Malignant Transformation Rate of Oral Submucous Fibrosis: A Systematic Review and Meta-Analysis

Area of Science:

• Oral Medicine
• Oncology
• Public Health

Background:

• Oral submucous fibrosis (OSF) is a chronic, progressive, potentially malignant disorder affecting the oral cavity and upper digestive tract.
• Understanding the malignant transformation rate (MTR) of OSF is crucial for risk assessment and management.

Purpose of the Study:

• To determine the overall MTR of oral submucous fibrosis (OSF) by analyzing existing literature.
• To investigate variations in MTR based on ethnicity and geographic location.

Main Methods:

• A retrospective analysis of medical and dental literature from 1956 to 2021 was conducted.
• Study quality was assessed using the Newcastle-Ottawa Scale (NOS).
• A meta-analysis of a single proportion using a random effects model was performed.

Main Results:

• The overall MTR across all studies was 6% (95% CI, 0.02-0.10).
• Significant differences in MTR were observed among ethnic groups: Chinese (2%), Taiwanese (6%), Indian (8%), and Pakistani (27%).
• Geographic variations in MTR were noted but did not reach statistical significance.

Conclusions:

• Oral submucous fibrosis (OSF) carries a significant risk of malignant transformation, averaging 6%.
• Ethnicity is a critical factor influencing the MTR of OSF, highlighting the need for targeted surveillance.
• Further research is required to elucidate the specific factors contributing to these ethnic variations.