A systematic review of measures of effectiveness in screening for oral cancer and precancer

Martin C. Downer; David R. Moles; Stephen Palmer; Paul M. Speight

doi:10.1016/j.oraloncology.2005.08.006

A systematic review of measures of effectiveness in screening for oral cancer and precancer

Martin C. Downer, David R. Moles, Stephen Palmer, Paul M. Speight

Centre for Health Economics

Research output: Contribution to journal › Literature review › peer-review

Abstract

Nine databases were searched for studies reporting a range of measures on the effectiveness of screening for oral cancer and precancer in primary care. Of 1114 papers generated in a search of nine databases, full texts of 90 were scrutinised by two reviewers to ensure that they were concerned with oral cancer/precancer, reported an oral cancer screening programme/exercise and included at least one effectiveness outcome. Criteria for considering studies for the review covered types of studies, participants, interventions and outcome measures. The latter inctuded measures of both end point and interim outcome and also process. Of 90 full text articles screened, examiners agreed on the inclusion of 28 (initial agreement-kappa = 0.60). The remaining 62 were excluded and the reasons recorded. The studies included showed substantial heterogeneity regarding objectives and study design, location and setting, numbers and characteristics of participants, screening personnel, methods of recruitment and types of data collected. Only one study, from the Indian sub-continent, reported a randomised controlled trial: interim results showed 14.9% of intervention subjects died after 3 years compared with 56.3% of non-intervention controls. The review overall produced no evidence in favour of or against the potential benefits associated with an oral cancer screening programme. It was concluded that there are insufficient available data to make an unequivocal determination as to the effectiveness of oral cancer screening programmes at the present time. However, a recent further report on the Indian study published after completion of the review, provides some evidence that screening for oral cancer may be effective, at least in developing countries with a high incidence of the disease. (c) 2005 Elsevier Ltd. All rights reserved.

Original language	English
Pages (from-to)	551-560
Number of pages	10
Journal	Oral oncology
Volume	42
Issue number	6
DOIs	https://doi.org/10.1016/j.oraloncology.2005.08.006
Publication status	Published - Jul 2006

Keywords

oral
cancer
precancer
systematic review
screening
effectiveness
process measurement
outcome measurement
SRI-LANKA
DETECTION PROGRAM
HEALTH-WORKERS
INTEGRAL-PART
INDIA
CARE
POPULATION
KERALA
TRIAL
REPRODUCIBILITY

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10.1016/j.oraloncology.2005.08.006

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@article{43a5bb4d3c07484a9003503c168ecb9f,

title = "A systematic review of measures of effectiveness in screening for oral cancer and precancer",

abstract = "Nine databases were searched for studies reporting a range of measures on the effectiveness of screening for oral cancer and precancer in primary care. Of 1114 papers generated in a search of nine databases, full texts of 90 were scrutinised by two reviewers to ensure that they were concerned with oral cancer/precancer, reported an oral cancer screening programme/exercise and included at least one effectiveness outcome. Criteria for considering studies for the review covered types of studies, participants, interventions and outcome measures. The latter inctuded measures of both end point and interim outcome and also process. Of 90 full text articles screened, examiners agreed on the inclusion of 28 (initial agreement-kappa = 0.60). The remaining 62 were excluded and the reasons recorded. The studies included showed substantial heterogeneity regarding objectives and study design, location and setting, numbers and characteristics of participants, screening personnel, methods of recruitment and types of data collected. Only one study, from the Indian sub-continent, reported a randomised controlled trial: interim results showed 14.9% of intervention subjects died after 3 years compared with 56.3% of non-intervention controls. The review overall produced no evidence in favour of or against the potential benefits associated with an oral cancer screening programme. It was concluded that there are insufficient available data to make an unequivocal determination as to the effectiveness of oral cancer screening programmes at the present time. However, a recent further report on the Indian study published after completion of the review, provides some evidence that screening for oral cancer may be effective, at least in developing countries with a high incidence of the disease. (c) 2005 Elsevier Ltd. All rights reserved.",

keywords = "oral, cancer, precancer, systematic review, screening, effectiveness, process measurement, outcome measurement, SRI-LANKA, DETECTION PROGRAM, HEALTH-WORKERS, INTEGRAL-PART, INDIA, CARE, POPULATION, KERALA, TRIAL, REPRODUCIBILITY",

author = "Downer, {Martin C.} and Moles, {David R.} and Stephen Palmer and Speight, {Paul M.}",

year = "2006",

month = jul,

doi = "10.1016/j.oraloncology.2005.08.006",

language = "English",

volume = "42",

pages = "551--560",

journal = "Oral oncology",

issn = "1368-8375",

publisher = "Elsevier",

number = "6",

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TY - JOUR

T1 - A systematic review of measures of effectiveness in screening for oral cancer and precancer

AU - Downer, Martin C.

AU - Moles, David R.

AU - Palmer, Stephen

AU - Speight, Paul M.

PY - 2006/7

Y1 - 2006/7

N2 - Nine databases were searched for studies reporting a range of measures on the effectiveness of screening for oral cancer and precancer in primary care. Of 1114 papers generated in a search of nine databases, full texts of 90 were scrutinised by two reviewers to ensure that they were concerned with oral cancer/precancer, reported an oral cancer screening programme/exercise and included at least one effectiveness outcome. Criteria for considering studies for the review covered types of studies, participants, interventions and outcome measures. The latter inctuded measures of both end point and interim outcome and also process. Of 90 full text articles screened, examiners agreed on the inclusion of 28 (initial agreement-kappa = 0.60). The remaining 62 were excluded and the reasons recorded. The studies included showed substantial heterogeneity regarding objectives and study design, location and setting, numbers and characteristics of participants, screening personnel, methods of recruitment and types of data collected. Only one study, from the Indian sub-continent, reported a randomised controlled trial: interim results showed 14.9% of intervention subjects died after 3 years compared with 56.3% of non-intervention controls. The review overall produced no evidence in favour of or against the potential benefits associated with an oral cancer screening programme. It was concluded that there are insufficient available data to make an unequivocal determination as to the effectiveness of oral cancer screening programmes at the present time. However, a recent further report on the Indian study published after completion of the review, provides some evidence that screening for oral cancer may be effective, at least in developing countries with a high incidence of the disease. (c) 2005 Elsevier Ltd. All rights reserved.

AB - Nine databases were searched for studies reporting a range of measures on the effectiveness of screening for oral cancer and precancer in primary care. Of 1114 papers generated in a search of nine databases, full texts of 90 were scrutinised by two reviewers to ensure that they were concerned with oral cancer/precancer, reported an oral cancer screening programme/exercise and included at least one effectiveness outcome. Criteria for considering studies for the review covered types of studies, participants, interventions and outcome measures. The latter inctuded measures of both end point and interim outcome and also process. Of 90 full text articles screened, examiners agreed on the inclusion of 28 (initial agreement-kappa = 0.60). The remaining 62 were excluded and the reasons recorded. The studies included showed substantial heterogeneity regarding objectives and study design, location and setting, numbers and characteristics of participants, screening personnel, methods of recruitment and types of data collected. Only one study, from the Indian sub-continent, reported a randomised controlled trial: interim results showed 14.9% of intervention subjects died after 3 years compared with 56.3% of non-intervention controls. The review overall produced no evidence in favour of or against the potential benefits associated with an oral cancer screening programme. It was concluded that there are insufficient available data to make an unequivocal determination as to the effectiveness of oral cancer screening programmes at the present time. However, a recent further report on the Indian study published after completion of the review, provides some evidence that screening for oral cancer may be effective, at least in developing countries with a high incidence of the disease. (c) 2005 Elsevier Ltd. All rights reserved.

KW - oral

KW - cancer

KW - precancer

KW - systematic review

KW - screening

KW - effectiveness

KW - process measurement

KW - outcome measurement

KW - SRI-LANKA

KW - DETECTION PROGRAM

KW - HEALTH-WORKERS

KW - INTEGRAL-PART

KW - INDIA

KW - CARE

KW - POPULATION

KW - KERALA

KW - TRIAL

KW - REPRODUCIBILITY

U2 - 10.1016/j.oraloncology.2005.08.006

DO - 10.1016/j.oraloncology.2005.08.006

M3 - Literature review

SN - 1368-8375

VL - 42

SP - 551

EP - 560

JO - Oral oncology

JF - Oral oncology

IS - 6

ER -