Evidence map›Paper›PMID 21170007›Full record

ArticleEvidence-based dentistry2010

Oral cancer screening programmes.

Derek Richards

Open access · bronzeAbstract readComment
PubMed Publisher
In one paragraph

Article in Evidence-based dentistry, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 87% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

1 author.

Derek RichardsCentre for Evidence-based Dentistry, Oxford.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

data sourcesThe Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase and CANCERLIT. STUDY SELECTION: Randomised controlled trials (RCTs) of screening for oral cancer or potentially malignant disorders using visual examination, toluidine blue, fluorescence imaging or brush biopsy were included. There were no restrictions regarding language or date of publication. DATA EXTRACTION AND SYNTHESIS: The original review identified 1,389 citations and this update identified an additional 330 studies. Validity assessment, data extraction and statistics evaluation were undertaken by six independent review authors.

resultsOnly one 9-year cluster RCT was included (n = 13 clusters: 191,873 participants). No statistically significant differences in the age-standardised oral cancer mortality rates for the screened group (16.4/100,000 person-years) and the control group (20.7/100,000 person-years) were identified. A 43% reduction in mortality was reported between the intervention cohort (29.9/100,000 person-years) and the control arm (45.4/100,000) for high-risk individuals who used tobacco or alcohol or both, which was statistically significant. However, this study had a number of methodological weaknesses and the associated risk of bias was high.

conclusionsAlthough there is evidence that a visual examination as part of a population-based screening programme reduced the mortality rate of oral cancer in high-risk individuals, whilst producing a stage shift and improvement in survival rates across the population as a whole, the evidence is limited to one study and is associated with a high risk of bias. This was compounded by the fact that the effect of cluster randomisation was not accounted for in the analysis. Furthermore, no robust evidence was identified to support the use of other adjunctive technologies like toluidine blue, brush biopsy or fluorescence imaging within a primary care environment. Further RCTs are recommended to assess the efficacy, effectiveness and cost-effectiveness of a visual examination as part of a population based screening programme.

Identifiers

PMID21170007
OpenAlexW2060968665

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.