Screening for oral cancer – A perspective from the Global Oral Cancer Forum

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2017-06, Vol.123 (6), p.680-687
• Main Authors: Speight, Paul M., BDS, FDSRCPS, FDSRCS (Eng), PhD, FRCPath, Epstein, Joel, DMD, MSD, FRCD(C), FDSRCS(Edin), Kujan, Omar, DDS, DipOPath, MSc, PhD, Lingen, Mark W., DDS, PhD, Nagao, Toru, PhD, DMSc, DDS, Ranganathan, Kannan, MDS, MS, PhD, FIAOMP, Vargas, Pablo, DDS, MSc, PhD, FRCPath
• Format: Article
• Language: English
• Subjects: Dentistry; Early Detection of Cancer; Global Health; Humans; Mass Screening; Mouth Neoplasms - diagnosis; Surgery
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2016.08.021

Abstract Screening for oral cancer should be defined as the application of a test to people who are free of disease, in order to identify those who may have oral cancer and to distinguish them from those who may not. The test does not aim to be diagnostic, but aims to identify changes, which may be the earliest signs of impending disease. Defined in this way, screening is an on going public health measure, often funded by governments. A screening programme must do no harm and must be cost effective. Governments demand that strict evidence of benefits and cost effectiveness must be met, before a programme might be implemented. Although there have been many studies investigating the utility of potential screening tests, there have been few evaluations of screening programmes, and only one randomised clinical trial. Systematic reviews have concluded that there is insufficient evidence to show that oral cancer screening can reduce mortality from oral cancer and to date, no country has implemented a formal oral cancer screening programme. This paper reviews this evidence and tries to identify the barriers to screening and suggests where future research might be focussed.