Utility of oral cancer diagnostic adjuncts in the adult US populations
Version of Record online: 1 DEC 2012
© 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd
Journal of Oral Pathology & Medicine
Volume 42, Issue 5, pages 363–367, May 2013
How to Cite
J Oral Pathol Med (2012)
- Issue online: 22 APR 2013
- Version of Record online: 1 DEC 2012
- Manuscript Accepted: 23 OCT 2012
- diagnostic adjuncts;
- oral cancer;
- oral cancer prevalence;
- screening tests
Utility of diagnostic adjuncts (DAs) in an adult population with a low oral and pharyngeal cancer (OPC) prevalence is unclear. In this study, we compare the effectiveness of DAs and clinicians' conventional oral examination (COE) in detecting oral and pharyngeal cancers (OPC), in high-risk (HR) users, low-risk (LR) and alcohol, and in the overall adult US populations (GP).
We assumed oral cancer DAs to have 99% sensitivity and specificity. For COE, 79.6% sensitivity and 97.7% specificity were used. Using Altman's mathematical model, the positive predictive values (PPV) for a DA and COE were estimated for HR, LR, and GP groups, respectively. Three different scenarios (sensitivity constant but decreasing specificity, specificity constant but decreasing sensitivity, and decreasing both sensitivity and specificity simultaneously) were developed to simulate the true effectiveness of DAs while keeping the prevalence of OPC in HR, LR, and GP groups constant at 0.4039%, 0.0362%, and 0.1109%, respectively.
The PPVs for a DA in HR, LR, and GP groups in the United States were estimated at 29%, 3%, and 10%, while for COE, the PPVs would be at 12%, 1%, and 4%, respectively.
Utility of DAs in LR and GP groups is negligible due to very low OPC prevalence in these populations. In HR population, DAs may have a slightly better effectiveness than clinicians only when assumed to have high sensitivity and specificity.