Diagnostic aids for the detection of oral cancer

Marika Zurmukhtashvili, Avtandil Machavariani, Giorgi Menabde, Ketevan Gogilashvili



Background:  Different oral mucosal conditions have a similar appearance and it is the real challenge for clinicians to properly diagnose the detected lesion. Survival rates for a patient with oral cancer are highly dependent on the stage at which the diagnosis is made. Early diagnosis of oral cancer is critically important for improving survival rates and quality of life for oral cancer patients worldwide. A wide range of commercial diagnostic tools is available for screening. They can be used to screen a healthy patient for cancerous and precancerous lesions as well as to assess the biological potential and risks of malignant mucosal lesions. It is essential to develop critical diagnostic tools for early detection of oral dysplasia and malignancy that are simple and practical to use, non-invasive, affordable and can be easily performed in the chairside in general dental practice.

Aim:  The aim of our review was to systematically and critically examine the literature about the aids used in oral cancer screening such as toluidine blue, brush cytology, tissue reflection, and autofluorescence and assess their efficacy in the diagnosis of oral lesions.

Methods:  Data was collected using the electronic search method in the following databases: PubMed/Medline, Web of Science. Terms “oral cancer”, OR “oral precancerous lesion”, AND “oral diagnosis” OR “Fluorescence visualization” were utilized. English articles published between 2000-2019, with the available summary and in humans were included.

Results: A total of 239 articles were found from different sources and finally, 14 were selected for this review. Three groups of screening and case-finding aids to the diagnosis of oral cancer and precancerous diseases were identified from the literature: Standard screening tests established diagnostic adjuncts and light-based detection systems. All methods and devices have different advantages and disadvantages and the published papers are controversial. Several studies prove the high specificity and sensitivity of these tests while others reveal no significant improvement of oral lesions detection ability and low clinical value of these methods.

Conclusions:  Tools and methodologies reviewed have significant potential to improve routine oral cancer screening procedures. All methods and devices have their limitations, which hinder their wide implementation in general dental practice. There is no sufficient evidence to declare the superiority of any of these methods. Further research is needed to improve the sensitivity and specificity of these methods.


Oral Cancer, Diagnosis, Spectroscopy

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