Validation of the Meticulous Clinical Exam (MCE) for the screening of oral cancer

Abstract

Recently, an increasing ten- dency on the mortality rate of oral cancer has been observed. This has reinforced the interest for early detection programs. There are two distinguished strategies for early de- tection: 1) screening – as prevention; and 2) screening – as treatment. The objective of this study was to eva- luate and validate the Meticulous Clinical Exam (MCE) as a second test in a combination of tests having as the first one, the self-examination and as gold standard the histopa- thological exam. In the first series of tests, the strategies to stimulate self-examination were implemen- ted and a group of 819 sympto- matic people were selected to be submitted to the MCE, which was carried out by one examiner, and all the exams were standardized . The MCE resulted in 439 positive exams, including 8 cases with cli- nical suspicion of oral cancer and 13 suspected cases of premalignant lesion which have been submitted to the third series of tests. The result showed 7 cases of oral can- cer and 14 negative exams. The validity of the MCE in relation to the histopathological exam showed sensitivity (100%), specificity (93%), positive predictive value (88%) and negative predictive value (73%). The results of this study recommend the use of the MCE only to programs, when used in combination of three exams where the first is self-examination and the third, the histopathological one . More studies are needed to evaluate programs which use self-examination in rela- tion to cost-benefit. Key words: screening, stan- dardized, oral cancer, premalig- nant lesions.