Evaluation of mouth self-examination in the control of oral cancer

This study was planned to evaluate the feasibility of mouth self-examination (MSE). Some 450 college students distributed to 9000 households a brochure describing the risk factors of oral cancer, the appearance of premalignant and malignant lesions of the oral cavity and the methods of MSE with pictures. All subjects with tobacco habits and/or aged 30 years or over were asked to read the brochure carefully and to report to the clinic conducted in their locality on fixed days, if they suspected an abnormality while practising MSE. Out of the approximately 22,000 eligible subjects, 8028 (36%) practised MSE. Among the 247 subjects reporting to the clinics seven (3%) had oral cancer and 85 (34%) had oral precancerous lesions; the others had either benign lesions or normal anatomical variations. Six of the seven subjects with oral cancer had stage I disease, five of whom accepted treatment and were alive disease-free 5 years later. The detection rates of oral cancer compared favourably with the previously reported detection rates using trained health workers. Although this study demonstrated that MSE is feasible, larger studies are required to evaluate whether health education could result in a sustained practice of MSE resulting in reduction in incidence of and mortality from oral cancer.