title: Opportunistic screening for oral cancer and precancer in general dental practice: results of a demonstration study.
abstract: OBJECTIVE
  To demonstrate the feasibility of opportunistic oral cancer and precancer screening in general dental practice and to determine the prevalence of relevant lesions and risk habits in a population of general dental practice attenders.
  
  
  METHODS
  A prospective demonstration study, recruiting patients opportunistically.
  
  
  METHODS
  General dental practices.
  
  
  METHODS
  Eighteen general dental practitioners took part in this study. Each attended training sessions to be advised of the study protocol and the criteria of a positive and negative screen. Patients over the age of 35 years were prospectively and opportunistically recruited. Each patient was asked to complete a health questionnaire concerning age, gender, ethnicity, smoking and drinking habits. The dentist then examined the soft tissues and recorded the presence or absence of lesions independently on a second form. The forms were collated and data were analysed to determine prevalence of lesions and associations with risk habits.
  
  
  RESULTS
  Data on 2,265 patients were available for analysis. Oral lesions were detected in 319 patients (14.1%). Ninety-four patients (4.2%) had lesions considered to be either malignant or potentially malignant. There was a significant association between positive lesions and male gender(IRR 1.86, 95% CI 1.22-2.82), heavy smoking (males: IRR 3.68, 95% Cl2.10-6.43: female; IRR 3.58, 954b CI 1.35-9.50) and heavy alcohol use in males (IRR 2.98, 95%q CI 1.06-3.47).
  
  
  CONCLUSIONS
  The results suggest that patients attending general dental practices are representative of the general population both in terms of lesion prevalence and high risk habits such as smoking and drinking. This supports the view that opportunistic screening in a general dental practice setting may be a realistic alternative to population screening. Further research is needed to determine the cost effectiveness of this approach and to investigate the value of targeting high risk groups within this population. General dental practice is ideal for the evaluation of such systems prior to extending these studies to other healthcare settings.
authors.affiliation: Department of Oral and Maxillofacial Pathology, Eastman Dental Institute.
authors.forename: K
authors.initials: K
authors.lastname: Lim
authors.forename: D R
authors.initials: DR
authors.lastname: Moles
authors.forename: M C
authors.initials: MC
authors.lastname: Downer
authors.forename: P M
authors.initials: PM
authors.lastname: Speight
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D016001:Confidence Intervals; D005006:Ethnicity; D005240:Feasibility Studies; D005260:Female; D005792:General Practice, Dental; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D016017:Odds Ratio; D010808:Physical Examination; D011230:Precancerous Conditions / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking