Comparison of Different Screening Methods in Estimating thePrevalence of Precancer and Cancer Amongst Male Inmatesof a Jail in Maharashtra, India

Aim: To compare the effectiveness of self-examination, clinical examination and screening methods using 1%toluidine blue and Lugol’s iodine in estimating the prevalence of lesions at risk of malignancy and oral malignantdisease amongst the male inmates of Yerwada Central Jail, Pune. Material and
Methods: Study was carried outon male inmates in two phases. In the first phase self-examination and clinical examination was carried out on2,257 male inmates. 164 suspicious cases were subjected to phase II of the study out of whom, 82 participantswere screened with 1% toluidine blue and 2% Lugol’s iodine followed by biopsy procedure.
Results: Sensitivityand specificity for self-examination with clinical examination was 92.2% and 96.6% respectively. Sensitivity,specificity, positive (PPV) and negative predictive values (NPV) and positive (+LR) and negative likelihood ratio(-LR) for Toluidine Blue were 88.1%, 66.6% 97.1%, 30%, 2.63 and 0.17 respectively while for Lugol’s Iodinethey were 94.7%, 83.8%, 98.6%, 55.5%, 5.67 and 0.06 respectively.
Conclusions: Prevalence of lesions at riskof malignancy and oral malignant disease by self-examination was 7.8% and by clinical examination was 6.3%.Self-examination is an effective tool in early detection of oral cancer. Use of Lugol’s iodine as a screening toolfor oral lesions is highly effective in inmate populations.