Prevalence and risk factors of oral potentially malignant disorders in Indonesia: a cross-sectional study undertaken in 5 provinces

Sari, Elizabeth Fitriana; Johnson, Newell W.; McCullough, Michael John; Cirillo, Nicola

doi:10.1038/s41598-024-54410-4

Cited by 4 publications

(1 citation statement)

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“…A meta-analysis showed that the global prevalence of OPMDs is 4.47% (excluding oral lichen planus and related disorders), with rates as high as 10.54% in Asia [60], and oral lichen planus occurs in about 1% of the population [61]. These findings align with our pilot population study surveying five Indonesian provinces, where over 14% of participants had an OPMD [62], with leukoplakia being the most common. In a more recent meta-analysis, the global prevalence of leukoplakia was found to be 1.39%, with a range from 0.12 to 33.33% [63].…”

Section: Overdiagnosis Of Opmdssupporting

confidence: 81%

Precursor Lesions, Overdiagnosis, and Oral Cancer: A Critical Review

Cirillo

2024

Cancers

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Despite the profession placing great emphasis on oral potentially malignant disorders (OPMDs) as a gateway for early recognition and consequently better outcomes for oral cancer, the death rates for lip and oral cavity cancer have remained stagnant for three decades. Evidence shows that only a small fraction of oral cancers are in fact preceded by OPMDs, and that most OPMDs have an annual transformation rate of less than 1%. As OPMDs encompass a very heterogeneous group of oral conditions, it could be argued that only patients with oral mucosal diseases bearing a substantial risk of malignant transformation warrant close surveillance and treatment, these include proliferative leukoplakia, erythroplakia, non-homogeneous leukoplakia, as well as diseases presenting with severe dysplasia at biopsy. In this narrative review, I discuss the intricate epidemiology of the malignancies that we colloquially refer to as oral cancer, explore the limitations of focusing on OPMDs to reduce the incidence and mortality of oral cavity cancer, and argue that a may-be cancer label represents overdiagnosis for most OPMDs.

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Section: Overdiagnosis Of Opmdssupporting

confidence: 81%

Precursor Lesions, Overdiagnosis, and Oral Cancer: A Critical Review

Cirillo

2024

Cancers

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The association between betel quid use and oral potentially malignant and malignant disorders in Southeast Asian and Pacific regions: a systematic review and meta-analysis with GRADE evidence profile

Jasim,

Li,

Octavia

et al. 2024

Front. Oral. Health

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BackgroundBetel quid (BQ) chewing is a prevalent habit in the Asian and Pacific regions. It is deeply intertwined within cultural customs, and has been reported to result in oral potentially malignant disorders (OPMDs) and malignant disorders (MDs).ObjectiveWe aim to present a summative and broad overview of the burden that BQ chewing has imposed on the residents of the Southeast Asian, Pacific, and Australasian regions, allowing us to quantify the level of impact it is currently causing on the risk of people developing oral cancer.MethodsThis scoping review and meta-analysis screened databases such as PubMed, MEDLINE, and Google Scholar for publications that investigated the association between BQ and OPMDs and MDs. The search strategy involved MeSH headings relating to BQ, OPMDs, and MDs, and a search for results during the period between January 2010 and June 2023 within the set geographical boundaries of the Southeast Asian and Pacific regions. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement for Scoping Reviews (PRISMA-ScR). R software was used to screen outliers. The included studies were further analysed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.ResultsNine articles (n = 19,312 participants) presented odds ratio outcomes from 11 regionally different study groups. We indicated a strong correlation between BQ chewing and the increased risk of OMPDs and MDs. The risk was quantified through meta-analyses with an odds ratio (OR) of 8.18 (5.27–12.72) and an increased OR of 9.93 (7.36–13.39) when the outlier was removed. BQ chewing was further identified within various Australian communities and discovered to be produced locally in North Queensland.DiscussionA meta-analysis of two outcomes revealed substantial heterogeneity and minor evidence of publication bias, thus the association effect was included with and without these articles. The overall GRADE quality of evidence ranged from moderate to very high and highlighted five studies with a high level of imprecision.ConclusionThe lingering high prevalence of BQ in the Southeast Asia and Pacific regions, as well as its rising acceptance among non-ethnic Australians, is alarming and requires prompt and rigorous intervention to prevent the risk of oral cancer.Systematic Review RegistrationPROSPERO (CRD42023429694).

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Estimating the Benefits of Oral Cancer Screening: Challenges and Opportunities

Farina,

Cirillo

2024

Cancers

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Screening is widely believed to facilitate early detection and improve health outcomes; however, recent evidence questions its overall benefits, highlighting the need for a critical assessment of cancer screening programs. The simplicity of clinical oral examination and the easy accessibility of the oral cavity make oral cancer a suitable candidate for opportunistic screening. Despite this uniqueness, studies that solidly assess the efficacy and cost-effectiveness of oral cancer screening are scanty, and the only large randomized trial undertaken so far shows limited evidence of mortality reduction through population screening. Research indicates that while early detection rates following screening may increase, they do not necessarily translate into decreased oral cancer deaths. This article emphasizes the need for a nuanced understanding of the benefits of screening, awareness of deceptive metrics and inherent biases in the context of early detection, and the importance of improving dentist education and introducing new technologies to enhance clinical decision-making. The review calls for a balanced and evidence-based approach to oral cancer screening, integrating it with broader oral health initiatives to maximize public health outcomes.

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Prevalence and risk factors of oral potentially malignant disorders in Indonesia: a cross-sectional study undertaken in 5 provinces

Cited by 4 publications

References 56 publications

Precursor Lesions, Overdiagnosis, and Oral Cancer: A Critical Review

Precursor Lesions, Overdiagnosis, and Oral Cancer: A Critical Review

The association between betel quid use and oral potentially malignant and malignant disorders in Southeast Asian and Pacific regions: a systematic review and meta-analysis with GRADE evidence profile

Estimating the Benefits of Oral Cancer Screening: Challenges and Opportunities

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