Oral Cancer Screening and Demographic Risk Assessment: A Community-Based Cross-sectional Study in Rural India

Oral cancer is a leading cause of mortality in India, yet rural populations face severe barriers to its early detection. This study evaluates the efficacy of a novel, portable optical screening device (OncoDiagnoScope) and assesses demographic risk factors in a resource-limited setting.

This community-based cross-sectional study (N = 1358; mean age 51.8 ± 13.7 years) was conducted in rural Tamil Nadu. Participants underwent a multitiered screening protocol: initial assessment via OncoDiagnoScope, secondary clinical evaluation by specialists, and histopathological confirmation for suspicious lesions. Risk factors were analyzed using univariate and multivariate logistic regression.

The OncoDiagnoScope identified 321 suspects (23.6%), of which 101 (7.4%) were clinically confirmed as having oral lesions and nine cases (0.66%) were histopathologically confirmed as malignancies. The device demonstrated a sensitivity of 100%, specificity of 82.14%, and a negative predictive value (NPV) of 100% compared to expert clinical examination. While univariate analysis showed significant associations between lesions and age (P = 0.040), tobacco chewing (P = 0.009), and betel leaf use (P = 0.002), these variables were not independent predictors in the multivariate adjusted model (Pseudo-R² = 0.027).

The OncoDiagnoScope is a highly sensitive, non-invasive tool for community-level oral cancer triaging. Despite a low positive predictive value (31.46%), its ability to accurately rule out disease (NPV 100%) makes it an ideal aid for rural outreach. Integrating portable diagnostic technologies into existing health-wellness programs can significantly bridge the gap in early cancer detection for marginalized populations.