Cost-effectiveness of oral cancer screening approaches by visual examination: Systematic review

The present study is the first systematic review of papers that have performed a full economic evaluation on oral cancer screening strategies using visual oral examination. The review questions were (1) Is screening a cost-effective strategy in oral cancer? (2) What is the most cost-effective strategy among the different screening approaches in oral cancer? The main outcome measure was the incremental cost-effectiveness ratio. The study identifies and reviews seven full economic evaluations. The included studies scored 75%-100% on the methodological appraisal. Majority of the studies reports that oral cancer screening is a cost-effective strategy, especially in an opportunistic setting and high-risk subset of patients. The results were sensitive to cost and effectiveness parameters. Oral cancer screening, though found cost-effective, the uncertainty around these parameters necessitates additional studies that include better estimates in the modeling assessments. The heterogeneity in studies limited comparison and generalization.