Is workplace screening for potentially malignant oral disorders feasible in India?

Background: Because of delays in diagnosis, oral cancer usually presents for therapy at a late stage. Patients are unaware of having lesions as they are mostly asymptomatic and physicians generally do not examine the mouth sufficiently. People in rural areas or are underserved may not frequently visit the dentist who can easily pick up these lesions early. Screening programs are useful in that regard. Such programs in general are conducted by either inviting people to come to a screening center or by health care workers visiting the individual households. However, those who work during the day may not visit screening centers or be at home during the day of the screening by a visiting health care worker. Workplace screening overcomes these challenges. Methods: To assess the feasibility of a screening program to detect potentially pre-malignant oral disorders in a workplace in India, clinically visible mucosal lesions were compared with the clinical photographs of the same lesions assessed by an expert. Role of smoking, alcohol, and chewing betel quid and tobacco in the etiology of those lesions were assessed. Results: Sixty-nine percent of the eligible subjects participated in the screening (n = 1613). Prevalence of leukoplakia was 5%. Bidi (OR = 35.6), and cigarette smoking (OR = 22.8), alcohol (OR = 17.6), and tobacco and areca nut chewing (OR = 7.5), were significantly associated with leukoplakia and erythroplakia (all P < 0.05). Conclusions: Conduction of a screening program by valid visual inspection to detect potentially malignant oral disorders within a workplace is not only feasible but also effective.