Malignant development in patients with oral potentially malignant disorders detected through nationwide screening: Outcomes of 5‐year follow‐up at a single hospital

• Published in: Head & neck Vol. 42; no. 1; pp. 67 - 76
• Main Authors: Chiang, Wei‐Fan, Liu, Shyun‐Yeu, Lin, Jen‐Fen, Chiu, Sheng‐Fu, Gou, Shin‐Bin, Chiou, Chang‐Ta, Chang, Chi‐Hua
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-01-2020; Wiley Subscription Services, Inc
• Subjects: Chewing; Fibrosis; Head and neck; high‐risk; Hyperplasia; interval carcinoma; Leukokeratosis; Morbidity; Oral carcinoma; oral potentially malignant disorders; Patients; Quality of life; Risk assessment; Risk factors; screening; Surgery; surgery refusal; surgery refusal; oral potentially malignant disorders; screening; high-risk; oral carcinoma; interval carcinoma
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.25973

Background
Although survival rate and quality of life are improved if patients with oral carcinoma can be detected early, however, such lesions are usually asymptomatic; therefore, it is hard to raise awareness. Screening has proved to be cost‐effective for early detection.
Methods
Sixty‐two patients with oral carcinomas and 555 patients with oral potentially malignant disorders (OPMDs) who were detected through screening were examined the relationship between clinicopathological features and follow‐up outcomes.
Results
The 5‐year cumulative cancer‐free interval rate was 94.1%, and the annual malignant transformation rate was 1.16%. The rate of interval carcinoma development from Candida hyperplasia, oral submucous fibrosis, homogeneous leukoplakia, non‐homogenous leukoplakia, and verrucous hyperplasia, was 13.6%, 5.7%, 4.6%, 12.1%, and 21.3%, respectively. Significant independent risk factors for interval carcinoma development were heavy betel quid chewing, verrucous hyperplasia, and surgery refusal.
Conclusions
Well‐designed risk assessment, treatment, and surveillance program could lead to earlier cancer detection and thereby reduce mortality and morbidity.