Attendance and compliance at an oral cancer screening programme in a general medical practice.

The purpose of this study was to measure the attendance and compliance rates in a demonstration invitational screening programme for oral cancer. 4348 subjects aged 40 years or over registered at an inner city medical practice in north London were invited for screening by post. The socioeconomic profile of the group was determined by analysis of residential areas. Screening was conducted by one of several dentists and a referral pathway was established for patients requiring follow-up. Attendance rates for screening and referral for follow-up were measured. The response rate was 985/3826 (25.7%) after removing 522 subjects whose invitations could not be delivered or who refused appointments. No reply was obtained for 2841 patients. Attendance for referral of lesions considered to have malignant potential was 67% (8/12), compared to 92% (11/12) for patients requiring referral for incidental benign lesions. The low compliance suggests that oral cancer screening may not be able to achieve the desired benefits of reducing morbidity and mortality, and establishment of such a programme may not, therefore, be cost-effective. Further research is required into how to identify people in high risk groups and motivate them to present themselves for screening.