Long term effect of visual screening on oral cancer incidence and mortality in a randomized trial in Kerala, India

Sankaranarayanan, Rengaswamy; Ramadas, Kunnambath; Somanathan, Thara; Muwonge, Richard; Thomas, Gigi; Anju, Gopan; Mathew, Babu

doi:10.1016/j.oraloncology.2012.11.004

Cited by 210 publications

(203 citation statements)

References 21 publications

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“…Unfortunately, most of the publications in oral cancer screening is based on observational, case cohort studies, but there is only single ongoing randomized controlled trail in Kerala, India using visual inspection and their most recent results concluded a sustained reduction in oral cancer mortality during the 15-year follow-up (Sankaranarayanan et al, 2013). The latest update of the ongoing Cochrane systematic review stated that this study is associated with great degree of bias (Brocklehurst et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of the Microlux/DLTM Chemiluminescence Device in Screening of Potentially Malignant and Malignant Oral Lesions

Ibrahim

Al-Attas²,

Darwish³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To evaluate the effectiveness of Microlux/DL with and without toluidine blue in screening of potentially malignant and malignant oral lesions. Materials and Methods: In this diagnostic clinical trial clinical examination was carried out by two teams: 1) two oral medicine consultants, and 2) two general dentists. Participants were randomly and blindly allocated for each examining team. A total of 599 tobacco users were assessed through conventional oral examination (COE); the examination was then repeated using Microlux/DL device and toluidine blue. Biopsy of suspicious lesions was performed. Also clinicians opinions regarding the two tools were obtained. Results: The sensitivity and, specificity and positive predictive value (PVP) of Microlux/DL for visualization of suspicious premalignant lesions considering COE as a gold standard (i.e screening device) were 94.3%, 99.6% and 96.2% respectively, while they were 100%, 32.4% and 17.9% when considering biopsy as a gold standard. Moreover, Microlux/DL enhanced detection of the lesion and uncovered new lesions compared to COE, whereas it did not alter the provisional clinical diagnosis, or alter the biopsy site. On the other hand, adding toluidine blue dye did not improve the effectiveness of the Microlux/DL system. Conclusions: The Microlux/DL seems to be a promising adjunctive screening device.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of the Microlux/DLTM Chemiluminescence Device in Screening of Potentially Malignant and Malignant Oral Lesions

Ibrahim

Al-Attas²,

Darwish³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…22,25 There is evidence for the use of DCPs and clinicians other than GDPs to detect caries and to screen for oral cancer. [26][27][28][29] Judgement under uncertainty favours safety and the only randomised controlled trial (RCT) that has examined screening for oral cancer used allied health providers, not GDPs, to undertake the screen. 28,30 The interviews from the Netherlands also highlight the need for rigorous evaluation of direct access.…”

Section: Discussionmentioning

confidence: 99%

Direct access: lessons learnt from the Netherlands

et al. 2013

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“…For example, randomized controlled trials have measured the impacts on mortality of visual inspection (VI) of the cervix followed by treatment of precancerous and cancerous lesions when implemented by different cadres of health workers with varying frequency (Sankaranarayanan et al, 2007;Sankaranarayanan et al, 2009;Shastri et al, 2014). In the case of oral cancer, a trial involving 191,872 individuals in Kerala, although underpowered to detect statistically significant reductions in mortality among all eligible individuals, found that screening was efficacious among those who adhered to three or four rounds of oral visual screening as well as among individuals using tobacco and/or alcohol, largely due to early detection and reductions in the incidence of advanced cancers (Sankaranarayanan et al, 2013). Breast cancer screening and early detection through clinical breast examinations are also being studied in India, with high rates of acceptance and adherence to diagnostic and treatment recommendations (Mittra et al, 2010;Sankaranarayanan et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Using Implementation Science to Advance Cancer Prevention in India

Krishnan

Sivaram

Anderson

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidencebased practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

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Long term effect of visual screening on oral cancer incidence and mortality in a randomized trial in Kerala, India

Cited by 210 publications

References 21 publications

Effectiveness of the Microlux/DLTM Chemiluminescence Device in Screening of Potentially Malignant and Malignant Oral Lesions

Effectiveness of the Microlux/DLTM Chemiluminescence Device in Screening of Potentially Malignant and Malignant Oral Lesions

Direct access: lessons learnt from the Netherlands

Using Implementation Science to Advance Cancer Prevention in India

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