What do systematic reviews say?

Visual examination (VE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 1 (no pooled analysis): for the 7 low-prevalence studies specificity ranged from 0.94 (95% CI 0.88 to 0.97) to 0.99 (95% CI 0.98 to 1.00); for the 3 higher-prevalence studies specificity ranged from…
  10 studies · 25568 participants
  Low

Visual examination (VE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 1 (no pooled analysis): for the 7 studies with low prevalence (<=10%) sensitivity ranged from 0.50 (95% CI 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00); for the 3 higher-prevalence studies…
  10 studies · 25568 participants
  Low

Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 4 (no pooled analysis): specificity 0.99 (95% CI 0.99 to 1.00), 1.00 (95% CI 0.91 to 1.00), and 0.72 (95% CI 0.63 to 0.80) across the 3 studies. Certainty VERY LOW.
  3 studies · 3600 participants
  Very low

Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 4 (no pooled analysis): sensitivity 0.85 (95% CI 0.81 to 0.88), 0.82 (95% CI 0.57 to 0.96), and 0.94 (95% CI 0.70 to 1.00) across the 3 studies. Prevalence 12.2% to 30.9%. Certainty VERY LOW.
  3 studies · 3600 participants
  Very low

Periodontitis vs Individuals without periodontal disease (by LOA)

Periodontitis is associated with roughly a threefold higher odds of oral cancer (pooled OR 2.94, 95% CI 2.13-4.07; low certainty of evidence), though heterogeneity is moderate (I2=52.4%).

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · Overall (random-effects pooled estimate)
  OR 2.94 [2.13, 4.07]
  8 studies · 6927 participants
  Low

Higher number of lost teeth (per one additional lost tooth) vs One fewer missing tooth

The number of missing teeth (per tooth) was not significantly associated with oral cancer (OR 0.96, 95% CI 0.92-1.01); ungraded.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · Missing teeth (per tooth)
  OR 0.96 [0.92, 1.01]
  2 studies
  GRADE not reported

Missing teeth / tooth loss vs Fewer or no missing teeth

Pooling across all missing-teeth measures, the overall association with oral cancer was not statistically significant (OR 1.20, 95% CI 0.97-1.48; high heterogeneity, I2=82.8%); ungraded.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · Overall (all missing-teeth measures pooled)
  OR 1.20 [0.97, 1.48]
  6 studies
  GRADE not reported

More than 15 missing teeth vs 15 or fewer missing teeth

More than 15 missing teeth was associated with higher odds of oral cancer.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Missing teeth >15
  OR 1.91 [1.01, 3.62]
  5 studies
  GRADE not reported

Intervention not reported

The intervention led to higher oral cancer (OC); GRADE not reported.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Sensitivity analysis: excluding Moraes et al. [34]
  OR 2.63 [1.92, 3.62]
  7 studies
  GRADE not reported

Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 2 (no pooled analysis): specificity 1.00 (95% CI 1.00 to 1.00), 0.95 (95% CI 0.88 to 0.99), 0.44 (95% CI 0.20 to 0.70), and 0.54 (95% CI 0.37 to 0.69) across the 4 studies. Certainty VERY LOW.
  4 studies · 35059 participants
  Very low

Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 2 (no pooled analysis): sensitivity 0.18 (95% CI 0.13 to 0.24), 0.09 (95% CI 0.04 to 0.15), 0.43 (95% CI 0.24 to 0.63), and 0.33 (95% CI 0.10 to 0.65) across the 4 studies. Prevalence 0.6% to 63.6%.…
  4 studies · 35059 participants
  Very low