College of Dentistry, The Ohio State University, Columbus, OH, USA.
J Am Dent Assoc. 2010 May;141(5):509-20. doi: 10.14219/jada.archive.2010.0223.
This article presents evidence-based clinical recommendations developed by a panel convened by the American Dental Association Council on Scientific Affairs. This report addresses the potential benefits and potential risks of screening for oral squamous cell carcinomas and the use of adjunctive screening aids to visualize and detect potentially malignant and malignant oral lesions.
The panel members conducted a systematic search of MEDLINE, identifying 332 systematic reviews and 1,499 recent clinical studies. They selected five systematic reviews and four clinical studies to use as a basis for developing recommendations.
The panel concluded that screening by means of visual and tactile examination to detect potentially malignant and malignant lesions may result in detection of oral cancers at early stages of development, but that there is insufficient evidence to determine if screening alters disease-specific mortality in asymptomatic people seeking dental care.
The panel suggested that clinicians remain alert for signs of potentially malignant lesions or early-stage cancers while performing routine visual and tactile examinations in all patients, but particularly in those who use tobacco or who consume alcohol heavily. Additional research regarding oral cancer screening and the use of adjuncts is needed.
本文提出了由美国牙科协会科学事务理事会召集的专家组制定的循证临床建议。本报告涉及口腔鳞状细胞癌筛查的潜在益处和潜在风险,以及使用辅助筛查工具来可视化和检测潜在恶性和恶性口腔病变。
小组成员对 MEDLINE 进行了系统搜索,确定了 332 项系统评价和 1499 项近期临床研究。他们选择了五项系统评价和四项临床研究作为制定建议的基础。
专家组得出结论,通过视觉和触觉检查进行筛查以检测潜在的恶性和恶性病变,可能会在发展早期发现口腔癌,但没有足够的证据表明筛查是否会改变无症状寻求牙科护理的人群的疾病特异性死亡率。
专家组建议临床医生在对所有患者进行常规视觉和触觉检查时,对潜在恶性病变或早期癌症的迹象保持警惕,但对使用烟草或大量饮酒的患者尤其如此。需要进一步研究口腔癌筛查和辅助工具的使用。