Feasibility of opportunistic screening for oral cancers in a dental outpatient department of a secondary care hospital in Northern India

BACKGROUND: Oral cancer is one of the most common forms of cancer in India. Majority of the patients are diagnosed at advanced stages, resulting in poor outcomes. Most of the oral cancers are preceded by visible lesions known as potentially malignant disorders (PMDs), which are amenable to early detection by screening. Oral visual examination is an established method of screening, and dentists have a unique opportunity to screen patients who come for various dental morbidities. Opportunistic screening is being recommended as a measure of cancer control. This study was conducted to assess the feasibility of opportunistic screening in a public health facility. METHODS: Patients coming to the dental outpatient department (OPD) of a secondary care hospital were screened for oral cancer or PMD by a trained dental surgeon by visual inspection of the oral cavity. In-depth interviews were conducted with the dental surgeon and officer-in-charge of dental OPD to identify barriers and facilitators for screening. A feasibility model was used to assess the acceptability, implementation, practicality, and integration of opportunistic screening. RESULTS: All patients attending dental OPD underwent screening. PMDs were detected in 0.5% of the new OPD attendees. Leukoplakia was found to be the most common lesion. Biopsy for suspected lesions was not conducted. The shortage of support staff was identified as a barrier to documenting risk factors. There was a lack of follow-up and referral linkages. CONCLUSION: Opportunistic screening for oral cancers is feasible at a secondary care public health care facility. However, a well-developed system for follow-up and linkage with referral sites is required.