Abstract
Data sources
Medline, the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Groups Trials Register, Embase and MEDION.
Study selection
Two of the reviewers independently assessed titles abstracts and extracted data. Cross-sectional diagnostic test accuracy studies (or consecutive series) and randomised studies of diagnostic test accuracy that reported the diagnostic test accuracy of vital staining, oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis used as an adjunct to conventional oral examination in detecting PMD or oral squamous cell carcinoma of the lip or oral cavity were considered. Scalpel, punch or fine needle aspiration biopsy with histological diagnosis was the reference test.
Data extraction and synthesis
Study quality was assessed using a modified version of QUADAS-2. Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. Meta-regressionanalysis was undertaken to explore possible sources of heterogeneity.
Results
Forty-one studies, recruiting 4002 patients were included. No single study could be classified as being at low risk of bias across all domains. Fourteen studies evaluated vital staining, 13 studies oral cytology and 13 studies light-based detection or oral spectroscopy, while six studies assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis.
Conclusions
The overall quality of the included studies was poor. None of the adjunctive tests can be recommended as a replacement for the currently used standard of a scalpel biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Warnakulasuriya S . Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009; 45: 309–316.
Cancer Research UK, (http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oral-cancer), Accessed [June] [2015].
Conway DI, McMahon AD, Smith K, et al. Components of socioeconomic risk associated with head and neck cancer: a population-based case-control study in Scotland. Br J Oral Maxillofac Surg. 2010; 48: 11–17.
Rusthoven KE, Raben D, Song JI, Kane M, Altoos TA, Chen C . Survival and patterns of relapse in patients with oral tongue cancer. J Oral Maxillofac Surg. 2010; 68: 584–589.
Glenny AM, Furness S . Worthington HV, et al. Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy. Cochrane Database Syst Rev. 2010; 8: [DOI: 10.1002/14651858.CD006387.pub2]
Furness S, Glenny AM, Worthington HV, et al. Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy. Cochrane Database Syst Rev. 2011; 13: [DOI: 10.1002/14651858.CD 006386.pub3]
QUADAS-2 http://www.bris.ac.uk/quadas/quadas-2/ (accessed June 2015)
Walsh T, Liu JLY, Brocklehurst P, et al. Clinical assessment to screen for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults. Cochrane Database Syst Rev. 2013; 11: Art. No. CD010173. DOI: 10.1002/14651858.CD 010173.pub2.
Brocklehurst P, Kujan O, O'Malley LA, Ogden G, Shepherd S, Glenny AM . Screening programmes for the early detection and prevention of oral cancer. Cochrane Database Syst Rev. 2013; 11: Art. No.: CD004150. DOI: 10.1002/14651858.CD004150.pub4.
NUK National Screening Committee- Oral Cancer in Screening in Adults http://www.screening.nhs.uk/oralcancer (accessed June 2015)
Author information
Authors and Affiliations
Additional information
Address for correspondence: Luisa Fernandez Mauleffinch, Managing Editor, Cochrane Oral Health Group, School of Dentistry, The University of Manchester, JR Moore Building, Oxford Road, Manchester, M13 9PL, UK. E-mail: luisa.fernandez@manchester.ac.uk
Macey R, Walsh T, Brocklehurst P, Kerr AR, Liu JL, Lingen MW, Ogden GR, Warnakulasuriya S, Scully C. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Syst Rev 2015; 5: CD010276. DOI:10.1002/14651858.CD010276.pub2.
This paper is based on a Cochrane Review published in the Cochrane Library 2015, issue 5 (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Library should be consulted for the most recent version of the review.
Rights and permissions
About this article
Cite this article
Richards, D. Adjunctive tests cannot replace scalpel biopsy for oral cancer diagnosis. Evid Based Dent 16, 46–47 (2015). https://doi.org/10.1038/sj.ebd.6401093
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.ebd.6401093
This article is cited by
-
The prognostic value of GLUT-1 staining in the detection of malignant transformation in oral mucosa
Clinical Oral Investigations (2017)
