N Praveen Birur1, Sanjana Patrick2, Suchitra Bajaj3, Shubhasini Raghavan4, Amritha Suresh5, Sumsum P Sunny5, Radhika Chigurupati6, Petra Wilder-Smith7, Keerthi Gurushanth4, Shubha Gurudath4, Pratima Rao3, Moni A Kuriakose8. 1. Department of Oral Medicine and Radiology, KLE Society's Institute of Dental Sciences, Bengaluru, Karnataka, India; Oral Cancer Screening, Biocon Foundation, Bengaluru, Karnataka India, Phone: +919845136960, e-mail: praveen.birur@biocon.com. 2. Department of Oral Cancer Screening, Biocon Foundation Bengaluru, Karnataka, India. 3. Department of Health Care, Biocon Foundation, Bengaluru Karnataka, India. 4. Department of Oral Medicine and Radiology, KLE Society's Institute of Dental Sciences, Bengaluru, Karnataka, India. 5. Department of Head and Neck Oncology, Mazumdar Shaw Center for Translational Research, Mazumdar Shaw Medical Center, Bengaluru, Karnataka, India. 6. Department of Oral and Maxillofacial Surgery, Boston University Medical Campus, Boston, Massachusetts, USA. 7. Department of Dentistry, Beckman Laser Institute, University of California, Irvine, California, USA. 8. Department of Head and Neck Oncology, Cochin Cancer Research Center, Ernakulum, Kerala, India.
Abstract
AIM: The incidence of oral cancer is high in India, which can be reduced by early detection. We aimed to empower frontline health care providers (FHP) for early detection and connect specialist to rural population through mHealth. MATERIALS AND METHODS: We provided training to FHPs in examination of oral cavity, use of mobile phone for image capture, and risk factor analysis. The FHPs were selected from different cohorts in resource-constrained settings. The workflow involved screening of high-risk individuals in door-to-door and workplace settings, and capture of images of suspected lesions. Uploaded data were interpreted and recommendation was sent by specialist from a remote location. Their recommendation was intimated to FHPs who arranged for further action. Two more initiatives, one for multiple dental schools and another for private practitioners, were undertaken. RESULTS: During the period from 2010 to 2018, 42,754 subjects have been screened, and 5,406 subjects with potentially malignant disorders have been identified. The prevalence of potentially malignant disorders varied from 0.8 to 62% at different cohorts; 516 biopsies have been performed at remote locations. CONCLUSION: Connecting specialists to rural population was made possible through the use of mobile health. Trained FHP were able to reach out to the population. Electronic data capture facilitated efficient follow-up. The program was very cost-effective with screening completed under $1 per person. CLINICAL SIGNIFICANCE: In view of the high incidence of oral cancer in India, and the resource-constrained settings, mobile health paves the way for better access to specialist care for the rural population.
AIM: The incidence of oral cancer is high in India, which can be reduced by early detection. We aimed to empower frontline health care providers (FHP) for early detection and connect specialist to rural population through mHealth. MATERIALS AND METHODS: We provided training to FHPs in examination of oral cavity, use of mobile phone for image capture, and risk factor analysis. The FHPs were selected from different cohorts in resource-constrained settings. The workflow involved screening of high-risk individuals in door-to-door and workplace settings, and capture of images of suspected lesions. Uploaded data were interpreted and recommendation was sent by specialist from a remote location. Their recommendation was intimated to FHPs who arranged for further action. Two more initiatives, one for multiple dental schools and another for private practitioners, were undertaken. RESULTS: During the period from 2010 to 2018, 42,754 subjects have been screened, and 5,406 subjects with potentially malignant disorders have been identified. The prevalence of potentially malignant disorders varied from 0.8 to 62% at different cohorts; 516 biopsies have been performed at remote locations. CONCLUSION: Connecting specialists to rural population was made possible through the use of mobile health. Trained FHP were able to reach out to the population. Electronic data capture facilitated efficient follow-up. The program was very cost-effective with screening completed under $1 per person. CLINICAL SIGNIFICANCE: In view of the high incidence of oral cancer in India, and the resource-constrained settings, mobile health paves the way for better access to specialist care for the rural population.
Entities:
Keywords:
Frontline health care providers; Mobile health; Oral cancer; Oral potentially malignant disorders Remote diagnosis.