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Feasibility of training community health workers in the detection of oral cancer

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Thampi, Vipin, Hariprasad, Roopa, John, Amrita, Nethan, Suzanne, Dhanasekaran, Kavitha, Kumar, Vipin, Birur, Praveen, Thakur, J. S., Lilford, Richard, Rajpoot, Nasir M. and Gill, Paramjit (2022) Feasibility of training community health workers in the detection of oral cancer. JAMA Network Open, 5 (1). e2144022. doi:10.1001/jamanetworkopen.2021.44022

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Official URL: http://dx.doi.org/10.1001/jamanetworkopen.2021.440...

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Abstract

Importance: Visual screening for oral cancer has been found to be useful in a large randomized clinical trial in Kerala, India, showing substantial reduction in mortality. To address the shortage of medical personnel in resource-deficient regions, using the services of community health workers has been proposed as a strategy to fill the gap in human resources in health care.

Objective: To assess the feasibility of community health workers in screening and early detection of oral cancer using a mobile application capturing system.

Design, Setting, and Participants A cross-sectional study using a household sample was conducted in 10 areas of Gautam Budhnagar district, Uttar Pradesh, India, from January 31, 2020, to March 31, 2021, to assess the feasibility of identification of oral lesions by community health workers using a mobile phone application compared with diagnosis by trained dentists in a screening clinic. Men and women aged 30 years or older as well as tobacco users younger than 30 years were eligible for screening.

Interventions: Screening by trained community health workers vs dentists.

Results: A total of 1200 participants were screened by the community health workers during their home visits; of these, 1018 participants (526 [51.7%] men; mean [SD] age, 35 [16] years) were also referred and screened by the dentists a clinic. There was near-perfect agreement (κ = 0.9) between the findings of the community health workers and the dentists in identifying the positive or negative cases with overall sensitivity of 96.69% (95% CI, 94.15%-98.33%) and specificity of identification of 98.69% (95% CI, 97.52%-99.40%).

Conclusions and Relevance: In this cross-sectional study, trained community health workers were able after initial supervision by qualified dentists to perform oral cancer screening programs. These findings suggest that community health workers can perform this screening in resource-constrained settings.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science > Computer Science
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Mouth -- Cancer, Mouth -- Cancer -- Diagnosis, Community health aides -- Training of -- India -- Kerla
Journal or Publication Title: JAMA Network Open
Publisher: JAMA Network
ISSN: 2574-3805
Official Date: 18 January 2022
Dates:
DateEvent
18 January 2022Published
22 November 2021Accepted
Volume: 5
Number: 1
Article Number: e2144022
DOI: 10.1001/jamanetworkopen.2021.44022
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDUniversity of Warwickhttp://dx.doi.org/10.13039/501100000741

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