Clinical assessment to screen for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults

The objective of this review is to estimate the accuracy of the conventional oral examination (COE) used singly or in combination with another index test (Additional Table 1) as a screening test for the detection of oral cancer and potentially malignant disorders (PMD) of the lip and oral cavity of apparently healthy adults.

The secondary objective of this review is to estimate the accuracy of the different tests with COE, when compared with each other.

We will use meta-regression to explore possible sources of heterogeneity, ways in which the observed diagnostic test accuracy varies according to particular characteristics. Covariates to be included in these analyses will include.
• Characteristics of the study sample: prevalence of carcinoma or PMD disease in the study (> 50% prevalence), inclusion of HPV + adults, tobacco users / high alcohol consumption.
• Target condition (oral squamous cell carcinoma alone or oral squamous cell carcinoma and PMD).
• Attributes of the screening programme: prospective organised or opportunistic, type of reference standard (examination and clinical evaluation by physician with specialist knowledge or extended follow-up), operator (dental or general practice professionals or other healthcare workers).