Oral cancers are malignancies that manifest themselves in many parts of the mouth, including the tongue, mouth lining, lips, gums, and the back of the throat. The highest age-standardized incidence rate and mortality rate for oral cancer were reported by the World Health Organisation (WHO) South-East Asia region in 2020, at 8.0 and 4.5, respectively. According to GLOBOCAN 2020 forecasts, India experienced over 100,000 new instances of lip and oral cavity cancer each year. Early identification of oral cancer is crucial because the majority of oral cancer patients in India present with advanced illnesses and need expensive and aggressive combined modality treatment. The financial burden of oral cancer (on individuals and government support for healthcare) is increased by late diagnosis and treatment in advanced stages. The best path forward is to make the best use of the resources that are currently available for essential medical expenses.
Spread of Oral Cancer Credit: Coronation Dental Specialty Group
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Fewer incidences and less financial burden
Risk factors for this condition are alcohol and smoking. Precancerous and cancerous lesions of the lip and oral cavity are frequently detected early using conventional oral examination (COE), toluidine blue staining (TBS), oral cytology (OC), light-based detection (LBD) devices like Velscope and ViziLite plus. According to a study, oral visual screening considerably decreased oral cancer mortality in high-risk people.
It’s important to address the financial burden associated with oral cancer screening in a resource-constrained nation like India. Since the majority of prior cost-effectiveness studies on oral cancer screening were conducted in high-income countries, the estimates cannot be generalized to low- and middle-income countries, including India. The cost-effectiveness of oral cancer screening in the Indian context must therefore be estimated.
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A study was carried out to assess the lifetime costs associated with oral cancer screening, diagnosis, and treatment and the health outcomes measured in terms of quality-adjusted life years (QALYs) obtained. The cost-effectiveness of the four widely used oral cancer screening approaches as mentioned above; COE, TBS, OC, and LBD, compared to no screening, was evaluated using economic modeling in the Indian population (> 30 years of age) by evaluating lifetime expenses and health outcomes.
It was discovered that when compared to no screening, oral visual screening dramatically reduced the number of incident cases. There were fewer disease instances when high-risk individuals were screened at five and ten-year intervals and the general population was screened every three years. This suggests that fewer cases will result in less of a financial burden as well as a reduction in the amount of resources needed for treatment and management. The suggested screening method for the Indian population, out of all the procedures examined, is screening utilizing COE of high-risk persons at intervals of ten years.
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Clinical significance
Considering the findings, high-risk screening for oral cancer has proven to be very beneficial and cost-effective. Precancerous lesions could be discovered and treated early leading to improved prognosis.
Conclusion
High-risk screening for oral cancer is India’s favored method due to its cost-effectiveness. The study offers data that can be used by policymakers to create recommendations for an effective plan for oral cancer screening in India.
References
Dwivedi, P., Lohiya, A., Bahuguna, P., Singh, A., Sulaiman, D., Singh, M. K., Rajsekar, K., & Rizwan, S. A. (2023). Cost-effectiveness of population-based screening for oral cancer in India: an economic modelling study. The Lancet Regional Health – Southeast Asia. https://doi.org/10.1016/j.lansea.2023.100224
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