A Cross-Sectional Study on Oral Potentially Malignant Disorders: Diagnostic Challenges in Early Detection of Dysplasia and the Role of Velscope

Abstract

Background: The oral cancer burden has become a global challenge in the present scenario. Early diagnosis of oral potentially malignant disorders (OPMDs) with dysplasia is crucial to increasing the overall survival rate of the patients. Efficient chairside techniques are much needed to enhance diagnostic efficacy at early stages. This study evaluates the effectiveness of Velscope in detecting dysplastic lesions and analyzes the impact of lifestyle factors on the prevalence and progression of oral potentially malignant disorders among 40 participants. Methods: A cross-sectional study was conducted with 40 participants diagnosed with OPMDs. Participants underwent a Velscope examination followed by incisional biopsy and histopathological evaluation. Data on lifestyle factors such as tobacco, alcohol, pan, and gutka use were collected through self-reported questionnaires. Data were analyzed to assess Velscope efficacy and correlations between lifestyle risk factors and lesion sites. Statistical analysis was performed using SPSS statistics for Windows (version 26.0, IBM Corp., Armonk, NY). The significance level was fixed at 5% (α=0.05). Results: The data analysis of the study revealed that Velscope showed a sensitivity of 88.89% and a specificity of 46.15% (p = 0.013). The positive predictive value (PPV) of the Velscope was 77.42%, and the negative predictive value (NPV) was 66.67%. Overall, the diagnostic accuracy of the Velscope in this study was 75.0%. Cohen's kappa of 0.381 indicated moderate agreement with biopsy results. Biopsy results showed no statistically significant correlation was found between dysplasia and lesion site, gender, smoking, alcohol, or pan use except for gutka users, who had a significantly higher rate of dysplasia (p = 0.027). Conclusion: Velscope demonstrated high sensitivity but moderate specificity in detecting dysplasia, emphasizing its role as an adjunctive tool in early detection and delineation of oral lesions in conjunction with biopsies for accurate diagnosis. The higher rate of positive results for dysplasia among gutka users suggests that focused public health interventions are needed to address significant lifestyle risk factors, which in turn could reduce malignant transformations in OPMDs.