Derivation and validation of a risk-factor model for detection of oral potentially malignant disorders in populations with high prevalence

Background: Oral and pharyngeal cancers constitute the sixth most common type of cancer globally, with high morbidity and mortality. In many countries, most cases of oral cancer arise from long-standing, pre-existing lesions, yet advanced malignancies prevail. A new approach to early detection is ne...

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Vydáno v:	British journal of cancer Ročník 103; číslo 3; s. 303 - 309
Hlavní autoři:	Amarasinghe, H K, Johnson, N W, Lalloo, R, Kumaraarachchi, M, Warnakulasuriya, S
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	London Nature Publishing Group UK 27.07.2010 Nature Publishing Group
Témata:	631/67/2322 692/499 692/699/67/1536/1665 Adult Alcohol Alcohol Drinking - adverse effects Areca - adverse effects Biological and medical sciences Biomedical and Life Sciences Biomedicine Cancer Research Clinical Study Drug Resistance Epidemiology Humans Medical research Medical sciences Medical screening Middle Aged Molecular Medicine Mouth Neoplasms - diagnosis Mouth Neoplasms - epidemiology Mouth Neoplasms - prevention & control Odds Ratio Oncology Oral cancer Oral hygiene Otorhinolaryngology. Stomatology Pharyngeal Neoplasms - epidemiology Pharyngeal Neoplasms - prevention & control Prevalence Risk Assessment Risk Factors ROC Curve Rural Population - statistics & numerical data Smoking - adverse effects Smoking - epidemiology Socioeconomic Factors Sri Lanka - epidemiology Surveys and Questionnaires Tobacco Tumors Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology Asia Sri Lanka Queensland Australia Australia INW, Asia ISW, Sri Lanka I, Pacific oral potentially malignant disorders risk factors screening Sri Lanka socioeconomic status oral cancer Human Validation Prevalence Socioeconomic status Oral cancer Stomatology Malignant tumor Medical screening Epidemiology Cancerology Risk factor Oral cavity disease Models Diagnosis Cancer
ISSN:	0007-0920, 1532-1827, 1532-1827
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Shrnutí:	Background: Oral and pharyngeal cancers constitute the sixth most common type of cancer globally, with high morbidity and mortality. In many countries, most cases of oral cancer arise from long-standing, pre-existing lesions, yet advanced malignancies prevail. A new approach to early detection is needed. We aimed to validate a model for screening so that only high-risk individuals receive the clinical examination. Methods: A community-based case–control study ( n =1029) in rural Sri Lanka assessed risk factors and markers for oral potentially malignant disorders (OPMD) by administering a questionnaire followed by an oral examination. We then developed a model based on age, socioeconomic status and habits of betel-quid chewing, alcohol drinking and tobacco smoking, with weightings based on odds ratios from the multiple logistic regression. A total, single score was calculated per individual. Standard receiver-operator characteristic curves were plotted for the total score and presence of OPMD. The model was validated on a new sample of 410 subjects in a different community. Results: A score of 12.0 produced optimal sensitivity (95.5%), specificity (75.9%), false-positive rate (24.0%), false-negative rate (4.5%), positive predictive value (35.9%) and negative predictive value (99.2%). Conclusion: This model is suitable for detection of OPMD and oral cancer in high-risk communities, for example, in Asia, the Pacific and the global diaspora therefrom. A combined risk-factor score of 12.0 was optimal for participation in oral cancer/OPMD screening in Sri Lanka. The model, or local adaptations, should have wide applicability.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0007-0920 1532-1827 1532-1827
DOI:	10.1038/sj.bjc.6605778