Modeling oral cancer screening in the United States population. (January 2022)

• Record Type: Journal Article
• Authors: Cramer, John D.; Grauer, Jordan
• Is Part Of: Oral oncology. Volume 124(2022)
• Publication Date: 2022-01
• Subjects: Oral cancer -- Oral cavity cancer -- Oropharyngeal cancer -- Screening -- Prevention; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2021.105656
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Data from three US cancer databases were used to model the potential effectiveness of oral cancer screening. The estimated screening efficiency increases when applied to higher-risk individuals. In ≥ 60 pack-year male smokers aged 50–79, we predict a 4.6% reduction in oral cancer mortality with an NNS = 1, 485. Screening high-risk individuals has the potential to reduce oral cancer mortality in the US. Abstract: Objectives: To evaluate the impact of oral cancer screening if applied to the United States (US) population or various high-risk populations in the US. Methods: We modeled the effects of applying an oral cancer screening program to the US population assuming a similar mortality reduction as seen in the randomized Kerala trial. We combined data on the incidence of oral cancer in the Surveillance, End Results, and Epidemiology database, data on the relative risk in various high-risk groups from the Prostate, Lung, Cervical, and Ovarian screening trial, and the National Lung Screening Trial and data on the prevalence of cigarette use from the National Health Interview Survey. Results: When extrapolating to the US population we predict the number needed to screen to prevent one oral cancer death (NNS) = 9, 845 in all individuals aged 35 + . Screening efficiency would increase if applied to higher-risk populations. If oral cancer screening were applied to male ≥ 60 pack-year current smokers or former smokers who have quit within 15 years aged 50–79 we predict a 4.6% reduction in oral cancer mortality with an NNS = 1, 485. Conclusions: Targeted screening of individuals at high risk for oral cancer has the potential to maximize the efficiency of screening and meaningfully impact oral cancer mortality. We suggest a future screening trial in high-risk individuals be considered to clarify the role of oral cancer screening in the US.