Affiliation:
1. KLE Society's Institute of Dental Sciences Bengaluru Karnataka India
2. Integrated Head and Neck Oncology Program Mazumdar Shaw Medical Foundation Bengaluru Karnataka India
3. Karkinos Healthcare Kochin India
Abstract
AbstractObjectivesThe incidence of oral cancer is significantly high in South Asia and Southeast Asia. Organized screening is an effective approach to early detection. The aim of this systematic review and meta‐analysis was to evaluate the reliability, diagnostic accuracy, and effectiveness of visual oral screening by community health workers (CHWs) in identifying oral cancer/oral potentially malignant disorders (OPMDs) in this region.Materials and MethodsWe conducted a bibliographic search in PubMed, Scopus, the gray literature of Google Scholar, ProQuest dissertations, and additional manual searches. Twelve articles were included for qualitative synthesis and six for meta‐analysis. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and forest plot analysis were performed.ResultsMeta‐analysis showed CHWs identified 8% (n = 6365) as suspicious and 92% (n = 74,140) as normal. The diagnostic accuracy of visual oral screening by CHWs showed a sensitivity of 75% (CI: 74–76) and specificity of 97% (CI: 97–97) in the detection of OPMDs/oral cancer. Forest plots were obtained using a random effects model (DOR: 24.52 (CI: 22.65–26.55)) and SAUC: 0.96 (SE = 0.05).ConclusionsOral visual examination by trained CHWs can be utilized for community screenings to detect oral cancer early. This approach can be used in primary healthcare to triage patients for further referral and management.