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Trained health workers looking inside the mouths of tobacco and alcohol users in Kerala cut oral cancer deaths by a third, and by four-fifths in those who came to every screening round.
96,517 people in seven intervention clusters and 95,356 in six control clusters were enrolled. After three rounds there were 77 oral cancer deaths in the intervention arm versus 87 in controls (mortality rate ratio 0.79; 95% CI 0.51-1.22 overall), with a significant reduction among tobacco or alcohol users (0.66; 95% CI 0.45-0.95), and 0.57 in male users. At 15 years, after four rounds, oral cancer mortality was 24% lower in tobacco or alcohol users in the intervention arm (95% CI 3-40%) and 81% lower (69-89%) in users who attended all four rounds, with a 38% fall in incidence in that group. It remains the only randomised evidence that oral cancer screening saves lives and underpins India's national screening programme for oral cancer.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Rengaswamy Sankaranarayanan, Cluster-randomised trial, International Agency for Research on Cancer (IARC / WHO), Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation.
Shares Rengaswamy Sankaranarayanan, International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed, The hardest cancers are found late.
Shares Chemoprevention & risk-reducing surgery, International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed, The hardest cancers are found late.
Shares Rengaswamy Sankaranarayanan, Global oncology and access in low- and middle-income countries, International Agency for Research on Cancer (IARC / WHO), Head and neck squamous cell carcinoma.
Shares Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue), Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Head and neck squamous cell carcinoma.
Shares Ethics review (IRB, research ethics committee), Pragmatic trial, Informed consent.
Shares Rengaswamy Sankaranarayanan, International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed.
Shares Rengaswamy Sankaranarayanan, International Agency for Research on Cancer (IARC / WHO), Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Prevention we already have is not deployed.