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Malignant transformation of oral potentially malignant disorders in Taiwan: An observational nationwide population database study
Authors:Sheng-Fu Chiu  Chung-Han Ho  Yi-Chen Chen  Li-Wha Wu  Yuh-Ling Chen  Jer-Horng Wu  Wei-Sheng Wu  Hui-Kun Hung  Wei-Fan Chiang
Abstract:Oral cancer is one of the leading causes of cancer death, which are mostly preceded by oral potentially malignant disorders (OPMDs). Taiwanese government launched a free oral cancer screening program. The aim of this study was to analyze the malignant transformation rate of OPMDs.This study was based on national-wide oral screening databases. 3,362,232 people were enrolled. Patients clinically diagnosed with leukoplakia, erythroplakia, oral submucosal fibrosis (OSF), oral verrucous hyperplasia (OVH), and oral lichen planus (OLP), from 2010 to 2013, were identified. We followed up OPMD patients in cancer registry databases to analyze the malignant transformation rate.The malignant transformation rates from the highest to the lowest were: OVH > OSF > erythroplakia > OLP > leukoplakia. The malignant transformation rate was 24.55, 12.76, 9.75, 4.23, and 0.60 per 1000 person-years in the OVH, OSF, erythroplakia, leukoplakia, and comparison cohort. The hazard ratio was 8.19 times higher in the OPMD group compared with comparison cohort group, after age and habit adjustment. Female patients with OPMDs had a high risk of malignant transformation.Nationwide screening is very important for early diagnosis. OVH had the highest malignant transformation possibility. Female OPMD patients are a rare but have a relatively high malignant transformation rate.
Keywords:betel nut   erythroplakia   leukoplakia   malignant transformation   oral cancer   oral lichen planus   oral mucosal screening   oral potentially malignant disorders   oral submucosal fibrosis   oral verrucous hyperplasia
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