vis progression, and histopathologic predictors of progression. METHODS We conducted a retrospective cohort study (1996-2012) of patients with oral leukoplakia (n = 4886), identified using electronic medical records within Kaiser Permanente Northern California. Among patients with leukoplakia who received a biopsy (n = 1888), we conducted a case-cohort study to investigate histopathologic predictors of progression. Analyses included indirect standardization and unweighted or weighted Cox regression. RESULTS Compared with the overall Kaiser Permanente Northern California population, oral cancer incidence was substantially elevated in oral leukoplakia patients (standardized incidence ratio = 40.8, 95% confidence interval [CI] = 34.8 to 47.6; n = 161 cancers over 22 582 person-years). Biopsied leukoplakias had a higher oral cancer risk compared with those that were not biopsied (adjusted hazard ratio = 2.38, 95% CI = 1.73 to 3.28). However, to identify a prevalent or incident oral cancer, the biopsy decision had low sensitivity (59.6%), low specificity (62.1%), and moderate positive-predictive value (5.1%). Risk of progression to oral cancer statistically significantly increased with the grade of dysplasia; 5-year competing risk-adjusted absolute risks were: leukoplakia overall = 3.3%, 95% CI = 2.7% to 3.9%; no dysplasia = 2.2%, 95% CI = 1.5% to 3.1%; mild-dysplasia = 11.9%, 95% CI = 7.1% to 18.1%; moderate-dysplasia = 8.7%, 95% CI = 3.2% to 17.9%; and severe dysplasia = 32.2%, 95% CI = 8.1%-60.0%. Yet 39.6% of cancers arose from biopsied leukoplakias without dysplasia. CONCLUSIONS The modest accuracy of the decision to biopsy a leukoplakia vis-à-vis presence or eventual development of oral cancer highlights the need for routine biopsy of all leukoplakias regardless of visual or clinical impression. Leukoplakia patients, particularly those with dysplasia, need to be closely monitored for signs of early cancer.
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Affiliation(s)
- Anil K Chaturvedi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Eric A Engels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Jed A Katzel
- Department of Oncology, Kaiser Permanente, San Francisco, CA, USA
| | | | - Hormuzd A Katki
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Mark W Lingen
- Department of Pathology, University of Chicago, Chicago, IL, USA
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Prevalence and risk factors of potentially malignant disorders of the mucosa in the general population: Mucosa lesions a general health problem? Ann Anat 2021; 237:151724. [PMID: 33798694 DOI: 10.1016/j.aanat.2021.151724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/10/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
AIM Oral cancer mostly develops from oral mucosa regions with morphological alterations transforming malignant. These visible precancerous mucosa lesions are named potentially malignant disorders (PMD). We aimed to analyze the prevalence of PMD and its risk factors for PMD in a population-based sample in Northern Germany. MATERIAL AND METHODS Data of 6078 individuals from the population-based Study of Health in Pomerania (SHIP) was used. PMD were photographically documented and periodontal health was assessed in a standardized procedure. RESULTS PMD were observed in 54 individuals (0.9%). The most prevalent PMD was homogenous leukoplakia (n = 37) followed by Lichen ruber (n = 9). Smoking (Odds Ratio (OR) 2.70; 95% confidence interval (CI): 1.24-5.87), male sex (OR 3.32; 95%-CI: 1.77-6.21), type 2 diabetes mellitus (OR 2.07; 95%-CI: 1.08-3.98) and body mass index (OR 1.09; CI 1.04-1.14) were significantly associated with PMD, with the corresponding area under the curve (AUC) being 0.696 (CI: 0.655; 0.737). CONCLUSION Our results suggest a clinically relevant prevalence of PMD in the population. We identified male sex, type 2 diabetes mellitus, current smoking, and obesity as risk factors. We recommend photographic documentation and intensified training of medical and dental staff to detect and monitor PMD.
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Gaballah K, Faden A, Fakih FJ, Alsaadi AY, Noshi NF, Kujan O. Diagnostic Accuracy of Oral Cancer and Suspicious Malignant Mucosal Changes among Future Dentists. Healthcare (Basel) 2021; 9:healthcare9030263. [PMID: 33801278 PMCID: PMC7998164 DOI: 10.3390/healthcare9030263] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 01/14/2023] Open
Abstract
This study aimed to assess the ability of dental students and recent graduates to detect and recognize mucosal changes that are suggestive of oral cancer and potentially malignant disorders. In this cross-sectional study, a questionnaire was administered to dental students and recent graduates of Ajman University (n = 132). Completed questionnaires were received from 84 (63.6%) females and 48 (36.4%) males which included fifth-year students (n = 80), interns (n = 39), and dental practitioners (n = 13). This questionnaire was designed to assess the respondent’s ability to detect and recognize different types of oral lesions, as well as their knowledge of oral cancer appearance and malignancy potential. The overall accuracy of diagnosis was 46%. The participants correctly identified normal variations, benign tumors, malignant tumors, and premalignant lesions at rates of 60.3%, 31.0%, 55.7%, and 33.4%, respectively. There was no significant difference between the two genders in their ability to recognize and detect correct answers (females, 48.3%; males, 47.2%). According to education level, interns provided the highest percentage of correct answers (52.5%), followed by newly dental practitioners (51.9%) and fifth-year students (44.1%). Conclusion: The respondents of this survey did not exhibit a satisfactory diagnostic capability in recognizing mucosal changes consistent with the clinical presentation of oral cancer. Thus, a need exists for improved and updated educational methods for undergraduate students regarding oral cancer and potentially malignant disorders. Meanwhile, practitioners should look for oral abnormalities to provide better diagnosis and management. Practitioners should also stay up to date on the oral malignancy topic by attending workshops and clinicopathological conferences.
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Affiliation(s)
- Kamis Gaballah
- Department of Clinical Sciences, College of Dental Sciences, Ajman University, P.O. Box 346 Ajman, United Arab Emirates; (K.G.); (F.J.F.); (A.Y.A.); (N.F.N.)
| | - Asmaa Faden
- Department of Oral Medicine and Diagnostic Science, College of Dentistry, King Saud University, Riyadh 4545, Saudi Arabia;
| | - Fatima Jassem Fakih
- Department of Clinical Sciences, College of Dental Sciences, Ajman University, P.O. Box 346 Ajman, United Arab Emirates; (K.G.); (F.J.F.); (A.Y.A.); (N.F.N.)
| | - Anfal Yousuf Alsaadi
- Department of Clinical Sciences, College of Dental Sciences, Ajman University, P.O. Box 346 Ajman, United Arab Emirates; (K.G.); (F.J.F.); (A.Y.A.); (N.F.N.)
| | - Nadeen Faiz Noshi
- Department of Clinical Sciences, College of Dental Sciences, Ajman University, P.O. Box 346 Ajman, United Arab Emirates; (K.G.); (F.J.F.); (A.Y.A.); (N.F.N.)
| | - Omar Kujan
- Oral Diagnostic and Surgical Sciences, UWA Dental School, The University of Western Australia, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-8-6457-7649
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Nair D, Qayyumi B, Sharin F, Mair M, Bal M, Pimple S, Mishra G, Nair S, Chaturvedi P. Narrow band imaging observed oral mucosa microvasculature as a tool to detect early oral cancer: an Indian experience. Eur Arch Otorhinolaryngol 2021; 278:3965-3971. [PMID: 33420841 DOI: 10.1007/s00405-020-06578-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/17/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Narrow band imaging (NBI) is a novel method with the potential to improve the diagnostic capability of white-light. METHODS A prospective observational study of 50 consecutive patients, with suspicious malignant/premalignant lesions. White-light images were assessed as suspicious for malignancy/negative for malignancy, whereas NBI images were classified based on the IPCL patterns. All lesions underwent biopsy and accuracy was compared with the histopathology (Fig. 1). Fig. 1 Representative images of the IPCL patterns from Types I-IV RESULTS: 25 lesions (49%) were positive for malignancy, 2 (3.9%) lesions showed severe dysplasia, and 24(47%) were considered negative on histopathology. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of white light and NBI in detecting invasive carcinoma was 74.07%, 79.17%, 80.00%, 73.08% and 76.47%, and 92.67%, 90.16%, 92.56%, 91.67% and 92.16% respectively. The NBI group had a significantly better sensitivity and specificity to white light. The interobserver concordance was κ = 0.881. CONCLUSION NBI is a highly effective tool to detect invasive carcinomas amongst suspicious lesions of the oral cavity.
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Affiliation(s)
- Deepa Nair
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, TMC, Dr. E Borges Road, Parel, Mumbai, 400012, India. .,Homi Bhabha National Institute, Mumbai, India.
| | - Burhanuddin Qayyumi
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, TMC, Dr. E Borges Road, Parel, Mumbai, 400012, India.,Homi Bhabha National Institute, Mumbai, India
| | - Florida Sharin
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, TMC, Dr. E Borges Road, Parel, Mumbai, 400012, India.,Homi Bhabha National Institute, Mumbai, India
| | - Manish Mair
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, TMC, Dr. E Borges Road, Parel, Mumbai, 400012, India.,Homi Bhabha National Institute, Mumbai, India
| | - Munita Bal
- Homi Bhabha National Institute, Mumbai, India.,Department of Pathology, Tata Memorial Hospital, TMC, Mumbai, India
| | - Sharmila Pimple
- Homi Bhabha National Institute, Mumbai, India.,Preventive Oncology, Tata Memorial Hospital, TMC, Mumbai, India
| | - Gauravi Mishra
- Homi Bhabha National Institute, Mumbai, India.,Preventive Oncology, Tata Memorial Hospital, TMC, Mumbai, India
| | - Sudhir Nair
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, TMC, Dr. E Borges Road, Parel, Mumbai, 400012, India.,Homi Bhabha National Institute, Mumbai, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, TMC, Dr. E Borges Road, Parel, Mumbai, 400012, India.,Homi Bhabha National Institute, Mumbai, India
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Diagnostic accuracy of clinical visualization and light-based tests in precancerous and cancerous lesions of the oral cavity and oropharynx: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4145-4159. [PMID: 33392809 DOI: 10.1007/s00784-020-03746-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate and compare the performance of autofluorescence, chemiluminescence, and clinical visual examination in the detection of oral potentially malignant disorders (OPMD), oral cancer (OC), and oropharyngeal cancer (OPC). MATERIALS AND METHODS A systematic review with meta-analysis based on diagnostic test studies. A literature search was carried out in the MEDLINE and EMBASE databases through August 30, 2020. For this review, the quality assessment tool of diagnostic precision studies (QUADAS-2) was used. Hierarchical regression models were used to estimate pooled diagnostic precision values in a random effects model. RESULTS A total of 40 studies were identified for this review according to each test evaluated: 5.562 samples for autofluorescence, 1.353 samples for chemiluminescence, and 1.892 samples for clinical examination. The summary measures sensitivity and specificity of the clinical examination were 63% and 78%, respectively, AUC = 0.78 95% CI (0.74-0.81). In the autofluorescence test, these were 86% and 72%, respectively, AUC = 0.86 95% CI (0.83-0.89); and the chemiluminescent test were 67% and 48%, respectively, AUC = 0.59 95% CI (0.54-0.63) CONCLUSIONS: Autofluorescence devices displayed superior accuracy levels in the identification of premalignant lesions and early neoplastic changes compared to clinical examination and chemiluminescent test. Overall, biopsy remains the gold standard for the definitive diagnosis of OPMD, OC, and OPC. CLINICAL RELEVANCE Light-based clinical methods such as autofluorescence and chemiluminescence techniques have been used in clinical diagnosis for the differentiation of OPMD and malignant and benign lesions; although detailed visual examination appears to be effective in identifying, previous systematic reviews have not evaluated a relevant number of studies and they did not evaluate the accuracy of the clinical examination.
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Abati S, Bramati C, Bondi S, Lissoni A, Trimarchi M. Oral Cancer and Precancer: A Narrative Review on the Relevance of Early Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249160. [PMID: 33302498 PMCID: PMC7764090 DOI: 10.3390/ijerph17249160] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/04/2020] [Accepted: 12/06/2020] [Indexed: 02/07/2023]
Abstract
Oral cancer (OC) is an uncommon malignancy in Western countries, being one of the most common cancers in some high-risk areas of the world. It is a largely preventable cancer, since most of the different risk factors identified, such as tobacco use, alcohol consumption, and betel nut chewing, are behaviors that increase the likelihood of the disease. Given its high mortality, early diagnosis is of utmost importance. Prevention and the anticipation of diagnosis begin with identification of potentially malignant lesions of the oral mucosa and with local conditions promoting chronic inflammation. Therefore, every lesion must be recognized promptly and treated adequately. The clinical recognition and evaluation of oral mucosal lesions can detect up to 99% of oral cancers/premalignancies. As stated by the World Health Organization, any suspicious lesion that does not subside within two weeks from detection and removal of local causes of irritation must be biopsied. Surgical biopsy remains the gold standard for diagnosis of oral cancer. Adjunctive tools have been developed and studied to help clinicians in the diagnostic pathway, such as toluidine blue vital staining and autofluorescence imaging. In the near future other methods, i.e., identification of salivary markers of progression may help in reducing mortality due to oral cancer.
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Affiliation(s)
- Silvio Abati
- Dentistry and Stomatology-IRCCS San Raffaele Hospital, University Vita-Salute, 20132 Milano, Italy;
- School of Medicine, University Vita-Salute, 20132 Milano, Italy; (C.B.); (M.T.)
- Correspondence: ; Tel.: +39-02-26433410
| | - Chiara Bramati
- School of Medicine, University Vita-Salute, 20132 Milano, Italy; (C.B.); (M.T.)
- Otorhinolaryngology-Head & Neck Surgery Department, San Raffaele Hospital, University Vita-Salute, 20132 Milano, Italy;
| | - Stefano Bondi
- Otorhinolaryngology-Head & Neck Surgery Department, San Raffaele Hospital, University Vita-Salute, 20132 Milano, Italy;
| | - Alessandra Lissoni
- Dentistry and Stomatology-IRCCS San Raffaele Hospital, University Vita-Salute, 20132 Milano, Italy;
| | - Matteo Trimarchi
- School of Medicine, University Vita-Salute, 20132 Milano, Italy; (C.B.); (M.T.)
- Otorhinolaryngology-Head & Neck Surgery Department, San Raffaele Hospital, University Vita-Salute, 20132 Milano, Italy;
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Lacey L, Daulton E, Wicaksono A, Covington JA, Quenby S. Volatile organic compound analysis, a new tool in the quest for preterm birth prediction-an observational cohort study. Sci Rep 2020; 10:12153. [PMID: 32699319 PMCID: PMC7376243 DOI: 10.1038/s41598-020-69142-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 07/01/2020] [Indexed: 01/26/2023] Open
Abstract
Preterm birth is the leading cause of death worldwide in children under five years. Due to its complex multifactorial nature, prediction is a challenge. Current research is aiming to develop accurate predictive models using patient history, ultrasound and biochemical markers. Volatile organic compound (VOC) analysis is an approach, which has good diagnostic potential to predict many disease states. Analysis of VOCs can reflect both the microbiome and host response to a condition. We aimed to ascertain if VOC analysis of vaginal swabs, taken throughout pregnancy, could predict which women go on to deliver preterm. Our prospective observational cohort study demonstrates that VOC analysis of vaginal swabs, taken in the midtrimester, is a fair test (AUC 0.79) for preterm prediction, with a sensitivity of 0.66 (95%CI 0.56–0.75) and specificity 0.89 (95%CI 0.82–0.94). Using vaginal swabs taken closest to delivery, VOC analysis is a good test (AUC 0.84) for the prediction of preterm birth with a sensitivity of 0.73 (95%CI 0.64–0.81) and specificity of 0.90 (95%CI 0.82–0.95). Consequently, VOC analysis of vaginal swabs has potential to be used as a predictive tool. With further work it could be considered as an additional component in models for predicting preterm birth.
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Affiliation(s)
- Lauren Lacey
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK. .,Department of Obstetrics and Gynaecology, University Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK.
| | - Emma Daulton
- School of Engineering, University of Warwick, Coventry, CV4 7AL, UK
| | - Alfian Wicaksono
- School of Engineering, University of Warwick, Coventry, CV4 7AL, UK
| | | | - Siobhan Quenby
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,Department of Obstetrics and Gynaecology, University Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK
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Garcia Dias da Conceição M, Cláudia Figueiró A, Lucia Luiza V. Non-Invasive Methods for Early Diagnosis of Oral Cancer. Oral Dis 2020. [DOI: 10.5772/intechopen.89280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Assessment of Clinical Examination Validity in Oral Cancer Risk Patients. BALKAN JOURNAL OF DENTAL MEDICINE 2020. [DOI: 10.2478/bjdm-2020-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Summary
Background/Aim: Oral cancer is one of the ten most common cancers in the world, recently positioned as a sixth one, unfortunately with poor prognosis after treatment because of the late diagnostics in advanced stages of the disease. Aim of this study was to present the basic criteria in assessment the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the conventional oral examination (COE) as the easiest and most acceptable procedure in detection of the early changes of the suspicious oral tissue changes compared to the diagnostic gold standard – tissue biopsy in two different groups of examinees.
Material and Methods: Sixty patients divided into two study groups (one with potentially malignant oral lesions and a second consisted of clinically suspicious oral cancer lesions) were examined with COE and subjected to histopathological confirmation - tissue biopsy. All examined patients underwent the diagnostic protocol by the American Joint Commission on Cancer, selected under certain inclusion and exclusion criteria.
Results: Sensitivity of COE in the group of examinees with oral potentially malignant lesions is 83.33%, its specificity is 20.83%, the positive predictive value is 20.83% and the negative predictive value is 83.33%. The accuracy of the COE method is 33.33%. The sensitivity, in the group of patients with oral cancer is 96.43%, specificity is 0%, the positive predictive value is 93.10% and the negative predictive value is 0%. The accuracy of this method is 90%.
Conclusions: The accuracy reaches a value over 90% for the group with lesions with highly suspected malignant potential – oral cancer, and sets the thesis that COE as screening method for oral cancer or premalignant tissue changes is more valuable for the patients with advanced oral epithelial changes, but is recommended to be combined with some other type of screening procedure in order to gain relevant results applicable in the everyday clinical practice.
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Lingen MW, Tampi MP, Urquhart O, Abt E, Agrawal N, Chaturvedi AK, Cohen E, D'Souza G, Gurenlian J, Kalmar JR, Kerr AR, Lambert PM, Patton LL, Sollecito TP, Truelove E, Banfield L, Carrasco-Labra A. Adjuncts for the evaluation of potentially malignant disorders in the oral cavity: Diagnostic test accuracy systematic review and meta-analysis-a report of the American Dental Association. J Am Dent Assoc 2019; 148:797-813.e52. [PMID: 29080605 DOI: 10.1016/j.adaj.2017.08.045] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Oral squamous cell carcinoma is the most common manifestation of malignancy in the oral cavity. Adjuncts are available for clinicians to evaluate lesions that seem potentially malignant. In this systematic review, the authors summarized the available evidence on patient-important outcomes, diagnostic test accuracy (DTA), and patients' values and preferences (PVPs) when using adjuncts for the evaluation of clinically evident lesions in the oral cavity. TYPES OF STUDIES REVIEWED The authors searched for preexisting systematic reviews and assessed their quality using the Assessing the Methodological Quality of Systematic Reviews tool. The authors updated the selected reviews and searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and DTA and PVPs studies. Pairs of reviewers independently conducted study selection, data extraction, and assessment of the certainty in the evidence by using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS The authors identified 4 existing reviews. DTA reviews included 37 studies. The authors retrieved 7,534 records, of which 9 DTA and 10 PVPs studies were eligible. Pooled sensitivity and specificity of adjuncts ranged from 0.39 to 0.96 for the evaluation of innocuous lesions and from 0.31 to 0.95 for the evaluation of suspicious lesions. Cytologic testing used in suspicious lesions appears to have the highest accuracy among adjuncts (sensitivity, 0.92; 95% confidence interval, 0.86 to 0.98; specificity, 0.94; 95% confidence interval, 0.88 to 0.99; low-quality evidence). CONCLUSIONS AND PRACTICAL IMPLICATIONS Cytologic testing appears to be the most accurate adjunct among those included in this review. The main concerns are the high rate of false-positive results and serious issues of risk of bias and indirectness of the evidence. Clinicians should remain skeptical about the potential benefit of any adjunct in clinical practice.
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Peterson CE, Gordon SC, Le Hew CW, Dykens JA, Jefferson GD, Tampi MP, Urquhart O, Lingen M, Watson KS, Buscemi J, Fitzgibbon ML. Society of Behavioral Medicine position statement: Society of Behavioral Medicine supports oral cancer early detection by all healthcare providers. Transl Behav Med 2019; 9:819-822. [PMID: 30007335 PMCID: PMC7184875 DOI: 10.1093/tbm/iby075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Indexed: 11/12/2022] Open
Abstract
In response to the increasing incidence of certain oral and oropharyngeal cancers, the Society of Behavioral Medicine (SBM) calls on healthcare providers and legislators to expand awareness of oral and oropharyngeal cancer risk factors, increase early detection, and support policies that increase utilization of dental services. SBM supports the American Dental Association's 2017 guideline for evaluating potentially malignant oral cavity disorders and makes the following recommendations to healthcare providers and legislators. We encourage healthcare providers and healthcare systems to treat oral exams as a routine part of patient examination; communicate to patients about oral/oropharyngeal cancers and risk factors; encourage HPV vaccination for appropriate patients based on recommendations from the Advisory Committee on Immunization Practices; support avoidance of tobacco use and reduction of alcohol consumption; and follow the current recommendations for evaluating potentially malignant oral cavity lesions. Because greater evidence is needed to inform practice guidelines in the primary care setting, we call for more research in collaborative health and dental services. We encourage legislators to support policies that expand Medicaid to cover adult dental services, increase Medicaid reimbursement for dental services, and require dental care under any modification of, or replacement of, the Affordable Care Act.
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Affiliation(s)
- Caryn E Peterson
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA
| | - Sara C Gordon
- School of Dentistry, University of Washington, Seattle, WA, USA
| | - Charles W Le Hew
- College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - J A Dykens
- Center for Global Health and College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | | | - Mark Lingen
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | | | | | - Marian L Fitzgibbon
- Institute for Health Research and Policy and Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
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Ahmed NHM, Naidoo S. Oral Cancer Knowledge, Attitudes, and Practices among Dentists in Khartoum State, Sudan. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:291-296. [PMID: 29151257 DOI: 10.1007/s13187-017-1300-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The dental professions hold an important responsibility in the control of oral cancer and the early diagnosis highly depends on their knowledge. The present study was developed to assess the knowledge, attitude, and practice of dentists in Khartoum State regarding oral cancer prevention and early detection. An administered questionnaire was structured and sent to all licensed 130 dentists working in public dental clinics in Khartoum State. Responses to the questionnaire were analyzed using descriptive and analytical statistics. Although the majority of the dentists were knowledgeable about the major risk factors of oral cancer, more than half of the dentists reported they do not carry out any special examination to detect oral cancer in age 40 and above in asymptomatic patients. Dentists indicated their lack of training as the main barrier for conducting a comprehensive oral cancer examination. Interestingly, the vast majority of the dentists express their interest to have further oral cancer educational and training sessions. The findings of the present study suggested strongly that educational and training interventions are necessary to enhance preventive measures which may lead to reduce mortality and morbidity from oral cancer.
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Affiliation(s)
- Nada H M Ahmed
- University of the Western Cape, Tygerberg, South Africa.
| | - Sudeshni Naidoo
- Department of Community Oral Health, University of the Western Cape, Tygerberg, South Africa
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Gupta B, Kumar N, Johnson NW. Evidence of past dental visits and incidence of head and neck cancers: a systematic review and meta-analysis. Syst Rev 2019; 8:43. [PMID: 30717784 PMCID: PMC6360721 DOI: 10.1186/s13643-019-0949-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 01/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Regular/frequent dental visits, at least annually, can aid in reducing the public health burden of head and neck cancers (HNCs) by facilitating earlier detection of the disease. The aim of this study was to conduct a quantitative assessment of any independent association between past dental visits/check-ups and incidence of cancers of HN/upper aerodigestive tract (UADT) and oral cavity worldwide. METHODS PubMed, CINAHL, and Cochrane databases were searched for all observational studies published until August 2017 in any language that assessed an association of past dental visits/dental check-ups among the incident cases of HNC/UADT cancers. Screening and quality assessment of the articles was performed by two independent reviewers. Three different meta-analyses were conducted: two based on the incident cancer reported in the studies (HNCs/cancers of UADT and oral cavity); another included all studies irrespective of the type of cancer reported with the frequency of past dental visits as subgroups. RESULTS Searches retrieved 3164 titles: after removing duplicates, 1377 remained. Of these, 62 were reviewed in full, but only 38 were eligible for inclusion. Under the random effects model, odds of past never/irregular/not frequent dental visits were greater in HNC cases and oral cancer cases as compared to the hospital-based/population-based controls [HNCs-unadjusted odds ratio (OR) 2.24; 95% confidence interval (CI) 1.89 to 2.65) and (oral cancers-OR 1.93; 95% CI 1.47 to 2.52]. Similar results were observed for all cancers with frequency of past dental visits as subgroup analysis (OR 2.01; 95% CI 1.76 to 2.30). Meta-regression findings indicate that none of the subgroup influenced the effect estimates for incidence of cancers. There was no publication bias in our study. CONCLUSION This systematic review and meta-analysis indicates that individuals with never/irregular/not frequent dental visits are more likely to be incident cases of HNCs/UADT cancers.
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Affiliation(s)
- Bhawna Gupta
- Torrens University, Adelaide, South Australia, 5000, Australia.
| | - Narinder Kumar
- Department of Orthopaedics, Base Hospital, Lucknow, India
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
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Screening for mouth cancer: the pros and cons of a national programme. Br Dent J 2018; 225:815-819. [DOI: 10.1038/sj.bdj.2018.918] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2018] [Indexed: 11/08/2022]
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Kondoh N, Mizuno-Kamiya M, Takayama E, Kawati H, Umemura N, Yamazaki Y, Mitsudo K, Tohnai I. Perspectives of Immune Suppression in the Tumor Microenvironment Promoting Oral Malignancy. Open Dent J 2018; 12:455-465. [PMID: 29988281 PMCID: PMC6018133 DOI: 10.2174/1874210601812010455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/15/2018] [Accepted: 05/29/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction In order to survive, cancers control immune systems and evade immune detection using mediators consisting of immune checkpoint molecules and cellular systems associated with immune suppression. Methodology During the development of cancer and chronic infections, the immune checkpoints and cellular components including regulatory T cells, myeloid derived suppressor cells and cancer associated fibroblasts are often enhanced as a mechanism of immune subversion and have therefore become very important therapeutic targets. Conclusion In this review, we will discuss the complexity of immune-suppressive mechanisms in the tumor milieu of cancers, including oral malignancy.
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Affiliation(s)
- Nobuo Kondoh
- Department of Oral Biochemistry, Division of Oral Structure, Function and Development, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Masako Mizuno-Kamiya
- Department of Management and Information Studies, Chemistry Laboratory, Asahi University School of Business Administration, 1851 Hozumi, Mizuho, Gifu 501-0296, Japan
| | - Eiji Takayama
- Department of Oral Biochemistry, Division of Oral Structure, Function and Development, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Harumi Kawati
- Department of Oral Biochemistry, Division of Oral Structure, Function and Development, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Naoki Umemura
- Department of Oral Biochemistry, Division of Oral Structure, Function and Development, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Yutaka Yamazaki
- Department of Oral Health Science, Gerodontology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Kita-ku, Sapporo, 060-8586, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Iwai Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Hashim R, Abo-Fanas A, Al-Tak A, Al-Kadri A, Ebaid YA. Early Detection of Oral Cancer- Dentists’ Knowledge and Practices in the United Arab Emirates. Asian Pac J Cancer Prev 2018; 19:2351-2355. [PMID: 30141314 PMCID: PMC6171382 DOI: 10.22034/apjcp.2018.19.8.2351] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objectives: The aim of this study was to evaluate the knowledge, opinions and practices of dentists regarding early
detection of oral cancer in the United Arab Emirates (UAE). Method: A cross-sectional study was conducted using
a simple random sampling technique with a self-reported questionnaire applied to 298 dentists, working in private and
public sectors in three cities (Abu Dhabi, Dubai and Sharjah) in the UAE. Dentists’ knowledge about risk factors and
diagnostic concepts of oral cancer, current practices and opinions as well as interest in continuing education programs
were assessed. Results: The dentists, aged 23-65 years, were generally aware of the major risk factors most likely
associated with oral cancer. Thirty percent of the participants identified the tongue as the most common site on which
oral cancer develops. The best known clinical presentation of oral cancer identified by the respondents was a persistent
ulcer (87.6 %). Only thirty dentists (9.9%) were comfortable in performing a biopsy in their clinic. Less than half (48.0%)
had attended a continuing education course on oral cancer within the past 5 years. The majority of the participants
(84.9%) felt that they needed further training on oral cancer detection. Conclusion: The findings of the present study
identified several deficiencies in the knowledge of dentists working in the UAE with regard to early detection of oral
cancer. Some changes to dental educational and training could be made to improve the confidence and ability of dentists
in this regard.
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Affiliation(s)
- Raghad Hashim
- Growth and Development Department Ajman University Ajman, United Arab Emirates,For Correspondence:
| | - Ayman Abo-Fanas
- Growth and Development Department Ajman University Ajman, United Arab Emirates
| | - Ali Al-Tak
- Growth and Development Department Ajman University Ajman, United Arab Emirates
| | - Amer Al-Kadri
- Growth and Development Department Ajman University Ajman, United Arab Emirates
| | - Yousef Abu Ebaid
- Growth and Development Department Ajman University Ajman, United Arab Emirates
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Leuci S, Amato M, Calabria E, Spagnuolo G, Masucci M, Davide MM. Screening Projects for Oral Carcinoma in Relation to Health Education and Patients' Compliance: Study on 600 Participants. J Int Soc Prev Community Dent 2017; 7:S163-S169. [PMID: 29285472 PMCID: PMC5730979 DOI: 10.4103/jispcd.jispcd_370_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/30/2017] [Indexed: 12/25/2022] Open
Abstract
Aims and Objectives: The lack of information among the population regarding the existence of oral squamous cell carcinoma (OSCC) and the lack of attention and expertise in examining the oral cavity of dentists and clinicians still remain very worrying and could explain the high incidence of OSCC. The aim of this study is to evaluate the level of awareness of OSCC among 600 participants from Southern Italy. Materials and Methods: A 13-question survey was prepared and distributed to 600 participants divided into two subgroups, the first one of 300 patients referring to the Department of Neuroscience, Reproductive, and Odontostomatological Sciences, University Federico II of Naples, for the treatment of dental pathologies, and the second one of 300 patients referring to the Department of Internal Medicine of the Second University of Naples for the diagnosis and treatment of cardiovascular diseases. Statistical analysis consisted in the calculation of percentages related to the answers given by patients. Comparison of percentages was after performed between the two subgroups. Result: Only 175 participants (29.1%) knew about the existence of pathologies which can affect the oral mucosa, and only 46 (7.6%) were aware that carcinoma can arise in the oral cavity; 345 (57,5%) stated that they had periodical dental visits, at least once a year but none of them stated they had a visit for the identification of oral carcinomas. Conclusion: The data acquired must be taken into consideration to outline essential socio-healthcare educational projects on carcinoma and its risk factors, training programs to increase dentists and clinicians’ competences, and to evaluate the feasibility and effectiveness of oral carcinoma screening programs.
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Affiliation(s)
- Stefania Leuci
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Massimo Amato
- Department of Medicine, Dentistry Unit, Surgery and Dentistry, University of Salerno, Fisciano, Italy
| | - Elena Calabria
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Michele Masucci
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Michele Mignogna Davide
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
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Ganga RS, Gundre D, Bansal S, Shirsat PM, Prasad P, Desai RS. Evaluation of the diagnostic efficacy and spectrum of autofluorescence of benign, dysplastic and malignant lesions of the oral cavity using VELscope. Oral Oncol 2017; 75:67-74. [PMID: 29224826 DOI: 10.1016/j.oraloncology.2017.10.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Conventional oral examination and biopsy are the only reliable methods for the early detection of oral cancer at present. Autofluorescence examination of oral tissues using the VELscope has been suggested as an adjunctive tool for cancer detection and diagnosis. The aim of our study was to evaluate the efficacy of the VELscope in recognizing dysplastic and/or neoplastic changes in oral mucosal lesions that were identified on conventional oral examination. MATERIALS AND METHODS Two hundred patients with oral mucosal lesions were subjected to conventional oral examination followed by VELscope examination and their autofluorescence characteristics were compared with the histopathological diagnosis. The sensitivity, specificity, positive and negative predictive values of the VELscope examination was calculated. RESULTS The VELscope examination showed sensitivity and specificity values of 76% (95% CI: 54.87-90.64%) and 66.29% (95% CI: 58.76-73.24%) respectively while the positive and negative predictive values were 24.36% (95% CI: 19.22-30.36%) and 95.08% (95% CI: 90.52-97.51%) respectively. CONCLUSION The VELscope examination alone cannot provide a definitive diagnosis as to the presence of dysplastic tissue change. In spite of having a reasonable sensitivity, the high number of false-positive results limits its efficiency as an adjunct. However, a high negative predictive value can serve to alleviate patient anxiety regarding suspicious mucosal lesions in a general practice setting.
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Affiliation(s)
- Ravikant S Ganga
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Dipali Gundre
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Shivani Bansal
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Pankaj M Shirsat
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Pooja Prasad
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Rajiv S Desai
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
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Ai R, Tao Y, Hao Y, Jiang L, Dan H, Ji N, Zeng X, Zhou Y, Chen Q. Microenvironmental regulation of the progression of oral potentially malignant disorders towards malignancy. Oncotarget 2017; 8:81617-81635. [PMID: 29113419 PMCID: PMC5655314 DOI: 10.18632/oncotarget.20312] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/04/2017] [Indexed: 02/05/2023] Open
Abstract
Oral potentially malignant disorders (OPMD) develop in a complex tissue microenvironment where they grow sustainably, acquiring oral squamous cell carcinoma (OSCC) characteristics. The malignant tumor depends on interactions with the surrounding microenvironment to achieve loco-regional invasion and distant metastases. Unlike abnormal cells, the multiple cell types in the tissue microenvironment are relatively stable at the genomic level and, thus, become therapeutic targets with lower risk of resistance, decreasing the risk of OPMD acquiring cancer characteristics and carcinoma recurrence. However, deciding how to disrupt the OPMD and OSCC microenvironments is itself a daunting challenge, since their microenvironments present opposite capacities, resulting in diverse consequences. Furthermore, recent studies revealed that tumor-associated immune cells also participate in the process of differentiation from OPMD to OSCC, suggesting that reeducating stromal cells may be a new strategy to prevent OPMD from acquiring OSCC characteristics and to treat OSCC. In this review, we discuss the characteristics of the microenvironment of OPMD and OSCC as well as new therapeutic strategies.
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Affiliation(s)
- Ruixue Ai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yan Tao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yilong Hao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ning Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Jokstad A. Cochrane Collaboration Systematic Reviews may be based on trials not approved by a research ethics committee. Clin Exp Dent Res 2017; 3:179-182. [PMID: 29744198 PMCID: PMC5839214 DOI: 10.1002/cre2.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/12/2017] [Accepted: 08/15/2017] [Indexed: 12/05/2022] Open
Abstract
Systematic reviews (SR) may potentially contain reports of primary trials with ethical problems. The Cochrane Collaboration SRs are considered as the highest standard in evidence-based health care resources. All SRs completed during the last 5 years (2013-2017) under the management of the Oral Health Group of the Cochrane Collaboration were identified. All primary trials included in the Oral Health Group SRs were identified and examined to establish their status regarding pre-hoc approval of an independent ethics committee (EC), often termed Institutional Review Board (IRB) before commencing recruitment of trial participants. Ninety-five SRs contained 960 primary trials, of which 272 (28.3%) were not examined by the author of this paper. Amongst the remaining 688 primary trials, 198 (29%) contained no reference to study conduct approval by a research ethics committee. The majority of primary studies referred to an EC/IRB approval with or without identifying the name of the ethics committee (n = 401, 58%), whereas some papers identified both the committee name and a protocol or reference number of the EC/IRB approval (n = 89, 13%). The Cochrane Collaboration, along with other developers of SRs, should adopt the policy established by COPE with regard to what to do if one suspect an ethical problem, that is, request evidence of EC/IRB approval. All stakeholders should rest assured that clinical policies and practices based on SRs are based on ethically sound clinical research.
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Affiliation(s)
- Asbjørn Jokstad
- Department of Clinical Dentistry, Faculty of Health SciencesUiT The Arctic University of NorwayNorway
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Tadakamadla J, Kumar S, Lalloo R, Johnson NW. Qualitative analysis of the impact of Oral Potentially Malignant Disorders on daily life activities. PLoS One 2017; 12:e0175531. [PMID: 28410381 PMCID: PMC5391936 DOI: 10.1371/journal.pone.0175531] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/28/2017] [Indexed: 01/11/2023] Open
Abstract
Objective To evaluate the impact of Oral Potentially Malignant Disorders (OPMD) on daily life activities. Materials and methods Patients diagnosed with Oral Leukoplakia, Oral submucous fibrosis and Oral Lichen Planus attending the Oral Medicine clinic of Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, India were invited to participate. Eighteen interviews and three focus groups were conducted in a non-clinical setting. Voice recordings were transcribed and translated from Telugu to English. Data coding was performed using the NVivo software. Results Sample size for this qualitative study comprised 32 patients. Four main themes emerged: (1) difficulties with diagnosis and knowledge about the condition, (2) physical impairment and functional limitations, (3) psychological and social wellbeing and (4) effects of treatment on daily life. In a majority of the patients, most of the interview time was spent discussing physical impairment and functional limitations. Patients also reported their mouth condition having a debilitating effect on their psychological well-being and social interactions. Conclusions ‘Physical impairment and functional limitations’ was the most important theme for many of the patients. However, the impacts of OPMD also extended beyond physical impairment and functional limitations to aspects of daily living, notably psychological and social wellbeing.
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Affiliation(s)
- Jyothi Tadakamadla
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
- * E-mail:
| | - Santhosh Kumar
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Newell W. Johnson
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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Babiker TM, Osman KAA, Mohamed SA, Mohamed MA, Almahdi HM. Oral Cancer Awareness Among Dental Patients in Omdurman, Sudan: a cross-sectional Study. BMC Oral Health 2017; 17:69. [PMID: 28335762 PMCID: PMC5364606 DOI: 10.1186/s12903-017-0351-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 02/21/2017] [Indexed: 11/30/2022] Open
Abstract
Background Oral cancer is a preventable disease. Its occurrence is mostly due to lifestyle. In Sudan, the use of smokeless tobacco (Toombak) has long been linked to oral cancer. Knowledge of the signs and symptoms of oral cancer may well aid in early diagnosis and treatment. This is bound to result in increasing survival rates, as well as reducing the oral cancer burden on the society. This study aimed to assess oral cancer awareness regarding knowledge of signs, symptoms, risk factors and sources of the information. Furthermore, it attempts to evaluate attitudes towards oral cancer screening and any previous experience of screening, amongst dental patients attending University of Science and Technology (UST) Dental Teaching Hospital. Omdurman, Sudan. Methods A hospital based cross-sectional study, interviewer-administered questionnaire was conducted amongst 500 adult patients attending the UST Dental Hospital during 2015. Results A total of 57.7% (286) of the individuals demonstrated good knowledge of signs and symptoms, whereas 49% (139) expressed good knowledge of risk factors of oral cancer. For the majority of the individuals 66.1% (290), the most common source of information about oral cancer was from the media, while 33.9% individuals (149), obtained knowledge from direct contact of health workers. The overwhelming majority, 93.2% (466) never screened for oral cancer despite their positive attitude towards it 66.4% (332). Knowledge of risk factors associated significantly with those reported positive attitude towards oral cancer screening and those reported direct contact with health workers as a source of information, (p ≤ 0.001). Moreover, females and those living in urban districts scores higher than their counterpart in knowledge of risk factor of oral cancer. In addition, those employed 58.6% (280) and 62.8% (164) with correct believes about oral cancer showed significant association with positive knowledge of signs and symptoms (p ≤ 0.05). Conclusions Awareness levels, knowledge of risk factors and identifying early signs and symptoms of oral cancer necessitate the need for more structured preventive programs using media. Dentists and health workers should do more because they have a pivotal role in early diagnosis by performing oral cancer screening, raising levels of knowledge and in rectifying misconceptions about oral cancer. This would entail a reduction in high rates of morbidity and mortality associated with oral cancer. Electronic supplementary material The online version of this article (doi:10.1186/s12903-017-0351-z) contains supplementary material, which is available to authorized users.
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47
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Hirshberg A, Allon I, Novikov I, Ankri R, Ashkenazy A, Fixler D. Gold nanorods reflectance discriminate benign from malignant oral lesions. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2017; 13:1333-1339. [PMID: 28115253 DOI: 10.1016/j.nano.2017.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/13/2016] [Accepted: 01/01/2017] [Indexed: 12/26/2022]
Abstract
Nanoparticle-based contrast agents have been used as an imaging tool for selectively detecting cancerous processes. We aimed to evaluate the detection sensitivity of reflection measurements of gold nanorods (GNRs) bio-conjugated to anti-epidermal growth factor receptor (GNRs-EGFR) monoclonal antibodies in discriminating benign from premalignant and malignant human oral lesions. Tissue sections incubated with GNRs-EGFR and the reflectance spectrum was measured using hyperspectral microscopy. Reflectance intensity increased with the progression of the disease, lowest in the control group and increasing as the dysplastic changes increase (P<0.001 for linear trend of grade). Intensity was significantly higher in the moderate and severe dysplasias and cancer patients than in the controls and mild dysplasia (t test P=0.0003, Mann-Whitney P<0.0001). The GNRs reflection measurements can discriminate benign and mild dysplastic lesions from the more severe dysplasia and invasive cancer, suggesting an objective, not dependent on the qualification of a technician and with less interpretation errors.
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Affiliation(s)
- Abraham Hirshberg
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Irit Allon
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilya Novikov
- Biostatistical Unit, Gertner institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Rinat Ankri
- Faculty of Engineering and Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan, Israel
| | - Ariel Ashkenazy
- Faculty of Engineering and Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan, Israel
| | - Dror Fixler
- Faculty of Engineering and Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan, Israel
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48
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Yu JS, Chen YT, Chiang WF, Hsiao YC, Chu LJ, See LC, Wu CS, Tu HT, Chen HW, Chen CC, Liao WC, Chang YT, Wu CC, Lin CY, Liu SY, Chiou ST, Chia SL, Chang KP, Chien CY, Chang SW, Chang CJ, Young JD, Pao CC, Chang YS, Hartwell LH. Saliva protein biomarkers to detect oral squamous cell carcinoma in a high-risk population in Taiwan. Proc Natl Acad Sci U S A 2016; 113:11549-11554. [PMID: 27663741 PMCID: PMC5068314 DOI: 10.1073/pnas.1612368113] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Most cases of oral squamous cell carcinoma (OSCC) develop from visible oral potentially malignant disorders (OPMDs). The latter exhibit heterogeneous subtypes with different transformation potentials, complicating the early detection of OSCC during routine visual oral cancer screenings. To develop clinically applicable biomarkers, we collected saliva samples from 96 healthy controls, 103 low-risk OPMDs, 130 high-risk OPMDs, and 131 OSCC subjects. These individuals were enrolled in Taiwan's Oral Cancer Screening Program. We identified 302 protein biomarkers reported in the literature and/or through in-house studies and prioritized 49 proteins for quantification in the saliva samples using multiple reaction monitoring-MS. Twenty-eight proteins were successfully quantified with high confidence. The quantification data from non-OSCC subjects (healthy controls + low-risk OPMDs) and OSCC subjects in the training set were subjected to classification and regression tree analyses, through which we generated a four-protein panel consisting of MMP1, KNG1, ANXA2, and HSPA5. A risk-score scheme was established, and the panel showed high sensitivity (87.5%) and specificity (80.5%) in the test set to distinguish OSCC samples from non-OSCC samples. The risk score >0.4 detected 84% (42/50) of the stage I OSCCs and a significant portion (42%) of the high-risk OPMDs. Moreover, among 88 high-risk OPMD patients with available follow-up results, 18 developed OSCC within 5 y; of them, 77.8% (14/18) had risk scores >0.4. Our four-protein panel may therefore offer a clinically effective tool for detecting OSCC and monitoring high-risk OPMDs through a readily available biofluid.
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Affiliation(s)
- Jau-Song Yu
- Department of Cell and Molecular Biology, Chang Gung University, Taoyuan 33302, Taiwan; Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Yi-Ting Chen
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Department of Biomedical Sciences, Chang Gung University, Taoyuan 33302, Taiwan; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan 33302, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Wei-Fan Chiang
- Department of Oral & Maxillofacial Surgery, Chi-Mei Medical Center, Liouying 736, Taiwan; School of Dentistry, National Yang Ming University, Taipei 112, Taiwan
| | - Yung-Chin Hsiao
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Lichieh Julie Chu
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Lai-Chu See
- Biostatistics Consulting Center, Chang Gung University, Taoyuan 33302, Taiwan; Department of Public Health, Chang Gung University, Taoyuan 33302, Taiwan; Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Chi-Sheng Wu
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan
| | - Hui-Tzu Tu
- Department of Public Health, Chang Gung University, Taoyuan 33302, Taiwan
| | - Hsiao-Wei Chen
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chia-Chun Chen
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Department of Colorectal Surgery, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Wei-Chao Liao
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan
| | - Ya-Ting Chang
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chih-Ching Wu
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan 33302, Taiwan; Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Che-Yi Lin
- Department of Oral & Maxillofacial Surgery, Chi-Mei Medical Center, Liouying 736, Taiwan
| | - Shyun-Yeu Liu
- Department of Oral & Maxillofacial Surgery, Chi-Mei Medical Center, Liouying 736, Taiwan
| | - Shu-Ti Chiou
- Health Promotion Administration, Ministry of Health and Welfare, Taipei 115, Taiwan; Institute of Public Health, National Yang Ming University, Taipei 112, Taiwan
| | - Shu-Li Chia
- Health Promotion Administration, Ministry of Health and Welfare, Taipei 115, Taiwan
| | - Kai-Ping Chang
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Su-Wei Chang
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - Chee-Jen Chang
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; Department of Cardiology, Chang Gung Memorial Hospital, Linkou 33375, Taiwan
| | - John D Young
- Center for Molecular and Clinical Immunology, Chang Gung University, Taoyuan 33302, Taiwan; Biochemical Engineering Research Center, Ming Chi University of Technology, New Taipei City 243, Taiwan; Chang Gung Biotechnology, Taipei 105, Taiwan; Laboratory of Cellular Physiology and Immunology, Rockefeller University, New York, NY 10065
| | - Chia C Pao
- Department of Cell and Molecular Biology, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yu-Sun Chang
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou 33375, Taiwan;
| | - Leland H Hartwell
- Center for Sustainable Health, Biodesign Institute, Arizona State University, Tempe, AZ 85281
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Hassona Y, Scully C, Shahin A, Maayta W, Sawair F. Factors Influencing Early Detection of Oral Cancer by Primary Health-Care Professionals. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:285-291. [PMID: 25851202 DOI: 10.1007/s13187-015-0823-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purposes of this study are to determine early detection practices performed by primary healthcare professionals, to compare medical and dental sub-groups, and to identify factors that influence the ability of medical and dental practitioners to recognize precancerous changes and clinical signs of oral cancer. A 28-item survey instrument was used to interview a total of 330 Jordanian primary health-care professionals (165 dental and 165 medical). An oral cancer knowledge scale (0 to 31) was generated from correct responses on oral cancer general knowledge. An early detection practice scale (0 to 24) was generated from the reported usage and frequency of procedures in oral cancer examination. Also, a diagnostic ability scale (0 to 100) was generated from correct selections of suspicious oral lesions. Only 17.8 % of the participants reported that they routinely performed oral cancer screening in practices. Their oral cancer knowledge scores ranged from 3 to 31 with a mean of 15.6. The early detection practice scores ranged from 2 to 21 with a mean of 11.6. A significant positive correlation was found between knowledge scores and early detection practice scores (r = 0.22; p < 0.001). The diagnostic ability scores ranged from 11.5 to 96 with a mean of 43.6. The diagnostic ability score was significantly correlated with knowledge scores (r = 0.39; p < 0.001), but not with early detection practice scores (r = 0.01; p = 0.92). Few significant differences were found between medical and dental primary care professionals. Continuous education courses on early diagnosis of oral cancer and oral mucosal lesions are needed for primary health-care professionals.
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Affiliation(s)
- Y Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontology, Faculty of Dentistry, The University of Jordan, PO Box 11942, Amman, Jordan.
| | - C Scully
- University College London, London, UK
| | - A Shahin
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontology, Faculty of Dentistry, The University of Jordan, PO Box 11942, Amman, Jordan
| | - W Maayta
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontology, Faculty of Dentistry, The University of Jordan, PO Box 11942, Amman, Jordan
| | - F Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontology, Faculty of Dentistry, The University of Jordan, PO Box 11942, Amman, Jordan
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Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wanyonyi L, Wachira J, Munene R, Onyuma T, Jaoko WG, Sagoo MS, Weiss HA, Burton MJ. Toluidine Blue 0.05% Vital Staining for the Diagnosis of Ocular Surface Squamous Neoplasia in Kenya. JAMA Ophthalmol 2016; 133:1314-21. [PMID: 26378623 DOI: 10.1001/jamaophthalmol.2015.3345] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Clinical features are unreliable for distinguishing ocular surface squamous neoplasia (OSSN) from benign conjunctival lesions. OBJECTIVE To evaluate the adverse effects, accuracy, and interobserver variation of toluidine blue 0.05% vital staining in distinguishing OSSN, confirmed by histopathology, from other conjunctival lesions. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study in Kenya from July 2012 through July 2014 of 419 adults with suspicious conjunctival lesions. Pregnant and breastfeeding women were excluded. EXPOSURES Comprehensive ophthalmic slitlamp examination was conducted. Vital staining with toluidine blue 0.05% aqueous solution was performed before surgery. Initial safety testing was conducted on large tumors scheduled for exenteration looking for corneal toxicity on histology before testing smaller tumors. We asked about pain or discomfort after staining and evaluated the cornea at the slitlamp for epithelial defects. Lesions were photographed before and after staining. MAIN OUTCOMES AND MEASURES Diagnosis was confirmed by histopathology. Six examiners assessed photographs from a subset of 100 consecutive participants for staining and made a diagnosis of OSSN vs non-OSSN. Staining was compared with histopathology to estimate sensitivity, specificity, and predictive values. Adverse effects were enumerated. Interobserver agreement was estimated using the κ statistic. RESULTS A total of 143 of 419 participants (34%) had OSSN by histopathology. The median age of all participants was 37 years (interquartile range, 32-45 years) and 278 (66%) were female. A total of 322 of the 419 participants had positive staining while 2 of 419 were equivocal. There was no histological evidence of corneal toxicity. Mild discomfort was reported by 88 (21%) and mild superficial punctate keratopathy seen in 7 (1.7%). For detecting OSSN, toluidine blue had a sensitivity of 92% (95% CI, 87%-96%), specificity of 31% (95% CI, 25%-36%), positive predictive value of 41% (95% CI, 35%-46%), and negative predictive value of 88% (95% CI, 80%-94%). Interobserver agreement was substantial for staining (κ = 0.76) and moderate for diagnosis (κ = 0.40). CONCLUSIONS AND RELEVANCE With the high sensitivity and low specificity for OSSN compared with histopathology among patients with conjunctival lesions, toluidine blue 0.05% vital staining is a good screening tool. However, it is not a good diagnostic tool owing to a high frequency of false-positives. The high negative predictive value suggests that a negative staining result indicates that OSSN is relatively unlikely.
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Affiliation(s)
- Stephen Gichuhi
- London School of Hygiene and Tropical Medicine, London, England2Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | | | | | | | | | | | | | | | | | - Timothy Onyuma
- Department of Pathology, MP Shah Hospital, Nairobi, Kenya
| | - Walter G Jaoko
- KAVI Institute of Clinical Research, University of Nairobi, Nairobi, Kenya
| | - Mandeep S Sagoo
- University College London Institute of Ophthalmology, London, England10Moorfields Eye Hospital, London, England11St Bartholomew's Hospital, London, England
| | - Helen A Weiss
- London School of Hygiene and Tropical Medicine, London, England
| | - Matthew J Burton
- London School of Hygiene and Tropical Medicine, London, England10Moorfields Eye Hospital, London, England
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