Comparison of Different Screening Methods in Estimating the Prevalence of Precancer and Cancer Amongst Male Inmates of a Jail in Maharashtra, India

Abstract

Aim: To compare the effectiveness of self-examination, clinical examination and screening methods using 1% toluidine blue and Lugol's iodine in estimating the prevalence of lesions at risk of malignancy and oral malignant disease amongst the male inmates of Yerwada Central Jail, Pune. Material and Methods: Study was carried out on male inmates in two phases. In the first phase self-examination and clinical examination was carried out on 2,257 male inmates. 164 suspicious cases were subjected to phase II of the study out of whom, 82 participants were screened with 1% toluidine blue and 2% Lugol's iodine followed by biopsy procedure. Results: Sensitivity and specificity for self-examination with clinical examination was 92.2% and 96.6% respectively. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) and positive (+LR) and negative likelihood ratio (-LR) for Toluidine Blue were 88.1%, 66.6% 97.1%, 30%, 2.63 and 0.17 respectively while for Lugol's Iodine they were 94.7%, 83.8%, 98.6%, 55.5%, 5.67 and 0.06 respectively. Conclusions: Prevalence of lesions at risk of malignancy and oral malignant disease by self-examination was 7.8% and by clinical examination was 6.3%. Self-examination is an effective tool in early detection of oral cancer. Use of Lugol's iodine as a screening tool for oral lesions is highly effective in inmate populations.

Effectiveness of the Microlux/DLTM Chemiluminescence Device in Screening of Potentially Malignant and Malignant Oral Lesions

“…Considering the inherent limitations of toluidine blue as a diagnostic test our results are in accordance with other studies (Epstein et al, 1997;Nagaraju et al, 2010;Chaudhari et al, 2013). However, results were different from other studies (Myers, 1970;Mashberg and Feldman, 1988) who observed specificity to be much higher 100% and 95% respectively.…”

Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity

“…Data from 15 included studies (N ¼ 1,453 lesions) showed that when vital staining adjuncts are used in patients with clinically evident, suspicious lesions, 87% of patients with the target condition (PMDs or OSCC) will be classified correctly, and 71% of patients who are healthy will be classified correctly (sensitivity, 0.87; 95% CI, 0.80 to 0.94; specificity, 0.71; 95% CI, 0.61 to 0.82). 45,[63][64][65][66][67][68][69][70][71][72][73][74][75][76] Patients who test positive for the target condition via vital staining are 3 times more likely to have the disease than are those without the disease (positive LR, 3.04; 95% CI, 2.06 to 4.48). Patients who test negative for the target condition via vital staining are 0.18 times as likely not to have the disease as are those with the disease (negative LR, 0.18; 95% CI, 0.10 to 0.32).…”

Non-Invasive Techniques for Detection and Diagnosis of Oral Potentially Malignant Disorders

“…When it is applied on the suspicious lesions, normal mucosa stains brown or mahogany due to its high glycogen content, while dysplastic and cancer lesions do not stain, and appear pale compared with the surrounding tissue (Petruzzi et al 2010). Chaudhari et al (2013) conducted a study on male inmates, and suggested that Lugol's iodine was highly effective as a screening tool for oral PMDs and oral cancer in inmate populations. Lugol's iodine staining during surgery can determine surgical resection margins, reduce local recurrence and improve survival in patients with epithelial dysphasia or malignant lesions (Umeda et al 2011;Kurita et al 2012).…”

“…Two studies demonstrated that RB staining may be a valuable diagnostic technique in the detection of oral PMDs and oral cancer (Du et al 2007;Mittal et al 2012). In one study, authors investigated the efficacy of RB staining in the detection of oral PMDs and (Warnakulasuriya and Johnson 1996;Epstein et al 1997;Ram and Siar 2005;Epstein et al 2008;Lingen et al 2008;Patton et al 2008;Balevi 2011;Awan et al 2012;Mojsa et al 2012;Rajmohan et al 2012) Methylene blue staining 90-91.4 66.6-69 (Chen et al 2007a;Chen et al 2007b;Riaz et al 2013) Rose bengal staining 90-100 73.7-89.09 (Du et al 2007;Zhang et al 2013) Lugol's iodine staining 87.5-94.7 83.8-84.2 (Epstein et al 1992;Chaudhari et al 2013) Light-based detection systems…”