Screening is widely believed to facilitate early detection and improve health outcomes; however, recent evidence questions its overall benefits, highlighting the need for a critical assessment of cancer screening programs. The simplicity of clinical oral examination and the easy accessibility of the oral cavity make oral cancer a suitable candidate for opportunistic screening. Despite this uniqueness, studies that solidly assess the efficacy and cost-effectiveness of oral cancer screening are scanty, and the only large randomized trial undertaken so far shows limited evidence of mortality reduction through population screening. Research indicates that while early detection rates following screening may increase, they do not necessarily translate into decreased oral cancer deaths. This article emphasizes the need for a nuanced understanding of the benefits of screening, awareness of deceptive metrics and inherent biases in the context of early detection, and the importance of improving dentist education and introducing new technologies to enhance clinical decision-making. The review calls for a balanced and evidence-based approach to oral cancer screening, integrating it with broader oral health initiatives to maximize public health outcomes.
筛查被广泛认为有助于早期发现并改善健康结果；然而，近期证据对其总体效益提出质疑，凸显了对癌症筛查项目进行严格评估的必要性。临床口腔检查操作简便且口腔易于观察，使得口腔癌成为机会性筛查的适宜对象。尽管具备这一独特优势，目前对口腔癌筛查效果及成本效益进行扎实评估的研究仍显不足，迄今唯一开展的大规模随机试验显示，通过人群筛查降低死亡率的证据有限。研究表明，筛查虽可能提高早期检出率，但这未必转化为口腔癌死亡率的下降。本文强调需要细致理解筛查的益处，认识早期检测背景下具有误导性的指标及固有偏倚，并重视加强牙医教育及引入新技术以提升临床决策水平。本综述呼吁采取平衡且基于证据的口腔癌筛查策略，将其纳入更广泛的口腔健康计划，以实现公共卫生效益的最大化。
Estimating the Benefits of Oral Cancer Screening: Challenges and Opportunities
肿瘤(癌症)患者之家