Investigators: Sook-Bin Woo, DMD, MMSc; Kathy Myers, RDH, MBA, project manager
Funder(s): National Institute of Dental and Craniofacial Research
The purpose of the study is to evaluate the efficiency of a risk-assessment algorithm in identifying subjects with suspicious precancerous or cancerous lesions in a high-risk population, as compared to broad screening in the general population.
The Preventive Services Task Force of the United States does not recommend broad population screening of asymptomatic adults for oral cancer based on lack of evidence in support of such screening. The decision is due to several unknown parameters that have to do with resource allocation as well as the accuracy of the employed methods. A community-based method targeting high-risk individuals would theoretically be more efficient, as it would maximize the output (number of identified lesions) for any given number of inputs (health-care personnel and/or monetary resources). While efficiency is an important attribute of successful public-health programs, it has not been evaluated in the context of oral cancer screening. To test the efficiency of risk assessment in a community setting, we propose to interview 2,000 individuals to calculate their oral cancer risk score, followed by intraoral examination using visual/tactile examination, and biopsy of suspicious lesions. Along with calculating the sensitivity and specificity of risk assessment, the results will be analyzed using the nonparametric Data Envelopment Analysis (DEA) methodology, a statistical methodology we have used successfully in the past in the evaluation of a national primary care network.