Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Building B, 24105, Kiel, Germany.
Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
J Cancer Res Clin Oncol. 2022 Jun;148(6):1375-1387. doi: 10.1007/s00432-022-03962-x. Epub 2022 Mar 6.
The majority of suspected malignant changes in the oral mucosa are detected by dentists in private practice. Statements regarding the effectiveness of visual examination of the oral cavity for early detection are not necessarily transferable between different health care systems. Our clinical-epidemiological and methodological aim was thus to conduct a prospective regional study in dental practices under everyday conditions, assess the frequency and type of oral mucosal changes, and evaluate the dental examination methodology.
A prospective observational study was conducted, combining a feasibility study of early detection of oral cancer and its documentation with phase I 'modelling' to conceptualize complex interventions in health services research. Dentists in private practice continuously recruited patients over 6 months and used two different sheets for the documentation of suspicious lesions. Statistical analysis involved descriptive statistics and tests for differences (Welch test) or association (Chi-squared test).
Twenty-five dentists (mean age: 50 years, 24% females) participated in this study. Eleven dentists achieved the overall aim of recruiting 200 patients. Around 4200 patients (mean age: 52 years, 57.5% females) participated. The prevalence of suspicious lesions was 8.5%.
It became apparent that a study in cooperation with dentists in private practice to generate clinical-epidemiological data on the early detection of oral mucosal lesions under everyday conditions can be carried out successfully. Further studies with a corresponding level of evidence should be carried out to be able to draw conclusions about the effectiveness of the early detection measure under everyday practice conditions.
大多数口腔黏膜可疑恶变是由私人执业牙医发现的。口腔肉眼检查对早期发现的有效性的相关结论，不一定适用于不同的医疗保健系统。因此，我们的临床流行病学和方法学目标是在日常条件下在牙科诊所中进行一项前瞻性区域研究，评估口腔黏膜变化的频率和类型，并评估牙科检查方法。
进行了一项前瞻性观察研究，结合了早期口腔癌检测的可行性研究及其记录，以及阶段 I“建模”，以概念化卫生服务研究中的复杂干预措施。私人执业牙医在 6 个月内连续招募患者，并使用两张不同的表记录可疑病变。统计分析包括描述性统计和差异检验（Welch 检验）或关联检验（卡方检验）。
25 名牙医（平均年龄：50 岁，24%为女性）参与了这项研究。11 名牙医达到了招募 200 名患者的总体目标。约有 4200 名患者（平均年龄：52 岁，57.5%为女性）参与了研究。可疑病变的患病率为 8.5%。
与私人执业牙医合作开展的这项研究成功地生成了日常条件下口腔黏膜病变早期检测的临床流行病学数据。应开展进一步具有相应证据水平的研究，以便能够根据日常实践条件得出早期检测措施的有效性结论。
