Autofluorescence-based devices for oral cancer screening - A scoping review

Oral cancer (OSCC) and oral potentially malignant disorders (OPMDs) present persistent diagnostic challenges, with late detection driving poor prognosis and high treatment morbidity. Chairside autofluorescence-based devices such as GOCCLES and OralID have been developed to complement conventional oral examination (COE), but their diagnostic performance and clinical utility requires further exploration. This scoping review maps the available evidence on GOCCLES and OralID, characterising study populations, clinical contexts, and reported diagnostic outcomes.

This review followed the PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, Web of Science, Embase, and Google Scholar (1^st January 1996 - June 2026) identified primary empirical studies evaluating GOCCLES or OralID in human subjects. A descriptive synthesis of the eligible studies was undertaken.

Of 122 identified records, 13 studies met inclusion criteria, and included observational studies, clinical trials, case series, and case reports. GOCCLES showed low sensitivity (33-66%) and low to moderate specificity (40-90.6%) against histopathology, with better specificity (90.6%) in primary care screening. OralID demonstrated high sensitivity (74-100%) but low specificity (18-89%). The strongest performance occurred in perioperative margin delineation. High false-positive rates and the 'umbrella effect' of hyperkeratosis limiting fluorescence penetration were consistently reported.

Evidence for GOCCLES and OralID is heterogeneous and context-dependent. Neither device consistently achieves high sensitivity and specificity concurrently. Their principal value appears adjunctive to guide biopsy site selection or intraoperative margins.

GOCCLES and OralID may be used as adjuncts to conventional oral examination rather than as standalone diagnostic or screening tools.