Discovery - University of Dundee - Online Publications

Library & Learning Centre

Screening programmes for the early detection and prevention of oral cancer

Standard

Screening programmes for the early detection and prevention of oral cancer. / Brocklehurst, Paul; Kujan, Omar; Glenny, Anne-Marie; Oliver, Richard; Sloan, Philip; Ogden, Graham; Shepherd, Simon.

In: Cochrane Database of Systematic Reviews, No. 11, CD004150, 2010, p. CD004150.

Research output: Contribution to journalScientific review

Harvard

Brocklehurst, P, Kujan, O, Glenny, A-M, Oliver, R, Sloan, P, Ogden, G & Shepherd, S 2010, 'Screening programmes for the early detection and prevention of oral cancer' Cochrane Database of Systematic Reviews, no. 11, CD004150, pp. CD004150., 10.1002/14651858.CD004150.pub3

APA

Brocklehurst, P., Kujan, O., Glenny, A-M., Oliver, R., Sloan, P., Ogden, G., & Shepherd, S. (2010). Screening programmes for the early detection and prevention of oral cancer. Cochrane Database of Systematic Reviews, (11), CD004150. [CD004150]. 10.1002/14651858.CD004150.pub3

Vancouver

Brocklehurst P, Kujan O, Glenny A-M, Oliver R, Sloan P, Ogden G et al. Screening programmes for the early detection and prevention of oral cancer. Cochrane Database of Systematic Reviews. 2010;(11):CD004150. CD004150. Available from: 10.1002/14651858.CD004150.pub3

Author

Brocklehurst, Paul; Kujan, Omar; Glenny, Anne-Marie; Oliver, Richard; Sloan, Philip; Ogden, Graham; Shepherd, Simon / Screening programmes for the early detection and prevention of oral cancer.

In: Cochrane Database of Systematic Reviews, No. 11, CD004150, 2010, p. CD004150.

Research output: Contribution to journalScientific review

Bibtex - Download

@article{b20dd850b02d4a7390f7adac36cc387d,
title = "Screening programmes for the early detection and prevention of oral cancer",
keywords = "Mass Screening [methods], Mouth Neoplasms [diagnosis; mortality; prevention & control], Physical Examination [methods], Randomized Controlled Trials as Topic, Humans, POTENTIALLY MALIGNANT DISORDERS, SQUAMOUS-CELL CARCINOMA, TOLUIDINE BLUE, PHARYNGEAL CANCER, BREAST-CANCER, PREMALIGNANT LESIONS, OROPHARYNGEAL CANCER, DIAGNOSTIC AIDS, PRIMARY-CARE, MORTALITY",
author = "Paul Brocklehurst and Omar Kujan and Anne-Marie Glenny and Richard Oliver and Philip Sloan and Graham Ogden and Simon Shepherd",
year = "2010",
doi = "10.1002/14651858.CD004150.pub3",
number = "11",
pages = "CD004150",
journal = "Cochrane Database of Systematic Reviews",
issn = "1469-493X",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Screening programmes for the early detection and prevention of oral cancer

A1 - Brocklehurst,Paul

A1 - Kujan,Omar

A1 - Glenny,Anne-Marie

A1 - Oliver,Richard

A1 - Sloan,Philip

A1 - Ogden,Graham

A1 - Shepherd,Simon

AU - Brocklehurst,Paul

AU - Kujan,Omar

AU - Glenny,Anne-Marie

AU - Oliver,Richard

AU - Sloan,Philip

AU - Ogden,Graham

AU - Shepherd,Simon

PY - 2010

Y1 - 2010

N2 - <p>Background</p> <p>Oral cancer is an important global healthcare problem, its incidence is increasing and late-stage presentation is common. Screening programmes have been introduced for a number of major cancers and have proved effective in their early detection. Given the high morbidity and mortality rates associated with oral cancer, there is a need to determine the effectiveness of a screening programme for this disease, either as a targeted, opportunistic or population based measure. Evidence exists from modelled data that a visual oral examination of high-risk individuals may be a cost-effective screening strategy and the development and use of adjunctive aids and biomarkers is becoming increasingly common.</p> <p>Objectives</p> <p>To assess the effectiveness of current screening methods in decreasing oral cancer mortality.</p> <p>Search strategy</p> <p>The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 20 May 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 2), MEDLINE via OVID (1950 to 20 May 2010), EMBASE viaOVID(1980 to 20 May 2010) and CANCERLIT via PubMed (1950 to 20 May 2010). There were no restrictions regarding language or date of publication.</p> <p>Selection criteria</p> <p>Randomised controlled trials (RCTs) of screening for oral cancer or potentially malignant disorders using visual examination, toluidine blue, fluorescence imaging or brush biopsy.</p> <p>Data collection and analysis</p> <p>The original review identified 1389 citations and this update identified an additional 330 studies, highlighting 1719 studies for consideration. Only one study met the inclusion criteria and validity assessment, data extraction and statistics evaluation were undertaken by six independent review authors.</p> <p>Main results</p> <p>One 9-year RCT has been included (n = 13 clusters: 191,873 participants). There was no statistically significant difference in the age-standardised oral cancer mortality rates for the screened group (16.4/100,000 person-years) and the control group (20.7/100,000 person-years). A 43% reduction in mortality was reported between the intervention cohort (29.9/100,000 person-years) and the control arm (45.4/100,000) for high-risk individuals who used tobacco or alcohol or both, which was statistically significant. However, this study had a number of methodological weaknesses and the associated risk of bias was high.</p> <p>Authors' conclusion</p> <p>Although there is evidence that a visual examination as part of a population based screening programme reduced the mortality rate of oral cancer in high-risk individuals, whilst producing a stage shift and improvement in survival rates across the population as a whole, the evidence is limited to one study and is associated with a high risk of bias. This was compounded by the fact that the effect of cluster randomisation was not accounted for in the analysis. Furthermore, no robust evidence was identified to support the use of other adjunctive technologies like toluidine blue, brush biopsy or fluorescence imaging within a primary care environment. Further randomised controlled trials are recommended to assess the efficacy, effectiveness and cost-effectiveness of a visual examination as part of a population based screening programme.<br/> <strong>This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 11. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</strong></p>

AB - <p>Background</p> <p>Oral cancer is an important global healthcare problem, its incidence is increasing and late-stage presentation is common. Screening programmes have been introduced for a number of major cancers and have proved effective in their early detection. Given the high morbidity and mortality rates associated with oral cancer, there is a need to determine the effectiveness of a screening programme for this disease, either as a targeted, opportunistic or population based measure. Evidence exists from modelled data that a visual oral examination of high-risk individuals may be a cost-effective screening strategy and the development and use of adjunctive aids and biomarkers is becoming increasingly common.</p> <p>Objectives</p> <p>To assess the effectiveness of current screening methods in decreasing oral cancer mortality.</p> <p>Search strategy</p> <p>The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 20 May 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 2), MEDLINE via OVID (1950 to 20 May 2010), EMBASE viaOVID(1980 to 20 May 2010) and CANCERLIT via PubMed (1950 to 20 May 2010). There were no restrictions regarding language or date of publication.</p> <p>Selection criteria</p> <p>Randomised controlled trials (RCTs) of screening for oral cancer or potentially malignant disorders using visual examination, toluidine blue, fluorescence imaging or brush biopsy.</p> <p>Data collection and analysis</p> <p>The original review identified 1389 citations and this update identified an additional 330 studies, highlighting 1719 studies for consideration. Only one study met the inclusion criteria and validity assessment, data extraction and statistics evaluation were undertaken by six independent review authors.</p> <p>Main results</p> <p>One 9-year RCT has been included (n = 13 clusters: 191,873 participants). There was no statistically significant difference in the age-standardised oral cancer mortality rates for the screened group (16.4/100,000 person-years) and the control group (20.7/100,000 person-years). A 43% reduction in mortality was reported between the intervention cohort (29.9/100,000 person-years) and the control arm (45.4/100,000) for high-risk individuals who used tobacco or alcohol or both, which was statistically significant. However, this study had a number of methodological weaknesses and the associated risk of bias was high.</p> <p>Authors' conclusion</p> <p>Although there is evidence that a visual examination as part of a population based screening programme reduced the mortality rate of oral cancer in high-risk individuals, whilst producing a stage shift and improvement in survival rates across the population as a whole, the evidence is limited to one study and is associated with a high risk of bias. This was compounded by the fact that the effect of cluster randomisation was not accounted for in the analysis. Furthermore, no robust evidence was identified to support the use of other adjunctive technologies like toluidine blue, brush biopsy or fluorescence imaging within a primary care environment. Further randomised controlled trials are recommended to assess the efficacy, effectiveness and cost-effectiveness of a visual examination as part of a population based screening programme.<br/> <strong>This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 11. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</strong></p>

KW - Mass Screening [methods]

KW - Mouth Neoplasms [diagnosis; mortality; prevention & control]

KW - Physical Examination [methods]

KW - Randomized Controlled Trials as Topic

KW - Humans

KW - POTENTIALLY MALIGNANT DISORDERS

KW - SQUAMOUS-CELL CARCINOMA

KW - TOLUIDINE BLUE

KW - PHARYNGEAL CANCER

KW - BREAST-CANCER

KW - PREMALIGNANT LESIONS

KW - OROPHARYNGEAL CANCER

KW - DIAGNOSTIC AIDS

KW - PRIMARY-CARE

KW - MORTALITY

U2 - 10.1002/14651858.CD004150.pub3

DO - 10.1002/14651858.CD004150.pub3

M1 - Scientific review

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1469-493X

IS - 11

SP - CD004150

ER -

Documents

Documents

  • Publisher's Final Version

    326 KB, PDF-document

    This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 11. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

DOI

Library & Learning Centre

Contact | Accessibility | Policy