Performance of a simplified scoring system for risk stratification in oral cancer and oral potentially malignant disorders screening

• DOI: 10.1111/jop.13293
• Publication Date: 2022-03-21T09:29:43Z
• Authors: John Adeoye; Abdulrahman Sakee...; Jia Yan Tan; Weilan Wang; Wang‐Yong Zhu; Peter Thomson; Li‐Wu Zheng; Siu‐Wai Choi; Yu‐Xiong Su
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 610; Humans; Mass Screening; Mouth Neoplasms; Precancerous Conditions; Risk Assessment; Early Detection of Cancer; 3. Good health

AbstractBackgroundImpact and efficiency of oral cancer and oral potentially malignant disorders screening are most realized in “at‐risk” individuals. However, tools that can provide essential knowledge on individuals' risks are not applied in risk‐based screening. This study aims to optimize a simplified risk scoring system for risk stratification in organized oral cancer and oral potentially malignant disorders screening.MethodsParticipants were invited to attend a community‐based oral cancer and oral potentially malignant disorders screening program in Hong Kong. Visual oral examination was performed for all attendees and information on sociodemographic characteristics as well as habitual, lifestyle, familial, and comorbidity risk factors were obtained. Individuals' status of those found to have suspicious lesions following biopsy and histopathology were classified as positive/negative and this outcome was used in a multiple logistic regression analysis with variables collected during screening. Odds ratio weightings were then used to develop a simplified risk scoring system which was validated in an external cohort.ResultsOf 979 participants, 4.5% had positive status following confirmatory diagnosis. A 12‐variable simplified risk scoring system with weightings was generated with an AUC, sensitivity, and specificity of 0.82, 0.71, and 0.78 for delineating high‐risk cases. Further optimization on the validation cohort of 491 participants yielded a sensitivity and specificity of 0.75 and 0.87 respectively.ConclusionsThe simplified risk scoring system was able to stratify oral cancer and oral potentially malignant disorders risk with satisfactory sensitivity and specificity and can be applied in risk‐based disease screening.