Sensitivity of direct tissue fluorescence visualization in screening for oral premalignant lesions in general practice

Abstract

Various specialty clinics and research centers have conducted studies of direct tissue fluorescence visualization as a screening technique for oral premalignant lesions and early oral squamous cell carcinoma (OSCC). The effectiveness of the VELscope in a private practice setting is unknown. This pilot study is the first report to assess the VELscope system as a screening adjunct among lower-risk populations seen by a primary care clinician in a general practice setting. This study involved a retrospective comparison of two oral cancer screening examination protocols conducted on a presumably low-risk patient population seen in a private general dentistry practice. For one year, all patients age 12 or older received oral examinations, according to a standard oral cancer screening protocol. The following year, the same population was examined according to the same protocol with the addition of direct tissue fluorescence visualization using the VELscope. Screening with incandescent light examination yielded a prevalence of mucosal abnormalities of 0.83%, none of wich were premalignant. Screening with incandescent light examination combined with direct tissue fluorescence visualization yielded a 1.3% prevalence of mucosal abnormalities; based on surgical biopsy and histopathologic examination, 83% of these were potentially premalignant epithelial dysplasia.