Systematic Reviews
Copyright ©The Author(s) 2022.
World J Methodol. Jul 20, 2022; 12(4): 293-304
Published online Jul 20, 2022. doi: 10.5662/wjm.v12.i4.293
Table 1 Quality assessment
Domain
Criteria
Examination0-Not mentioned
1-Others (Nurse, ENT doctor, Medical officer, Health worker etc.)
2-by dentist
Study settingsCommunity setting (field); Hospital setting.
Clinical examination 0-Not mentioned
1-Visual screening (Tongue blade, Illumination)
2-Mouth mirror
Sampling techniqueDetailed description of the sampling strategy used, type of sampling (random or non-random) was determined.
0-Not mentioned
1-Non-random
2-Random sampling
Sample size adequacyIf description of sample size calculations was not done, the relative precision was calculated (assuming simple random sampling) from the study sample size and estimated proportion.
Relative precision was ≤ 20% of the point estimate
0-Relative precision > 20% of the point estimate
(e.g., If the precision of a study varied from 8%-28% for different lesions and conditions in the mouth, prevalence of more than 20% was considered and score 0 was given)
Table 2 Meta-Analyses for the point estimate of various pre-cancerous lesions and conditions
Precancerous lesions and conditions (Event/n)
No of estimates included
Point prevalence (95%CI)
I2(%)
LKP1 (16828/901715)924.3 (4.0-4.6)99.47
LKP2 (23090/653349)466.7 (6.0-7.3)99.74
LKP3 (39918/1555064)1384.9 (4.7-5.2)99.65
ERP1 (223/20,164)121.2 (0.7-1.7)94.97
ERP2 (1112/275674)62.5 (0.4-4.5)99.15
ERP3 (1335/295838)181.4 (1.0-1.7)97.91
PL1 (4353/488610)165.8 (4.4-7.2)99.49
PL2 (8148/57951)1911.5 (8.0-15.0)99.81
PL3 (12501/546561)358.9 (7.4-10.3)99.77
OSMF1 (9229/749768)502.7 (2.5-3.0)99.18
OSMF2 (8160/487272)384.5 (4.2-4.9)99.58
OSMF3 (17389/1237040)883.4 (3.2-3.6)99.43
LP1 (2759/233782)481.1 (0.9-1.2)97.59
LP2 (3811/50300)257.5 (5.3-9.6)99.92
LP3 (6570/627947)731.2 (1.1-1.3)98.14
1Community-based studies.
2Hospital based studies.
3Pooled community and hospital based studies.
LKP: Leukoplakia; ERP: Erythroplakia; PL: Palatal lesion; OSMF: Oral Submucous fibrosis; LP: Lichen planus.
Table 3 Subgroup analyses of precancerous lesions and conditions showing pooled point prevalence before and after COTPA (2003) was enacted
Period of study
LKP (95%CI) (Estimates)
ERP (95%CI) (Estimates)
PL (95%CI) (Estimates)
OSMF (95%CI) (Estimates)
LP (95%CI) (Estimates)
≤ 20033.2 (2.5-4.0) (15)No study; (0)5.2 (-3.2-13.6); (2)0.6 (0.4-0.7); (13)0.6 (0.2-1.0); (4)
> 20035.5 (5.2-5.9); (123)1.4 (1.0-1.7); (18)9.2 (7.5-10.8); (33)4.7 (4.4-5.0); (75)1.3 (1.1-1.4); (69)
LKP: Leukoplakia; ERP: Erythroplakia; PL: Palatal lesion; OSMF: Oral Submucous fibrosis; LP: Lichen planus.
Table 4 Subgroup analyses of precancerous lesions and conditions showing pooled point prevalence in different regions of India
Regions
East (95%CI) (Estimates)
West (95%CI) (Estimates)
North (95%CI) (Estimates)
South (95%CI) (Estimates)
LKP4.4 (1.9-6.9) (7)8.4 (7.7-9.1) (44)5.2 (4.6-5.8) (24)3.4 (3.0-3.8) (63)
ERPOne study (1)3.5 (2.1-5.0) (4)2.9 (-1.5-7.2) (3)1.0 (0.5-1.5) (10)
PLNo study (0)16.9 (5.0-28.7) (5)6.2 (2.4-10.0) (10)8.1 (6.4-9.8) (20)
OSMF3.4 (2.1-4.6) (2)5.1 (4.7-5.4) (34)1.4 (1.0-1.8) (15)4.7 (4.2-5.3) (37)
LP5.0 (1.2-8.7) (3)1.2 (1.0-1.5) (15)1.7 (1.2-2.3) (15)1.0 (0.7-1.2) (40)
LKP: Leukoplakia; ERP: Erythroplakia; PL: Palatal lesion; OSMF: Oral Submucous fibrosis; LP: Lichen planus.
Table 5 Sensitivity analyses of precancerous lesions and conditions showing pooled
Study quality (Studies)
LKP (95%CI)
ERP (95%CI)
PL (95%CI)
OSMF (95%CI)
LP (95%CI)
High (52)4.6 (4.2-5.0)1.6 (0.9-2.3)11.0 (8.2-13.8)4.0 (3.6-4.4)1.1 (0.9-1.3)
Moderate (71)6.6 (5.9-7.2)1.6 (0.5-2.7)8.2 (5.2-11.2)3.3 (3.0-3.5)1.3 (1.1-1.5)
Low (7)1.4 (0.9-1.8)One studyOne study2.8 (1.3-4.3)No study
LKP: Leukoplakia; ERP: Erythroplakia; PL: Palatal lesion; OSMF: Oral Submucous fibrosis; LP: Lichen planus.