Oral and Pharyngeal Cancers: Population-Based Interventions for Early Detection

Population-based interventions to detect pre-cancers and cancers of the mouth and throat early in their development seek to:

• Educate the public about the risk factors, symptoms, and signs of mouth and throat cancers, and the value of detecting them early
• Encourage people at high risk or with symptoms of mouth or throat cancer to have a medical examination and follow-up
• Train health workers to detect suspicious lesions (abnormalities or changes in the mouth or throat, e.g., leukoplakia, erythroplakia, lichen planus, submucous fibrosis) in clients as possible signs of cancer and refer the clients for follow-up and treatment
• Examine people at the workplace, home, health fairs, field clinics, or the usual source of care

Summary of Task Force Recommendations & Findings

The Community Preventive Services Task Force finds insufficient evidence to determine the effectiveness of population-based interventions for early detection of oral (mouth) and pharyngeal (throat) pre-cancers and cancers because the available studies did not report the effects of the programs on morbidity, mortality, or quality of life outcomes.

Task Force Finding

Results from the Systematic Reviews

• No studies reported estimates of effect in terms of morbidity, mortality, or quality of life.
• Of 19 studies identified, 7 measured the accuracy of such interventions in detecting suspicious lesions for follow-up and treatment.
  • Estimates of the accuracy of such screening activities varied widely (sensitivity: 59% – 97%; specificity: 69% – 99%; predictive value positive: 31% – 87%) within ranges reported in other published reviews (e.g., in Chapter 16 of the Guide to Clinical Preventive Services).

These results were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to oral health.

Economic Review

An economic review of this intervention was not conducted because the Task Force found insufficient evidence to determine its effectiveness.

Supporting Materials

• Analytic framework [PDF - 2.52MB]- See Figure 1 on page 24
• Research gaps

Publications

Truman BI, Gooch BF, Sulemana I, et al. Reviews of evidence on interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. [PDF - 2.52MB] Am J Prev Med 2002;23(1S):21-54.

Task Force on Community Preventive Services. Recommendations on selected interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. [PDF - 69KB] Am J Prev Med 2002;23(1S):16-20.

Task Force on Community Preventive Services. Promoting oral health: interventions for preventing dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries: A Report on Recommendations of the Task Force on Community Preventive Services. MMWR 2001;50(RR21):1-13.

Task Force on Community Preventive Services. Oral health. [PDF - 359KB] In : Zaza S, Briss PA, Harris KW, eds. The Guide to Community Preventive Services: What Works to Promote Health? Atlanta (GA): Oxford University Press;2005:304-28.

More Community Guide publications about Oral Health

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Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Oral and pharyngeal cancers: population-based interventions for early detection. www.thecommunityguide.org/oral/earlydetection.html. Last updated: MM/DD/YYYY.

Review completed: June 2000