Assessment of Clinical Examination Validity in Oral Cancer Risk Patients

Bruno Nikolovski 1 , Danica Popovik Monevska 2 , Mirjana Popovska 3 , Vera Radojkova Nikolovska 3  and Ana Minovska 4
  • 1 Center for dental health – ETERNAdent, , Skopje
  • 2 University Clinic for Maxillofacial surgery, University “Ss. Cyril and Methodius”, , Skopje
  • 3 Clinic for Oral Pathology and Periodontology, Faculty of Dentistry, University “Ss. Cyril and Methodius”, Skopje
  • 4 Faculty of Medical Sciences, University Goce Delcev, Stip


Background/Aim: Oral cancer is one of the ten most common cancers in the world, recently positioned as a sixth one, unfortunately with poor prognosis after treatment because of the late diagnostics in advanced stages of the disease. Aim of this study was to present the basic criteria in assessment the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the conventional oral examination (COE) as the easiest and most acceptable procedure in detection of the early changes of the suspicious oral tissue changes compared to the diagnostic gold standard – tissue biopsy in two different groups of examinees.

Material and Methods: Sixty patients divided into two study groups (one with potentially malignant oral lesions and a second consisted of clinically suspicious oral cancer lesions) were examined with COE and subjected to histopathological confirmation - tissue biopsy. All examined patients underwent the diagnostic protocol by the American Joint Commission on Cancer, selected under certain inclusion and exclusion criteria.

Results: Sensitivity of COE in the group of examinees with oral potentially malignant lesions is 83.33%, its specificity is 20.83%, the positive predictive value is 20.83% and the negative predictive value is 83.33%. The accuracy of the COE method is 33.33%. The sensitivity, in the group of patients with oral cancer is 96.43%, specificity is 0%, the positive predictive value is 93.10% and the negative predictive value is 0%. The accuracy of this method is 90%.

Conclusions: The accuracy reaches a value over 90% for the group with lesions with highly suspected malignant potential – oral cancer, and sets the thesis that COE as screening method for oral cancer or premalignant tissue changes is more valuable for the patients with advanced oral epithelial changes, but is recommended to be combined with some other type of screening procedure in order to gain relevant results applicable in the everyday clinical practice.

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