Early findings from a community‐based, cluster‐randomized, controlled oral cancer screening trial in Kerala, India

Sankaranarayanan, Rengaswamy; Mathew, Babu; Jacob, Binu; Thomas, Gigi; Somanathan, Thara; Pisani, Paola; Pandey, Manoj; Ramadas, Kunnambath; Najeeb, K.; Abraham, Elizabeth

doi:10.1002/(sici)1097-0142(20000201)88:3<664::aid-cncr25>3.3.co;2-m

Cited by 21 publications

(31 citation statements)

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“…Sensitivity ranged from 59% to 97%, specificity ranged from 75% to 99%, and meta-analysis resulted in a weighted pooled sensitivity of 85% and a specificity of 97%. Other reports of the performance of visual oral screening include Sankaranarayanan et al (sensitivity 77%, specificity 76%) 33, Ramadas et al (sensitivity 82%, specificity 85%) 34, and Nagao et al (sensitivity 92%, specificity 64%) 35. The classifier in this study can be applied to entire images of the oral cavity to visualize areas with a high probability of being neoplastic; disease probability maps are consistent with histologic sections obtained from tissue in the field of view.…”

Section: Discussionmentioning

confidence: 99%

Objective Detection and Delineation of Oral Neoplasia Using Autofluorescence Imaging

Roblyer

Kurachi

Stepanek

et al. 2009

Cancer Prevention Research

162

157

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Although the oral cavity is easily accessible to inspection, patients with oral cancer most often present at a late stage, leading to high morbidity and mortality. Autofluorescence imaging has emerged as a promising technology to aid clinicians in screening for oral neoplasia and as an aid to resection, but current approaches rely on subjective interpretation. We present a new method to objectively delineate neoplastic oral mucosa using autofluorescence imaging.Autofluorescence images were obtained from 56 patients with oral lesions and 11 normal volunteers. From these images, 276 measurements from 159 unique regions of interest (ROI) sites corresponding to normal and confirmed neoplastic areas were identified. Data from ROIs in the first 46 subjects were used to develop a simple classification algorithm based on the ratio of red-to-green fluorescence; performance of this algorithm was then validated using data from the ROIs in the last 21 subjects. This algorithm was applied to patient images to create visual disease probability maps across the field of view. Histologic sections of resected tissue were used to validate the disease probability maps.The best discrimination between neoplastic and nonneoplastic areas was obtained at 405 nm excitation; normal tissue could be discriminated from dysplasia and invasive cancer with a 95.9% sensitivity and 96.2% specificity in the training set, and with a 100% sensitivity and 91.4% specificity in the validation set. Disease probability maps qualitatively agreed with both clinical impression and histology. Autofluorescence imaging coupled with objective image analysis provided a sensitive and noninvasive tool for the detection of oral neoplasia.

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Section: Discussionmentioning

confidence: 99%

Objective Detection and Delineation of Oral Neoplasia Using Autofluorescence Imaging

Roblyer

Kurachi

Stepanek

et al. 2009

Cancer Prevention Research

162

157

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“…The study, which is described elsewhere,14 15 was carried out in a rural area of the Trivandrum district, Kerala State, India. A total of 191 873 subjects aged 34 years and older were eligible, out of which 167 331 were recruited between 1 January 1996 and 31 December 2004 during three successive screening rounds (87% participation rate).…”

Section: Methodsmentioning

confidence: 99%

Prognosis criteria of casual systolic and diastolic blood pressure values in a prospective study in India

Sauvaget

Ramadas

Thomas

et al. 2009

Journal of Epidemiology & Community Health

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“…The analysis included only the intervention group since subjects from this group had been screened with oral visual inspections and their disease status was known. The objective of the randomized oral cancer screening trial is to evaluate the efficacy of oral visual inspections by trained health workers in preventing death from this cancer 8. The randomization unit was the panchayath ( n =13), which is a rural administrative structure.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for multiple oral premalignant lesions

Thomas

Hashibe

Jacob

et al. 2003

Intl Journal of Cancer

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114

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Oral leukoplakia, oral submucous fibrosis and erythroplakia are 3 major types of oral premalignant lesions. Multiple oral premalignant lesions may possibly develop due to field cancerization, where carcinogenic exposures can cause simultaneous genetic defects to the upper aerodigestive tract epithelium, putting the epithelium at high risk for development of premalignant lesions at different stages of carcinogenesis. There have been no epidemiological studies on risk or protective factors of the disease. A case-control study was conducted with data from the baseline screening of a randomized oral cancer screening trial in Kerala, India. A total of 115 subjects with multiple oral premalignant lesions (8 -10% of oral premalignant lesions in our case series) were included: 64 subjects with oral leukoplakia and oral submucous fibrosis, 19 subjects with oral leukoplakia and erythroplakia, 22 subjects with oral submucous fibrosis and erythroplakia and 10 subjects with all 3 lesions. Individuals without oral lesions were considered controls (n‫.)377,74؍‬ The odds ratio (OR) for ever tobacco chewers was 37.8 (95% confidence interval (CI)‫-2.61؍‬ 88.1) when adjusted for age, sex, education, BMI, smoking, drinking and fruit/vegetable intake. Dose-response relationships were seen for the frequency (p<0.0001) and duration of tobacco chewing (p<0.0001) with the risk of multiple oral premalignant lesions. Whereas alcohol drinking may possibly be a risk factor for multiple oral premalignant lesions, smoking was not associated with the risk of multiple oral premalignant lesions (OR‫,9.0؍‬ 95%CI‫.)7.1-5.0؍‬ The results suggest that tobacco chewing was the most important risk factor for multiple oral premalignant lesions and may be a major source of field cancerization on the oral epithelium in the Indian population.

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Early findings from a community‐based, cluster‐randomized, controlled oral cancer screening trial in Kerala, India

Abstract: Though compliance with referral for confirmatory examination in the first round was lower than the 70% anticipated, intermediate end points, such as stage at diagnosis and case fatality, indicate that the trial is making fairly satisfactory progress.

Cited by 21 publications

References 0 publications

Objective Detection and Delineation of Oral Neoplasia Using Autofluorescence Imaging

Objective Detection and Delineation of Oral Neoplasia Using Autofluorescence Imaging

Prognosis criteria of casual systolic and diastolic blood pressure values in a prospective study in India

Risk factors for multiple oral premalignant lesions

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