Oral leukoplakia – world prevalence

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The definition of oral leukoplakia has developed through the years because the 1978 definition of,  “a white patch or plaque that can’t be characterised clinically or pathologically as every other illness”  to the 2020 World Well being Group (WHO) Collaborating Centre definition of oral leukoplakia as, “White plaques of questionable danger having excluded (different) recognized ailments that carry no elevated danger for most cancers” (Warnakulasuriya et al., 2021). Oral leukoplakia is certainly one of a bunch of oral doubtlessly malignant problems (OPMD) with research reporting prevalence of 4.11% [95%CI: 1.98 to 6.97%] (Dental Elf – 8th Aug 2018) and a possible for malignant transformation of 9.8% [95%CI: 7.9 to 11.7%] (Dental Elf – 25th Jun 2021).

The goal of this evaluate was to evaluate the prevalence of oral leukoplakia (OLK) reported from 1996 to 2022, and to categorise the analysis into completely different teams by continent, definition, age, and dwelling habits.

Strategies

The evaluate protocol was registered with PROSPERO. Searches have been performed within the PubMed, Embase, Scopus and Net of Science databases from January 1996 to December 2022. Cross-section, case-control, or cohort research printed in English reporting numbers of OLK sufferers and whole inhabitants have been thought-about.  Two reviewers independently looked for research with 3 reviewers choosing research with 2 reviewers evaluating danger of bias utilizing the Joanna Briggs Institute (JBI) crucial appraisal instruments for prevalence research. General crude prevalence of oral leucoplakia was derived together with meta-analyses for pooled estimates.

Outcomes

  • 69 research involving a complete inhabitants of 1,263,028; 17,524 with oral leukoplakia.
  • The crude total prevalence charge was 1.39%.
  • 28 international locations from Asia, Africa, Europe, Oceania, South and North America have been represented.
  • Three broad teams of research have been recognized, population-based, clinic-based and particular inhabitants teams (e.g., Troopers, fisherman and so forth) and total prevalence estimates and group estimates from meta-analyses are proven within the desk beneath.
Sort of examine No. of research Oral leukoplakia prevalence (95percentCI)
Inhabitants based mostly 38 2.23% (1.44– 3.18%)
Clinic based mostly 12 1.36% (0.82–2.02%)
Particular populations 19 9.10% (4.85–14.47%)
General 69 3.41% (2.65–4.26%)
  • The prevalence of OLK in males was estimated to be between 3.9 and 1.8 occasions larger than females with prevalence estimates for the completely different teams as proven within the desk beneath.
Sort of examine Oral leukoplakia prevalence (95percentCI)
Males Females
Inhabitants based mostly 5.86% (1.71–12.20%) 1.50% (0.44–3.14%)
Clinic based mostly 2.29% (0.88–4.31%) 1.27% (0.55–2.26%)
Particular populations 4.69% (1.71–8.97% 4.58% (1.24–9.69%)
  • 15 research investigated the correlation between leukoplakia and tobacco use with 180,898 individuals out of 641,004 (28.2%) reporting a smoking behavior.
  • The estimated prevalence of leukoplakia in these reporting tobacco use (no matter sort or frequency was 9.48 (95percentCI: 3.98–16.96) in population-based research and 9.59 (95percentCI: 4.44–16.37) in particular populations.

Conclusions

The authors concluded: –

the prevalence of oral leukoplakia was decided as 1.39% and the pooling estimated world prevalence was 3.41%. The prevalence was comparatively constant and secure throughout completely different continents and completely different definitions. A better pooled estimated prevalence was discovered amongst males, these aged over 60 years previous, people who smoke, and alcohol customers.

Feedback

Whereas a protocol for the evaluate was registered within the PROSPERO database ahtough the code quantity supplied in the principle publication is wrong and the proper hyperlink is supplied beneath. Searches have been performed in a number of main databases though just for a particular time interval. As well as, solely English language papers have been included so doubtlessly related research might have been excluded.   This new evaluate included 69 research offering an estimated pooled world prevalence of three.41% (95percentCI: 2.65 to 4.26%) which is analogous to findings from a broader evaluate of a OPMDs in 2018 by Mello et al., (Dental Elf – 8th Aug 2018) which included 22 research and located a prevalence of 4.11% (95percentCI: 1.98 to six.97%).  The authors spotlight important heterogeneity within the included research and an absence of element within the included research regarding definition of leukoplakia, geographical location age, intercourse, tobacco and alcohol use which must be considered in when deciphering the findings. Future major research ought to be reported consistent with the STROBE pointers and there ought to be settlement on what components ( eg age, intercourse, tobacco and alcohol use and so forth) ought to be reported.

Hyperlinks

Main Paper  

Zhang C, Li B, Zeng X, Hu X, Hua H. The worldwide prevalence of oral leukoplakia: a scientific evaluate and meta-analysis from 1996 to 2022. BMC Oral Well being. 2023 Sep 6;23(1):645. doi: 10.1186/s12903-023-03342-y. PMID: 37670255; PMCID: PMC10481497.

Evaluation protocol on PROSPERO database

Different references

Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, Lodi G, Mello FW, Monteiro L, Ogden GR, Sloan P, Johnson NW. Oral doubtlessly malignant problems: A consensus report from a global seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Most cancers. Oral Dis. 2021 Nov;27(8):1862-1880. doi: 10.1111/odi.13704. Epub 2020 Nov 26. PMID: 33128420.

Dental Elf – 8th Aug 2018

Oral doubtlessly malignant problems – how widespread are they?

Dental Elf – 25th Jun 2021

Oral leukoplakia and charge of malignant transformation

Picture credit

By Unknown photographer – This picture was launched by the Nationwide Most cancers Institute, an company a part of the Nationwide Institutes of Well being, with the ID 2583. Public Area

 

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