Fragmented Thresholds, Unified Vision: Advancing Salivary Diagnostics for OSCC and OPMD

Salivary diagnostics for oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) have advanced significantly, yet clinical translation remains limited. A key barrier is the lack of harmonized thresholds for candidate biomarkers, ranging from cytokines to genetic and epigenetic markers, across studies. This variability undermines biosensor calibration, impedes algorithmic integration, and restricts the scalability of AI and eHealth tools. Paradoxically, saliva is well-established in systemic disease diagnostics but remains undervalued in oral oncology. Recent initiatives, such as COST Action CA21140-INTERCEPTOR, are working to intercept oral carcinogenesis through collaborative innovation in molecular diagnostics and surveillance technologies. This letter calls for standardized protocols, multicenter validation, and digital integration to unlock saliva's full potential as a frontline diagnostic fluid. By addressing biomarker variability and embracing cross-sector collaboration, the field can move toward clinically actionable, digitally enabled solutions for early detection and monitoring of OSCC and OPMD.