Oral cancer: experiences and diagnostic abilities elicited by dentists in North‐western Spain

Seoane, Juan; Warnakulasuriya, Saman; Varela‐Centelles, Pablo; Esparza, German; Dios, Pedro Diz

doi:10.1111/j.1601-0825.2005.01225.x

Cited by 56 publications

(53 citation statements)

References 63 publications

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“…38 The high degree of accuracy and high positive and negative predictive values (81.9% and 98.9%, respectively) for clinical diagnosis of PMD and malignant lip lesions in this study reflect clinicians' ability to discern the nature of these cases correctly. The overall accuracy and sensitivity of clinical diagnosis found in this study are greater than reported in previous studies, 20,26 but this difference must be interpreted with caution, given that our sample included only lip lesions. On the other hand, the sensitivity of clinical diagnosis of malignant lesions and disorders of epithelial maturation separately was lower (57% and 52%, respectively).…”

Section: Discussioncontrasting

confidence: 54%

“…23 The rate of concordance between clinical and histopathological diagnoses of oral lesions ranges from 36% to 50%. 24,25,26,27 In contrast, a few studies have reported high degrees of sensitivity and specificity, and high positive predictive value, of clinical oral examination for the detection of malignancies, 28,29,30 indicating that the initial clinical evaluation is reliable for the early detection of malignant and PMD lesions. More importantly, clinicians' decision making following such examination can be supported by knowledge of diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 96%

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Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

et al. 2016

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The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 96%

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

et al. 2016

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“…Education actions are needed to increase the awareness of these associations and to encourage individuals to give up habits involved in the pathogenesis of oral cancer. 18 Although the National Oral Health Policy included the diagnosis of oral lesions, with special emphasis on oral cancer, 13 in the scope of practice of primary health care facilities in 2004, and the PMAQ-AB launched in 2011 15 included an indicator of the incidence of mucosal changes, primary health care dentists still have little knowledge of stomatology. For example, most dentists (74.1%) considered themselves incapable of performing biopsies, which are essential for the early diagnosis of oral lesions.…”

Section: Discussionmentioning

confidence: 99%

Oral cancer from a health promotion perspective: experience of a diagnosis network in Ceará

et al. 2014

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The aim of this study is to share the experience of implementing a network for the diagnosis of oral cancer by integrating primary, secondary, and tertiary oral health care centers and identifying the possible weaknesses of the process. The study also investigated the risks of exposure to the main risk factors for oral and lip cancer and their most common potentially malignant lesions (PML). A quantitative cross-sectional study was conducted in two different regions, with patients seen at a primary health care facility from August 2010 to July 2011. Patients with oral lesions were referred to dental specialty centers for biopsy. Patients with PML were treated in dental specialty centers, and patients with squamous cell carcinoma (SCC) were referred to tertiary health care facilities. The dentists' knowledge of PML and SCC was assessed by an objective questionnaire. A total of 3,965 individuals were examined, 296 lesions were found, and 73 biopsies were performed, of which 13.7% were diagnosed as PML and 9.6% as SCC. Tobacco use and sunlight exposure were associated with SCC (85.7%) and PML (80%), respectively. In total, 55 dentists were assessed. The lesions most commonly recognized as PML were leukoplakia (74%), erythroplakia (57%), and actinic cheilosis (56%). Most dentists (74%) felt incapable of performing biopsies, most likely because of an anxiety towards oral cancer, and 57% had never performed one. The integration of primary and secondary health care enables the diagnosis of PML and SCC and establishes a diagnosis network. However, the inability of most primary care dentists to identify PML and perform biopsies is a weakness of the diagnostic process.

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“…To test knowledge is surely important an important goal, but these questionnaires are incomplete tools for assessing competence at a professional task. On the other hand, the use of clinical cases (images and clinical records) has been widely utilised for evaluating and training screeners for oral cancer and precancer (14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

The use of clinical guidelines for referral of patients with lesions suspicious for oral cancer may ease early diagnosis and improve education of healthcare professionals

Seoane

Corral-Lizana²,

González-Mosquera³

et al. 2011

Med Oral

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Early diagnosis and referral of oral cancer is essential. Successful implementation of clinical guidelines must include current practitioners and students. Objective: To evaluate the diagnostic accuracy of students at oral cancer screening and to assess the effectiveness of clinical referral guidelines. Study Design: Fifth year dental students were randomly allocated to either control (n=19) or experimental groups (n=18). Both received the customary training in oral diagnosis. The experimental group underwent a 2 hour workshop where the guidelines for the referral of suspicious lesions were discussed. Three months later, a set of 51 clinical cases including benign, malignant, and precancerous conditions/lesions were used to assess the screening ability of each subject. Results: All 37 students entered the study. Sensitivity (control group) ranged from 16.7% to 66.7%; the experimental group scored from 16.7% to 83.3%. Fifty percent of the experimental students reached sensitivity values ≥62.5% (p=0.01). Diagnostic specificity (control group) spanned from 80% to 93.3% (median=50%); amongst experimental group it ranged from 82.2% to 97.8% (median=92.8%); (p=0.003). Concordance -control group-was X=82.5 (SD=3.2), and X=88.2 (SD=4.3) for the experimental, (p>0.001). Cohen's kappa test was poor (K<0.40) for the controls and moderate for the experimental group. The experimental group referred more oral cancers urgently (p=0.002) and left less unreferred cancers (0.04). This group also referred more precancerous lesions/conditions urgently (p=0.02). Conclusions: The implementation of a clinical referral guideline at undergraduate level has proved valuable, under experimental conditions, to significantly increase diagnostic abilities of the examiners and thus to improve screening for oral cancer.

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Oral cancer: experiences and diagnostic abilities elicited by dentists in North‐western Spain

Abstract: Our data from Spain suggest a need for improving the diagnostic ability of GDPs in the visual detection of oral cancer/precancer by strengthening continuing professional education.

Cited by 56 publications

References 63 publications

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

Oral cancer from a health promotion perspective: experience of a diagnosis network in Ceará

The use of clinical guidelines for referral of patients with lesions suspicious for oral cancer may ease early diagnosis and improve education of healthcare professionals

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