Critical evaluation of diagnostic aids for the detection of oral cancer docx

REVIEW

Critical evaluation of diagnostic aids for the

detection of oral cancer

Mark W. Lingen a,*, John R. Kalmar b,e, Theodore Karrison c,f,

Paul M. Speight d,g

a Departments of Pathology, Medicine, and Radiation & Cellular Oncology, The University of Chicago,

Pritzker School of Medicine, 5841 S. Maryland Avenue, Chicago, IL 60637, USA

b Section of Oral and Maxillofacial Surgery, Pathology and Dental Anesthesiology, The Ohio State University College

of Dentistry, Columbus, OH 43218, USA

c Department of Health Studies, The University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637, USA

d Department of Oral Pathology, The University of Sheffield, Claremont Cres. Sheffield S10 2TA, Sheffield, UK

Received 30 April 2007; received in revised form 21 June 2007; accepted 22 June 2007

KEYWORDS

Oral cancer;

Premalignancy;

Screening;

Diagnosis

Summary Historically, the screening of patients for signs of oral cancer and precancerous

lesions has relied upon the conventional oral examination. A variety of commercial diagnostic

aids and adjunctive techniques are available to potentially assist in the screening of healthy

patients for evidence of otherwise occult cancerous change or to assess the biologic potential

of clinically abnormal mucosal lesions. This manuscript systematically and critically examines

the literature associated with current oral cancer screening and case-finding aids or adjuncts

such as toluidine blue, brush cytology, tissue reflectance and autofluorescence. The character￾istics of an ideal screening test are outlined and the authors pose several questions for clini￾cians and scientists to consider in the evaluation of current and future studies of oral cancer

detection and diagnosis. Although the increased public awareness of oral cancer made possible

by the marketing of recently-introduced screening adjuncts is commendable, the tantalizing

implication that such technologies may improve detection of oral cancers and precancers

beyond conventional oral examination alone has yet to be rigorously confirmed.

ª 2007 Elsevier Ltd. All rights reserved.

Introduction

Oral cancer is traditionally defined as squamous cell carci￾noma of the lip, oral cavity and oropharynx. At current

rates, approximately 30,000 cases in the United States and

more than 400,000 cases worldwide will be diagnosed in

1368-8375/$ - see front matter ª 2007 Elsevier Ltd. All rights reserved.

doi:10.1016/j.oraloncology.2007.06.011

* Corresponding author. Tel.: +1 773 702 5548; fax: +1 773 834

7644.

E-mail addresses: [email protected] (M.W. Lingen),

[email protected] (J.R. Kalmar), [email protected].

edu (T. Karrison), [email protected] (P.M. Speight). e Tel.: +1 614 292 0197; fax: +1 614 292 9384.

f Tel.: +1 773 702 9326; fax: +1 773 702 1979. g Tel.: +44 114 2717960; fax: +44 114 271 7894.

Oral Oncology (2007) xxx, xxx– xxx

available at www.sciencedirect.com

journal homepage: http://intl.elsevierhealth.com/journals/oron/

ARTICLE IN PRESS

Please cite this article in press as: Lingen MW et al., Critical evaluation of diagnostic aids for the..., Oral Oncol (2007),

doi:10.1016/j.oraloncology.2007.06.011