Mouth self‐examination as a screening tool for oral potentially malignant disorders among a high‐risk Indigenous population

Abstract

Objectives To evaluate the efficacy of mouth self‐examination (MSE) as a self‐screening tool for detection of oral mucosal lesions among an Indigenous population in Malaysia at high risk for oral premalignant and malignant disorders. Methods Two villages were selected as the sampling frame based on prevalence of tobacco and betel quid chewing habit. Respondents were asked to check their mouth for presence of lesion or abnormalities. Education on oral cancer, including MSE, was provided. Subsequently, respondents were asked to perform MSE. Finally, a clinical oral examination (COE) was done by a specialist and the presence of oral mucosal lesions was recorded. Results Almost 64.5 percent of respondents exhibited high levels of difficulty and low mucosal visualization and retracting ability, whereas 3.0 percent demonstrated high attention level when performing MSE. Prevalence of oral mucosal lesions was 59.0 percent, whereas the prevalence of oral potentially malignant disorders (OPMDs) was 9.0 percent. Detection of oral lesions by respondents using MSE was lower than detection by the gold standard. Sensitivity and specificity of MSE for detection of all types of lesions were 8.6 and 95.0 percent respectively. When analyzing each lesion type separately, MSE was found to be most sensitive in detection of swellings (10.0 percent), and most specific in identifying white lesions (97.8 percent). For detection of OPMDs, although specificity was high (98.9 percent), sensitivity (0 percent), and +LR (0) was poor. Conclusion MSE is not an effective self‐screening tool for early detection of potentially malignant lesions for this population.

Oral lesions detected during a population screening for prevention and early diagnosis of oral cancer and potentially malignant disorders

“…Many studies reported the lack of general population awareness and knowledge regarding oral cancer 2,9 . In the present, we believe that the diagnosis of only one OSCC and 25 OPMDs from 1.282 screened patients may reflect that the real at-risk population was not reached.…”

Effectiveness of mouth self-examination for screening of oral premalignant/malignant diseases in tribal population of Dehradun district

“…Similar results were observed in the study conducted by Ghani et al . [ 7 ] and Elango et al . [ 19 ] The most prevalent lesion recorded in the present study was difficulty in mouth opening.…”

“…Utilizing theory, observation, expert opinion, and previous studies,[ 7 27 ] a questionnaire was prepared which was validated before the data collection. The final questionnaire consisted of three subdivisions: sociodemographic details, history of risk factors, and practice of MSE.…”

“…Risk habits include, use of tobacco with or without alcohol, nutritional deficiency and having spicy food. [ 3 7 ] The early recognition of these lesions/conditions can avoid the malignant transformation. [ 8 ]…”

Assessment of clinical examination validity in oral cancer risk patients

“…Healthcare is expected to become increasingly inadequate over the coming years. If we rely on existing conventional diagnostic technologies, which are subjective and depend on examiner experience, provision of sufficient quality and quantity of these would place further demands on the availability of healthcare 39 .…”