Materiały źródłowe

• #1 Oral Leukoplakia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442013/

  Leukoplakia is the best-known potentially malignant disorder of the oral cavity, and its epidemiology is well documented. The prevalence of leukoplakia varies among various scientific studies. It has a comprehensive global review point at a prevalence of 2.6% and a malignancy conversion rate ranging from 0.1% to 17.5%. […] The statistical analysis from several studies piloted on the Indian subcontinent in general and in India, in particular, concluded the prevalence of leukoplakia ranging from 0.2% to 5.2% and the malignant transformation of 0.13% to 10%. […] This alarming increase in the prevalence of leukoplakia in India could be mainly due to its cultural, ethnic, and geographic factors. Downer and Petti found an annual malignant conversion incidence rate of leukoplakia arrays between 6.2 and 29.1 cases per 100,000 people.

• #2 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10481497/

  The overall prevalence of OPMD worldwide was 4.47%, with OLK ranking second with 4.11%. […] The global prevalence of OLK lacks support from epidemiological data. […] The overall estimated prevalence of OLK was 3.41% with high heterogeneity. The pooled estimated prevalence of the specific population studies (9.10%) was the highest among the population-based studies (2.23%) and clinic-based studies (1.36%). […] The prevalence of OLK in population-based studies was 2.53% in Asia, 1.82% in Europe, 1.15% in South America, and 0.33% in North America. […] The prevalence of OLK was relatively consistent and stable across different continents and different definitions. The pooled estimated prevalence of males was higher than in females, with statistically significant differences in clinic-based studies. A higher pooled estimated prevalence was found among people aged over 60 years old, the smoking population, and those consuming alcohol. […] More study is required to develop early treatment and clinical surveillance strategies, as well as to effect habit intervention in these populations.

• #3 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022 | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03342-y

  The overall prevalence of OPMD worldwide was 4.47%, with OLK ranking second with 4.11%. […] The prevalence of OLK was determined as 1.39% and the pooling estimated global prevalence was 3.41%. […] The prevalence was relatively consistent and stable across different continents and different definitions. […] The prevalence of OLK in population-based studies was 2.53% in Asia, 1.82% in Europe, 1.15% in South America, and 0.33% in North America. […] The global prevalence of OPMD by continent was reported at 10.54% in Asia, 3.07% in Europe, 3.93% in South America and Caribbean, and 0.11% in North America. […] The estimated prevalence in population based studies according to the WHO 1996 definition (3.06%) was the highest, greater than WHO 2005 definition(1.61), the other definition (2.56%) and unclear definition (1.60%).

• #4 Oral leukoplakia – UpToDate

  https://www.uptodate.com/contents/oral-leukoplakia/print

  Oral leukoplakia is not a rare condition. A systematic review pooling data from studies with at least 1000 individuals estimated that the prevalence in the general population is between 0.3 and 4.1 percent, with high heterogeneity among continents and the highest prevalence rates recorded in Asia and Oceania. […] Risk factors for oral leukoplakia are similar to those for squamous cell carcinoma (SCC), including tobacco use (smoked and smokeless) and alcohol drinking. In addition, leukoplakia has been shown to be associated with human papillomavirus (HPV) infection.

• #5 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022 | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03342-y

  Oral leukoplakia(OLK) is a common oral potentially malignant disorder. […] This study aimed to perform a systematic review of prevalence studies of oral leukoplakia and assess predisposing factors of its occurrence. […] The estimated prevalence calculation and risk of bias analysis used STATA 16.0. […] The prevalence was 1.39%, varying from 0.12 to 33.33%. […] The overall pooled estimated prevalence of OLK was 2.23% for population-based studies, 1.36% for clinic-based population studies, and 9.10% for specific populations. […] The estimated prevalence of OLK was higher in males than in females. […] A higher pooled estimated prevalence was found among males, those aged over 60 years old, smokers, and alcohol consumers. […] The results from the included studies in this systematic review revealed that the prevalence was relatively consistent and stable across various definitions and continents, which may help in developing global treatment and prevention strategies for oral leukoplakia.

• #6 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022 | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03342-y

  The overall prevalence of OPMD worldwide was 4.47%, with OLK ranking second with 4.11%. […] The prevalence of OLK was determined as 1.39% and the pooling estimated global prevalence was 3.41%. […] The prevalence was relatively consistent and stable across different continents and different definitions. […] The prevalence of OLK in population-based studies was 2.53% in Asia, 1.82% in Europe, 1.15% in South America, and 0.33% in North America. […] The global prevalence of OPMD by continent was reported at 10.54% in Asia, 3.07% in Europe, 3.93% in South America and Caribbean, and 0.11% in North America. […] The estimated prevalence in population based studies according to the WHO 1996 definition (3.06%) was the highest, greater than WHO 2005 definition(1.61), the other definition (2.56%) and unclear definition (1.60%).

• #7 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10481497/

  The overall prevalence of OPMD worldwide was 4.47%, with OLK ranking second with 4.11%. […] The global prevalence of OLK lacks support from epidemiological data. […] The overall estimated prevalence of OLK was 3.41% with high heterogeneity. The pooled estimated prevalence of the specific population studies (9.10%) was the highest among the population-based studies (2.23%) and clinic-based studies (1.36%). […] The prevalence of OLK in population-based studies was 2.53% in Asia, 1.82% in Europe, 1.15% in South America, and 0.33% in North America. […] The prevalence of OLK was relatively consistent and stable across different continents and different definitions. The pooled estimated prevalence of males was higher than in females, with statistically significant differences in clinic-based studies. A higher pooled estimated prevalence was found among people aged over 60 years old, the smoking population, and those consuming alcohol. […] More study is required to develop early treatment and clinical surveillance strategies, as well as to effect habit intervention in these populations.

• #8 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022 | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03342-y

  The overall prevalence of OPMD worldwide was 4.47%, with OLK ranking second with 4.11%. […] The prevalence of OLK was determined as 1.39% and the pooling estimated global prevalence was 3.41%. […] The prevalence was relatively consistent and stable across different continents and different definitions. […] The prevalence of OLK in population-based studies was 2.53% in Asia, 1.82% in Europe, 1.15% in South America, and 0.33% in North America. […] The global prevalence of OPMD by continent was reported at 10.54% in Asia, 3.07% in Europe, 3.93% in South America and Caribbean, and 0.11% in North America. […] The estimated prevalence in population based studies according to the WHO 1996 definition (3.06%) was the highest, greater than WHO 2005 definition(1.61), the other definition (2.56%) and unclear definition (1.60%).

• #9 Oral leukoplakia – UpToDate

  https://www.uptodate.com/contents/oral-leukoplakia/print

  Oral leukoplakia is not a rare condition. A systematic review pooling data from studies with at least 1000 individuals estimated that the prevalence in the general population is between 0.3 and 4.1 percent, with high heterogeneity among continents and the highest prevalence rates recorded in Asia and Oceania. […] Risk factors for oral leukoplakia are similar to those for squamous cell carcinoma (SCC), including tobacco use (smoked and smokeless) and alcohol drinking. In addition, leukoplakia has been shown to be associated with human papillomavirus (HPV) infection.

• #10 Oral Leukoplakia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442013/

  Leukoplakia is the best-known potentially malignant disorder of the oral cavity, and its epidemiology is well documented. The prevalence of leukoplakia varies among various scientific studies. It has a comprehensive global review point at a prevalence of 2.6% and a malignancy conversion rate ranging from 0.1% to 17.5%. […] The statistical analysis from several studies piloted on the Indian subcontinent in general and in India, in particular, concluded the prevalence of leukoplakia ranging from 0.2% to 5.2% and the malignant transformation of 0.13% to 10%. […] This alarming increase in the prevalence of leukoplakia in India could be mainly due to its cultural, ethnic, and geographic factors. Downer and Petti found an annual malignant conversion incidence rate of leukoplakia arrays between 6.2 and 29.1 cases per 100,000 people.

• #11 Oral Leukoplakia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442013/

  Leukoplakia is the best-known potentially malignant disorder of the oral cavity, and its epidemiology is well documented. The prevalence of leukoplakia varies among various scientific studies. It has a comprehensive global review point at a prevalence of 2.6% and a malignancy conversion rate ranging from 0.1% to 17.5%. […] The statistical analysis from several studies piloted on the Indian subcontinent in general and in India, in particular, concluded the prevalence of leukoplakia ranging from 0.2% to 5.2% and the malignant transformation of 0.13% to 10%. […] This alarming increase in the prevalence of leukoplakia in India could be mainly due to its cultural, ethnic, and geographic factors. Downer and Petti found an annual malignant conversion incidence rate of leukoplakia arrays between 6.2 and 29.1 cases per 100,000 people.

• #12

  https://biomedres.us/fulltexts/BJSTR.MS.ID.001126.php

  The prevalence of leukoplakia in India varies from 0.2% to 4.9%. Men are affected more frequently than women, and a vast majority of leukoplakia occurs in the age range of 35-45 years. Less than 1.3% of leukoplakias in India are idiopathic. […] Leukoplakia is seen most frequently in middle-aged and older men, with an increasing prevalence with age. Less than one percent of men below the age of 30 have leukoplakia, but the prevalence increases to an alarming eight percent in men over the age of 70. The prevalence in women past the age of 70 is approximately two percent. The most common sites are the buccal mucosa, alveolar mucosa, and lower lip; however, lesions in the floor of mouth, lateral tongue, and lower lip are most likely to show dysplastic or malignant changes.

• #13 Epidemiological study of oral leukoplakia based on mass screening for oral mucosal diseases in a selected Japanese population

  https://www.periodicos.capes.gov.br/index.php/acervo/buscador.html?task=detalhes&id=W2036922327

  The purpose of this study was 1) to show the epidemiological status of oral leukoplakia in a selected population of 3131 Japanese (504 women, 2627 men, aged 18-63 yr, mean age 35.9 yr), and 2) to estimate of the validity of the diagnosis of oral leukoplakia by general practitioners. […] Seventy-seven individuals were detected as having leukoplakia, a prevalence of 2.5%; 2.7% and 1.0% for men and women, respectively, a difference that is statistically significant (P less than 0.001). […] The percentage of smokers was 75.3% for patients with leukoplakia and 47.8% for individuals detected as not having leukoplakia, a difference which is statistically significant (P less than 0.001). […] The results of this study suggest that in order to carry out an efficient oral health program in Japan, the objects for mass screening for leukoplakia might be better limited to men over 30 and women over 40 yr of age.

• #14 Leukoplakia – Wikipedia

  https://en.wikipedia.org/wiki/Leukoplakia

  The prevalence of oral leukoplakia varies around the world, but generally speaking it is not an uncommon condition. Reported prevalence estimates range from less than 1% to more than 5% in the general population. Leukoplakia is, therefore, the most common premalignant lesion that occurs in the mouth. Leukoplakia is more common in middle-aged and elderly males. The prevalence increases with increasing age. In areas of the world where smokeless tobacco use is common, there is a higher prevalence. In the Middle East region, the prevalence of leukoplakia is less than 1% (0.48%).

• #15 Oral Leukoplakia in Arab Countries: A Review

  https://jmscr.igmpublication.org/home/index.php/archive/147-volume-06-issue-02-february-2018/4322-oral-leukoplakia-in-arab-countries-a-review

  Oral Leukoplakia (OL) is a term describing the white lesions of the oral mucosa; it is the most common potentially malignant lesion of the oral cavity. The epidemiology of this condition in Arab countries is not well studied. […] A total of 12 articles were used for this review. Eight studies were cross-sectional, of them, two studies estimated a prevalence that ranged between 1.9% and 3.6%. […] The results demonstrate a strong relationship between OL and Qat and Shammah Chewing (OL prevalence was 22-27% among tobacco users). Further population-based studies should be conducted in Arab countries to identify a causal relationship between these factors and the development, onset and progression of OL.

• #16 Oral Leukoplakia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/853864-overview

  OL occurs in fewer than 1% of individuals. […] OL is considered to be potentially malignant, with a transformation rate in various studies and locations that range from 0.6 to 20%. […] A long-term follow-up study by Fan et al indicated that oral leukoplakia can increase the risk of esophageal squamous cell carcinoma (ESCC). […] A retrospective study by Rubert et al found the malignization rate in OL to be 8.3%. […] A literature review by Paglioni et al indicated that size is one of the factors influencing malignant transformation in potentially malignant oral disorders, with the chance of turning malignant being 4.10-fold greater in leukoplakia lesions more than 200 mm2 in size. […] OL is more common in men than in women, with a male-to-female ratio of 2:1. […] Most cases of OL occur in persons in their fifth to seventh decade of life. Approximately 80% of patients are older than 40 years.

• #17 Leukoplakia (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/leukoplakia-pro

  Prevalence – the estimated worldwide prevalence is around 2%.5 […] Most cases of leukoplakia occur in middle and older age.1 Less than 1% of patients are under the age of 30 years.6 […] Leukoplakia is more common in men than in women, with a male-to-female ratio of 2:1.7

• #18 Leukoplakia and Erythroplakia – Premalignant Squamous Lesions of the Oral Cavity: Definition, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1840467-overview

  The prevalence of premalignant oral lesions is approximately 1%-5%. […] Overall, the rates of oral squamous dysplasia and subsequent squamous cell carcinoma (SCC) are decreasing, closely paralleling the reduction in cigarette smoking. […] Most cases of leukoplakia and erythroplakia are seen in adults older than 50 years who have risk factors (discussed in Etiology). […] Males are predominantly affected, with a male-to-female ratio of approximately 3:1; this difference becomes more pronounced with increasing age. […] Proliferative verrucous leukoplakia (PVL), in contrast, is seen much more often in women (male-to-female ratio, 1:4) in their seventh and eighth decades of life. […] Of note, this clinical diagnosis is associated with a high rate of malignant transformation, generally considered to be over 70%.

• #19 Leukoplakia, Oral | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116350/0.0/Leukoplakia_Oral

  Most common in individuals who use tobacco (smoking and smokeless), heavy alcohol use, and areca nuts (Asian populations). […] Incidence 250,000 annual cases worldwide […] Age of onset is 40 years old with peak in the 60s. […] Males are 3 times more likely to be affected than females. […] Smokers are 6 times more likely to be affected than nonsmokers. […] Malignant transformation to carcinoma is more common in older patients. […] 70-90% of oral leukoplakia is related to tobacco, particularly smokeless tobacco or areca/betel nut use. […] Alcohol increases risk by 1.5-fold. […] Risk factors for malignant transformation of leukoplakia include long duration of leukoplakia, nonsmoker (idiopathic leukoplakia), located on tongue or floor of mouth, size 200 mm2, nonhomogeneous type, presence of epithelial dysplasia, presence of C. albicans.

• #20 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10481497/

  The overall prevalence of OPMD worldwide was 4.47%, with OLK ranking second with 4.11%. […] The global prevalence of OLK lacks support from epidemiological data. […] The overall estimated prevalence of OLK was 3.41% with high heterogeneity. The pooled estimated prevalence of the specific population studies (9.10%) was the highest among the population-based studies (2.23%) and clinic-based studies (1.36%). […] The prevalence of OLK in population-based studies was 2.53% in Asia, 1.82% in Europe, 1.15% in South America, and 0.33% in North America. […] The prevalence of OLK was relatively consistent and stable across different continents and different definitions. The pooled estimated prevalence of males was higher than in females, with statistically significant differences in clinic-based studies. A higher pooled estimated prevalence was found among people aged over 60 years old, the smoking population, and those consuming alcohol. […] More study is required to develop early treatment and clinical surveillance strategies, as well as to effect habit intervention in these populations.

• #21 Oral Leukoplakia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442013/

  In a study by Martorell-Calatayud et al. determined the prevalence of leukoplakia to be in the range of 0.4% to 0.7%, whereas Feller et al. estimated the prevalence towards a higher range of 0.5% to 3.46%. Furthermore, the same study concluded that the malignant transformation rate of leukoplakia ranged from 0.7% to 2.9%. […] In yet another study by Brouns et al. showed the prevalence and annual malignant transformation rate of approximately 2% and 1%, respectively. […] Among the recent studies, leukoplakia was evident in 1.59% of the study sample. […] Leukoplakia is more common in middle-aged and elderly males than in other group studies. The prevalence increases with increasing age.

• #22 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Commonly diagnosed in middle-aged to elderly patients. […] More commonly identified in males. […] OL is six times more common among smokers than non-smokers. […] The prevalence of OL varies significantly with geographical variations due to different risk factors, such as betel nut chewing in South East Asia. […] OL is associated with various risk factors, similar to those observed in oral cancer, such as tobacco (both smoked and smokeless), heavy alcohol consumption, betel quid chewing (especially in South Asian countries) and, for lesions involving the lip, ultraviolet (UV) light exposure. […] Alcohol consumption is an independent risk factor. It has been established that these factors may have an aetiological role in the development of OL in more than 75% of the affected individuals.

• #23 Oral Leukoplakia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/853864-overview

  OL occurs in fewer than 1% of individuals. […] OL is considered to be potentially malignant, with a transformation rate in various studies and locations that range from 0.6 to 20%. […] A long-term follow-up study by Fan et al indicated that oral leukoplakia can increase the risk of esophageal squamous cell carcinoma (ESCC). […] A retrospective study by Rubert et al found the malignization rate in OL to be 8.3%. […] A literature review by Paglioni et al indicated that size is one of the factors influencing malignant transformation in potentially malignant oral disorders, with the chance of turning malignant being 4.10-fold greater in leukoplakia lesions more than 200 mm2 in size. […] OL is more common in men than in women, with a male-to-female ratio of 2:1. […] Most cases of OL occur in persons in their fifth to seventh decade of life. Approximately 80% of patients are older than 40 years.

• #24 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022 | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03342-y

  Oral leukoplakia(OLK) is a common oral potentially malignant disorder. […] This study aimed to perform a systematic review of prevalence studies of oral leukoplakia and assess predisposing factors of its occurrence. […] The estimated prevalence calculation and risk of bias analysis used STATA 16.0. […] The prevalence was 1.39%, varying from 0.12 to 33.33%. […] The overall pooled estimated prevalence of OLK was 2.23% for population-based studies, 1.36% for clinic-based population studies, and 9.10% for specific populations. […] The estimated prevalence of OLK was higher in males than in females. […] A higher pooled estimated prevalence was found among males, those aged over 60 years old, smokers, and alcohol consumers. […] The results from the included studies in this systematic review revealed that the prevalence was relatively consistent and stable across various definitions and continents, which may help in developing global treatment and prevention strategies for oral leukoplakia.

• #25 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10481497/

  Oral leukoplakia (OLK) is a common oral potentially malignant disorder. The global prevalence of solely OLK was published in 2003, while the prevalence varied among different studies. […] This study aimed to perform a systematic review of prevalence studies of oral leukoplakia and assess predisposing factors of its occurrence. […] The estimated prevalence of OLK was higher in males than in females. Those who smoked and consumed alcohol had a higher prevalence than those who did not. […] The prevalence of OLK was determined as 1.39% and the pooling estimated global prevalence was 3.41%. The prevalence was relatively consistent and stable across different continents and different definitions. A higher pooled estimated prevalence was found among males, those aged over 60 years old, smokers, and alcohol consumers.

• #26

  https://biomedres.us/fulltexts/BJSTR.MS.ID.001126.php

  The prevalence of leukoplakia in India varies from 0.2% to 4.9%. Men are affected more frequently than women, and a vast majority of leukoplakia occurs in the age range of 35-45 years. Less than 1.3% of leukoplakias in India are idiopathic. […] Leukoplakia is seen most frequently in middle-aged and older men, with an increasing prevalence with age. Less than one percent of men below the age of 30 have leukoplakia, but the prevalence increases to an alarming eight percent in men over the age of 70. The prevalence in women past the age of 70 is approximately two percent. The most common sites are the buccal mucosa, alveolar mucosa, and lower lip; however, lesions in the floor of mouth, lateral tongue, and lower lip are most likely to show dysplastic or malignant changes.

• #27 Premalignant Lesions – Oral Cancer Foundation | Information and Resources about Oral Head and Neck Cancer

  https://oralcancerfoundation.org/cdc/premalignant-lesions/

  The term leukoplakia is sometimes used inappropriately to indicate a premalignant condition. […] Most cases of leukoplakia are a hyperkeratotic response to an irritant and are asymptomatic, but about 20% of leukoplakic lesions show evidence of dysplasia or carcinoma at first clinical recognition. […] However, some anatomic sites (floor of mouth and ventral tongue) have rates of dysplasia or carcinoma as high as 45%. […] In one large study, lesions with an erythroplakic component had a 23.4% malignant transformation rate, compared with a 6.5% rate for lesions that were homogeneous. […] The mean age at diagnosis of oral premalignancy is 50-69; less than 5% of diagnoses are in patients under 30 years of age. […] Studies have shown that epithelial dysplasia has a predilection for males, but the decrease in the male:female ratio for oral squamous cell carcinoma suggests the picture may be changing.

• #28 Oral leukoplakia – UpToDate

  https://www.uptodate.com/contents/oral-leukoplakia/print

  Oral leukoplakia is not a rare condition. A systematic review pooling data from studies with at least 1000 individuals estimated that the prevalence in the general population is between 0.3 and 4.1 percent, with high heterogeneity among continents and the highest prevalence rates recorded in Asia and Oceania. […] Risk factors for oral leukoplakia are similar to those for squamous cell carcinoma (SCC), including tobacco use (smoked and smokeless) and alcohol drinking. In addition, leukoplakia has been shown to be associated with human papillomavirus (HPV) infection.

• #29 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Commonly diagnosed in middle-aged to elderly patients. […] More commonly identified in males. […] OL is six times more common among smokers than non-smokers. […] The prevalence of OL varies significantly with geographical variations due to different risk factors, such as betel nut chewing in South East Asia. […] OL is associated with various risk factors, similar to those observed in oral cancer, such as tobacco (both smoked and smokeless), heavy alcohol consumption, betel quid chewing (especially in South Asian countries) and, for lesions involving the lip, ultraviolet (UV) light exposure. […] Alcohol consumption is an independent risk factor. It has been established that these factors may have an aetiological role in the development of OL in more than 75% of the affected individuals.

• #30 Recognizing and treating oral leukoplakia in primary care – Oral Cancer News

  https://oralcancernews.org/wp/recognizing-and-treating-oral-leukoplakia-in-primary-care/

  Oral leukoplakia is considered one of the most common oral potentially malignant disorders (OPMDs) with an estimated worldwide prevalence of 1.5% to 2.6%.1 […] It is reported that leukoplakia is 6 times more common in smokers than nonsmokers.1 […] Oral leukoplakia is most commonly seen in men aged 40 years and older, particularly after years of chronic tobacco use.1,2 […] Primary care providers can aid in the primary prevention of oral leukoplakia by routinely screening their patients for this condition; risk factors include the use of tobacco products and excess alcohol consumption. […] Secondary prevention refers to monitoring the disease. Patients diagnosed with oral leukoplakia require frequent oral cavity examinations to identify any possible changes; especially because clinically lesions are asymptomatic. Thus, it is essential for primary care clinicians to be proactive and assess the oral cavity in all patients, especially those with risk factors, to promptly diagnose conditions such as oral leukoplakia.

• #31 Leukoplakia, Oral | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116350/0.0/Leukoplakia_Oral

  Most common in individuals who use tobacco (smoking and smokeless), heavy alcohol use, and areca nuts (Asian populations). […] Incidence 250,000 annual cases worldwide […] Age of onset is 40 years old with peak in the 60s. […] Males are 3 times more likely to be affected than females. […] Smokers are 6 times more likely to be affected than nonsmokers. […] Malignant transformation to carcinoma is more common in older patients. […] 70-90% of oral leukoplakia is related to tobacco, particularly smokeless tobacco or areca/betel nut use. […] Alcohol increases risk by 1.5-fold. […] Risk factors for malignant transformation of leukoplakia include long duration of leukoplakia, nonsmoker (idiopathic leukoplakia), located on tongue or floor of mouth, size 200 mm2, nonhomogeneous type, presence of epithelial dysplasia, presence of C. albicans.

• #32 Epidemiological study of oral leukoplakia based on mass screening for oral mucosal diseases in a selected Japanese population

  https://www.periodicos.capes.gov.br/index.php/acervo/buscador.html?task=detalhes&id=W2036922327

  The purpose of this study was 1) to show the epidemiological status of oral leukoplakia in a selected population of 3131 Japanese (504 women, 2627 men, aged 18-63 yr, mean age 35.9 yr), and 2) to estimate of the validity of the diagnosis of oral leukoplakia by general practitioners. […] Seventy-seven individuals were detected as having leukoplakia, a prevalence of 2.5%; 2.7% and 1.0% for men and women, respectively, a difference that is statistically significant (P less than 0.001). […] The percentage of smokers was 75.3% for patients with leukoplakia and 47.8% for individuals detected as not having leukoplakia, a difference which is statistically significant (P less than 0.001). […] The results of this study suggest that in order to carry out an efficient oral health program in Japan, the objects for mass screening for leukoplakia might be better limited to men over 30 and women over 40 yr of age.

• #33 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  The use of different terminologies and definitions have made it difficult to properly evaluate the reported data on epidemiology, treatment results and rates of malignant transformation of oral leukoplakia. […] A high frequency of leukoplakia is observed in populations with a high prevalence of tobacco habits, particularly chewing, such as those in South and Southeast Asia. […] The risk of developing malignancies at lesion sites is greater in those with leukoplakia than in subjects without leukoplakia. […] A significant rate of regression of leukoplakia has been reported after stopping tobacco habits. […] An association between candida infection and leukoplakia, especially non-homogenous leukoplakia, has also been shown, and higher rates of malignant transformation have been reported in candida superimposed leukoplakias.

• #34 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?lang=1&cat=Az

  The use of different terminologies and definitions have made it difficult to properly evaluate the reported data on epidemiology, treatment results and rates of malignant transformation of oral leukoplakia. […] A high frequency of leukoplakia is observed in populations with a high prevalence of tobacco habits, particularly chewing, such as those in South and Southeast Asia. […] The risk of developing malignancies at lesion sites is greater in those with leukoplakia than in subjects without leukoplakia. […] A significant rate of regression of leukoplakia has been reported after stopping tobacco habits. […] An association between candida infection and leukoplakia, especially non-homogenous leukoplakia, has also been shown, and higher rates of malignant transformation have been reported in candida superimposed leukoplakias.

• #35 Leukoplakia, Oral | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116350/0.0/Leukoplakia_Oral

  Most common in individuals who use tobacco (smoking and smokeless), heavy alcohol use, and areca nuts (Asian populations). […] Incidence 250,000 annual cases worldwide […] Age of onset is 40 years old with peak in the 60s. […] Males are 3 times more likely to be affected than females. […] Smokers are 6 times more likely to be affected than nonsmokers. […] Malignant transformation to carcinoma is more common in older patients. […] 70-90% of oral leukoplakia is related to tobacco, particularly smokeless tobacco or areca/betel nut use. […] Alcohol increases risk by 1.5-fold. […] Risk factors for malignant transformation of leukoplakia include long duration of leukoplakia, nonsmoker (idiopathic leukoplakia), located on tongue or floor of mouth, size 200 mm2, nonhomogeneous type, presence of epithelial dysplasia, presence of C. albicans.

• #36 Leukoplakia, Oral | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116350/0.0/Leukoplakia_Oral

  Most common in individuals who use tobacco (smoking and smokeless), heavy alcohol use, and areca nuts (Asian populations). […] Incidence 250,000 annual cases worldwide […] Age of onset is 40 years old with peak in the 60s. […] Males are 3 times more likely to be affected than females. […] Smokers are 6 times more likely to be affected than nonsmokers. […] Malignant transformation to carcinoma is more common in older patients. […] 70-90% of oral leukoplakia is related to tobacco, particularly smokeless tobacco or areca/betel nut use. […] Alcohol increases risk by 1.5-fold. […] Risk factors for malignant transformation of leukoplakia include long duration of leukoplakia, nonsmoker (idiopathic leukoplakia), located on tongue or floor of mouth, size 200 mm2, nonhomogeneous type, presence of epithelial dysplasia, presence of C. albicans.

• #37 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022 | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03342-y

  Oral leukoplakia(OLK) is a common oral potentially malignant disorder. […] This study aimed to perform a systematic review of prevalence studies of oral leukoplakia and assess predisposing factors of its occurrence. […] The estimated prevalence calculation and risk of bias analysis used STATA 16.0. […] The prevalence was 1.39%, varying from 0.12 to 33.33%. […] The overall pooled estimated prevalence of OLK was 2.23% for population-based studies, 1.36% for clinic-based population studies, and 9.10% for specific populations. […] The estimated prevalence of OLK was higher in males than in females. […] A higher pooled estimated prevalence was found among males, those aged over 60 years old, smokers, and alcohol consumers. […] The results from the included studies in this systematic review revealed that the prevalence was relatively consistent and stable across various definitions and continents, which may help in developing global treatment and prevention strategies for oral leukoplakia.

• #38 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10481497/

  Oral leukoplakia (OLK) is a common oral potentially malignant disorder. The global prevalence of solely OLK was published in 2003, while the prevalence varied among different studies. […] This study aimed to perform a systematic review of prevalence studies of oral leukoplakia and assess predisposing factors of its occurrence. […] The estimated prevalence of OLK was higher in males than in females. Those who smoked and consumed alcohol had a higher prevalence than those who did not. […] The prevalence of OLK was determined as 1.39% and the pooling estimated global prevalence was 3.41%. The prevalence was relatively consistent and stable across different continents and different definitions. A higher pooled estimated prevalence was found among males, those aged over 60 years old, smokers, and alcohol consumers.

• #39 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Commonly diagnosed in middle-aged to elderly patients. […] More commonly identified in males. […] OL is six times more common among smokers than non-smokers. […] The prevalence of OL varies significantly with geographical variations due to different risk factors, such as betel nut chewing in South East Asia. […] OL is associated with various risk factors, similar to those observed in oral cancer, such as tobacco (both smoked and smokeless), heavy alcohol consumption, betel quid chewing (especially in South Asian countries) and, for lesions involving the lip, ultraviolet (UV) light exposure. […] Alcohol consumption is an independent risk factor. It has been established that these factors may have an aetiological role in the development of OL in more than 75% of the affected individuals.

• #40 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Commonly diagnosed in middle-aged to elderly patients. […] More commonly identified in males. […] OL is six times more common among smokers than non-smokers. […] The prevalence of OL varies significantly with geographical variations due to different risk factors, such as betel nut chewing in South East Asia. […] OL is associated with various risk factors, similar to those observed in oral cancer, such as tobacco (both smoked and smokeless), heavy alcohol consumption, betel quid chewing (especially in South Asian countries) and, for lesions involving the lip, ultraviolet (UV) light exposure. […] Alcohol consumption is an independent risk factor. It has been established that these factors may have an aetiological role in the development of OL in more than 75% of the affected individuals.

• #41 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Leukoplakias are classified as oral potentially malignant disorders predisposing affected individuals to an increased risk of development of oral squamous cell carcinoma. […] OL shows variable percentages of progression to OSCC, varying from 0% to 36.4%. The annual rate of transformation ranged from 0.3% to 6.9% per year as reported by a recent review of observational studies. […] Risk factors, which have shown statistical significance, for cancer development in individuals affected by OL are listed in table 4. […] Non-homogenous leukoplakias carry a higher risk of OSCC development compared to homogeneous leukoplakias there is an approximately 7-fold increase risk for malignant development with non-homogeneous leukoplakia compared with homogeneous leukoplakia and a 5-fold increase in risk when the lesion size is greater than 200 mm2. […] The risk of cancer development is closely related to the type of lesion and the grade of dysplasia.

• #42 Oral Leukoplakia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/853864-overview

  OL occurs in fewer than 1% of individuals. […] OL is considered to be potentially malignant, with a transformation rate in various studies and locations that range from 0.6 to 20%. […] A long-term follow-up study by Fan et al indicated that oral leukoplakia can increase the risk of esophageal squamous cell carcinoma (ESCC). […] A retrospective study by Rubert et al found the malignization rate in OL to be 8.3%. […] A literature review by Paglioni et al indicated that size is one of the factors influencing malignant transformation in potentially malignant oral disorders, with the chance of turning malignant being 4.10-fold greater in leukoplakia lesions more than 200 mm2 in size. […] OL is more common in men than in women, with a male-to-female ratio of 2:1. […] Most cases of OL occur in persons in their fifth to seventh decade of life. Approximately 80% of patients are older than 40 years.

• #43 Oral Leukoplakia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442013/

  Leukoplakia is the best-known potentially malignant disorder of the oral cavity, and its epidemiology is well documented. The prevalence of leukoplakia varies among various scientific studies. It has a comprehensive global review point at a prevalence of 2.6% and a malignancy conversion rate ranging from 0.1% to 17.5%. […] The statistical analysis from several studies piloted on the Indian subcontinent in general and in India, in particular, concluded the prevalence of leukoplakia ranging from 0.2% to 5.2% and the malignant transformation of 0.13% to 10%. […] This alarming increase in the prevalence of leukoplakia in India could be mainly due to its cultural, ethnic, and geographic factors. Downer and Petti found an annual malignant conversion incidence rate of leukoplakia arrays between 6.2 and 29.1 cases per 100,000 people.

• #44 Oral Leukoplakia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/853864-overview

  OL occurs in fewer than 1% of individuals. […] OL is considered to be potentially malignant, with a transformation rate in various studies and locations that range from 0.6 to 20%. […] A long-term follow-up study by Fan et al indicated that oral leukoplakia can increase the risk of esophageal squamous cell carcinoma (ESCC). […] A retrospective study by Rubert et al found the malignization rate in OL to be 8.3%. […] A literature review by Paglioni et al indicated that size is one of the factors influencing malignant transformation in potentially malignant oral disorders, with the chance of turning malignant being 4.10-fold greater in leukoplakia lesions more than 200 mm2 in size. […] OL is more common in men than in women, with a male-to-female ratio of 2:1. […] Most cases of OL occur in persons in their fifth to seventh decade of life. Approximately 80% of patients are older than 40 years.

• #45 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Leukoplakias are classified as oral potentially malignant disorders predisposing affected individuals to an increased risk of development of oral squamous cell carcinoma. […] OL shows variable percentages of progression to OSCC, varying from 0% to 36.4%. The annual rate of transformation ranged from 0.3% to 6.9% per year as reported by a recent review of observational studies. […] Risk factors, which have shown statistical significance, for cancer development in individuals affected by OL are listed in table 4. […] Non-homogenous leukoplakias carry a higher risk of OSCC development compared to homogeneous leukoplakias there is an approximately 7-fold increase risk for malignant development with non-homogeneous leukoplakia compared with homogeneous leukoplakia and a 5-fold increase in risk when the lesion size is greater than 200 mm2. […] The risk of cancer development is closely related to the type of lesion and the grade of dysplasia.

• #46 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Leukoplakias are classified as oral potentially malignant disorders predisposing affected individuals to an increased risk of development of oral squamous cell carcinoma. […] OL shows variable percentages of progression to OSCC, varying from 0% to 36.4%. The annual rate of transformation ranged from 0.3% to 6.9% per year as reported by a recent review of observational studies. […] Risk factors, which have shown statistical significance, for cancer development in individuals affected by OL are listed in table 4. […] Non-homogenous leukoplakias carry a higher risk of OSCC development compared to homogeneous leukoplakias there is an approximately 7-fold increase risk for malignant development with non-homogeneous leukoplakia compared with homogeneous leukoplakia and a 5-fold increase in risk when the lesion size is greater than 200 mm2. […] The risk of cancer development is closely related to the type of lesion and the grade of dysplasia.

• #47

  https://journals.lww.com/jpat/fulltext/2004/08020/oral_leukoplakia__leukokeratosis___compilation_of.4.aspx

  In two studies from India (Gupta PC et al 1980, Silvennan S et al 1976), rather low annual malignant transformation rates of oral leukoplakia have been reported, 0.3% and 0.06% respectively. […] On the basis of the lowest reported annual malignant transformation rate of oral leukoplakia, it can be calculated that patients with oral leukoplakia carry a 5-fold higher risk of developing oral cancer than controls. […] It is apparent that in addition to tobacco use, intake of specific nutrients and their deficiency may have a role in the development and progression of oral precancerous lesions.

• #48 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Leukoplakias are classified as oral potentially malignant disorders predisposing affected individuals to an increased risk of development of oral squamous cell carcinoma. […] OL shows variable percentages of progression to OSCC, varying from 0% to 36.4%. The annual rate of transformation ranged from 0.3% to 6.9% per year as reported by a recent review of observational studies. […] Risk factors, which have shown statistical significance, for cancer development in individuals affected by OL are listed in table 4. […] Non-homogenous leukoplakias carry a higher risk of OSCC development compared to homogeneous leukoplakias there is an approximately 7-fold increase risk for malignant development with non-homogeneous leukoplakia compared with homogeneous leukoplakia and a 5-fold increase in risk when the lesion size is greater than 200 mm2. […] The risk of cancer development is closely related to the type of lesion and the grade of dysplasia.

• #49 Head and Neck: Oral leukoplakia

  https://atlasgeneticsoncology.org/solid-tumor/5937/head-and-neck-oral-leukoplakia

  The malignant transformation risk varies from 3.6% to 36.0%, and some features as presence and degree of dysplasia, female gender, time of duration, non-smoker patient, location at floor of the mouth or tongue, size higher than 200mm2, and non-homogeneous type, seem to be associated with a worse prognosis (Cruz et al., 2002; Holmstrup et al., 2006; Hsue et al., 2007; Smith et al., 2009; van der Waal, 2009).

• #50 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  The frequency of malignant transformation is lower in cohort studies compared to hospital based studies. […] Clinical type and size of the lesion are the important predictors of malignant transformation, and other factors like gender and site have no influence. […] A higher risk of malignant transformation is observed in non-homogeneous leukoplakia compared to homogeneous leukoplakia. […] The malignant potential is almost 7 times higher for non-homogeneous leukoplakia compared to homogeneous type. […] Although epithelial dysplasia is an important predictive factor of malignant transformation, not all dysplastic lesions become malignant. […] All leukoplakias should be viewed with suspicion because even small, subtle lesions can manifest significant dysplasia or harbour unsuspected carcinoma.

• #51 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?lang=1&cat=Az

  The frequency of malignant transformation is lower in cohort studies compared to hospital based studies and the rate of malignant transformation increases over time. […] A higher risk of malignant transformation is observed in non-homogeneous leukoplakia compared to homogeneous leukoplakia. […] The malignant potential is almost 7 times higher for non-homogeneous leukoplakia compared to homogeneous type. […] All leukoplakias should be viewed with suspicion because even small, subtle lesions can manifest significant dysplasia or harbour unsuspected carcinoma. […] Follow-up studies have clearly established that oral leukoplakia is a precancerous lesion for cancers of the oral cavity. […] Although several management regimes have been suggested, results in term of preventing malignant transformation are highly variable, particularly due to the field cancerisation effect. […] Stopping the use of tobacco and alcohol and management of superadded fungal infection may result in the regression of lesions. […] Long-term follow-up, even after removal, is essential because recurrences are frequent and additional leukoplakias may occur.

• #52 Oral Leukoplakia – OPMDCARE

  https://opmdcare.com/oral-leukoplakia/

  Leukoplakias are classified as oral potentially malignant disorders predisposing affected individuals to an increased risk of development of oral squamous cell carcinoma. […] OL shows variable percentages of progression to OSCC, varying from 0% to 36.4%. The annual rate of transformation ranged from 0.3% to 6.9% per year as reported by a recent review of observational studies. […] Risk factors, which have shown statistical significance, for cancer development in individuals affected by OL are listed in table 4. […] Non-homogenous leukoplakias carry a higher risk of OSCC development compared to homogeneous leukoplakias there is an approximately 7-fold increase risk for malignant development with non-homogeneous leukoplakia compared with homogeneous leukoplakia and a 5-fold increase in risk when the lesion size is greater than 200 mm2. […] The risk of cancer development is closely related to the type of lesion and the grade of dysplasia.

• #53 Oral Leukoplakia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/853864-overview

  OL occurs in fewer than 1% of individuals. […] OL is considered to be potentially malignant, with a transformation rate in various studies and locations that range from 0.6 to 20%. […] A long-term follow-up study by Fan et al indicated that oral leukoplakia can increase the risk of esophageal squamous cell carcinoma (ESCC). […] A retrospective study by Rubert et al found the malignization rate in OL to be 8.3%. […] A literature review by Paglioni et al indicated that size is one of the factors influencing malignant transformation in potentially malignant oral disorders, with the chance of turning malignant being 4.10-fold greater in leukoplakia lesions more than 200 mm2 in size. […] OL is more common in men than in women, with a male-to-female ratio of 2:1. […] Most cases of OL occur in persons in their fifth to seventh decade of life. Approximately 80% of patients are older than 40 years.

• #54 Leukoplakia and Erythroplakia – Premalignant Squamous Lesions of the Oral Cavity: Definition, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1840467-overview

  The term „leukoplakia” is often used as if it were synonymous with premalignant condition, but it is important to remember that only a distinct minority of leukoplakias harbor dysplasia or carcinoma. […] Homogeneous leukoplakia transforms to malignancy in only about 6% of cases. […] Nonhomogeneous leukoplakia and erythroplakia, although less common, have a much higher rate of dysplasia, with at least 85% of cases showing severe dysplasia or frank squamous cell carcinoma (SCC). […] Note that lesions of the floor of the mouth and the lateral and ventral tongue are more likely to represent dysplasia and that premalignant lesions of these sites are at a higher risk for malignant transformation than similar lesions at other sites in the oral cavity. […] Follow-up studies examining the progression of dysplasia to carcinoma have found that patients with any dysplasia progress to cancer in 5%-36% of cases. […] Proliferative verrucous leukoplakia (PVL), in contrast, is a slowly progressive, multifocal disease that eventually progresses to SCC in almost all cases.

• #55 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. The incidence and prevalence of leukoplakia vary in different parts of the world. In general the reported prevalence ranges from 0.2 to 5%, with remarkable regional differences: India (0.2-4.9%), Sweden (3.6%), Germany (1.6%), Holland (1.4%). Leukoplakia is seen most frequently in middle-aged and older men. […] Any leukoplakia could transform into a carcinoma, even those which did not show epithelial dysplasia initially (or in which dysplasia happened to be absent from the biopsy taken). The main problem is that the malignant transformation cannot be reliably predicted yet. Nonetheless, some data could help identifying the possible risk. Leukoplakias show a high transformation risk when they: 1.- affect women; 2.- persist for long periods; 3.- appear in non smokers, 4.- are located on the floor of the mouth or tongue; 5.- are seen in patients with a previous head and neck carcinoma; 6.- are non-homogenous; 7.- are infected by Candida; 8.- show epithelial dysplasia, 9.- show DNA aneuploidy. […] Regular check-up of these patients is essential, probably every 3, 6 and then 12 months, both in treated and untreated patients.

• #56 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. The incidence and prevalence of leukoplakia vary in different parts of the world. In general the reported prevalence ranges from 0.2 to 5%, with remarkable regional differences: India (0.2-4.9%), Sweden (3.6%), Germany (1.6%), Holland (1.4%). Leukoplakia is seen most frequently in middle-aged and older men. […] Any leukoplakia could transform into a carcinoma, even those which did not show epithelial dysplasia initially (or in which dysplasia happened to be absent from the biopsy taken). The main problem is that the malignant transformation cannot be reliably predicted yet. Nonetheless, some data could help identifying the possible risk. Leukoplakias show a high transformation risk when they: 1.- affect women; 2.- persist for long periods; 3.- appear in non smokers, 4.- are located on the floor of the mouth or tongue; 5.- are seen in patients with a previous head and neck carcinoma; 6.- are non-homogenous; 7.- are infected by Candida; 8.- show epithelial dysplasia, 9.- show DNA aneuploidy. […] Regular check-up of these patients is essential, probably every 3, 6 and then 12 months, both in treated and untreated patients.

• #57 Head and Neck: Oral leukoplakia

  https://atlasgeneticsoncology.org/solid-tumor/5937/head-and-neck-oral-leukoplakia

  The malignant transformation risk varies from 3.6% to 36.0%, and some features as presence and degree of dysplasia, female gender, time of duration, non-smoker patient, location at floor of the mouth or tongue, size higher than 200mm2, and non-homogeneous type, seem to be associated with a worse prognosis (Cruz et al., 2002; Holmstrup et al., 2006; Hsue et al., 2007; Smith et al., 2009; van der Waal, 2009).

• #58 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. The incidence and prevalence of leukoplakia vary in different parts of the world. In general the reported prevalence ranges from 0.2 to 5%, with remarkable regional differences: India (0.2-4.9%), Sweden (3.6%), Germany (1.6%), Holland (1.4%). Leukoplakia is seen most frequently in middle-aged and older men. […] Any leukoplakia could transform into a carcinoma, even those which did not show epithelial dysplasia initially (or in which dysplasia happened to be absent from the biopsy taken). The main problem is that the malignant transformation cannot be reliably predicted yet. Nonetheless, some data could help identifying the possible risk. Leukoplakias show a high transformation risk when they: 1.- affect women; 2.- persist for long periods; 3.- appear in non smokers, 4.- are located on the floor of the mouth or tongue; 5.- are seen in patients with a previous head and neck carcinoma; 6.- are non-homogenous; 7.- are infected by Candida; 8.- show epithelial dysplasia, 9.- show DNA aneuploidy. […] Regular check-up of these patients is essential, probably every 3, 6 and then 12 months, both in treated and untreated patients.

• #59 Head and Neck: Oral leukoplakia

  https://atlasgeneticsoncology.org/solid-tumor/5937/head-and-neck-oral-leukoplakia

  The malignant transformation risk varies from 3.6% to 36.0%, and some features as presence and degree of dysplasia, female gender, time of duration, non-smoker patient, location at floor of the mouth or tongue, size higher than 200mm2, and non-homogeneous type, seem to be associated with a worse prognosis (Cruz et al., 2002; Holmstrup et al., 2006; Hsue et al., 2007; Smith et al., 2009; van der Waal, 2009).

• #60 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. The incidence and prevalence of leukoplakia vary in different parts of the world. In general the reported prevalence ranges from 0.2 to 5%, with remarkable regional differences: India (0.2-4.9%), Sweden (3.6%), Germany (1.6%), Holland (1.4%). Leukoplakia is seen most frequently in middle-aged and older men. […] Any leukoplakia could transform into a carcinoma, even those which did not show epithelial dysplasia initially (or in which dysplasia happened to be absent from the biopsy taken). The main problem is that the malignant transformation cannot be reliably predicted yet. Nonetheless, some data could help identifying the possible risk. Leukoplakias show a high transformation risk when they: 1.- affect women; 2.- persist for long periods; 3.- appear in non smokers, 4.- are located on the floor of the mouth or tongue; 5.- are seen in patients with a previous head and neck carcinoma; 6.- are non-homogenous; 7.- are infected by Candida; 8.- show epithelial dysplasia, 9.- show DNA aneuploidy. […] Regular check-up of these patients is essential, probably every 3, 6 and then 12 months, both in treated and untreated patients.

• #61 Leukoplakia, Oral | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116350/0.0/Leukoplakia_Oral

  Most common in individuals who use tobacco (smoking and smokeless), heavy alcohol use, and areca nuts (Asian populations). […] Incidence 250,000 annual cases worldwide […] Age of onset is 40 years old with peak in the 60s. […] Males are 3 times more likely to be affected than females. […] Smokers are 6 times more likely to be affected than nonsmokers. […] Malignant transformation to carcinoma is more common in older patients. […] 70-90% of oral leukoplakia is related to tobacco, particularly smokeless tobacco or areca/betel nut use. […] Alcohol increases risk by 1.5-fold. […] Risk factors for malignant transformation of leukoplakia include long duration of leukoplakia, nonsmoker (idiopathic leukoplakia), located on tongue or floor of mouth, size 200 mm2, nonhomogeneous type, presence of epithelial dysplasia, presence of C. albicans.

• #62 Malignant transformation of oral leukoplakia: a retrospective cohort study of 218 Chinese patients | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-10-685

  Oral leukoplakia (OL) is the best-known potentially malignant disorder. […] Pooled estimate of annual rate of OL malignant transformation is 1.36% (95% confidence interval, 0.69%-2.03%) in various populations and geographical areas. […] The risk factors of clinical features and lifestyle habits associated with transformation of OL into carcinoma have been evaluated in previous studies. […] Dysplasia was an independent risk factor for OL malignant transformation, but age, gender, site, diet habit, smoking and ethanol intake were not risk factors. […] The high-risk dysplastic lesions were associated with 4.57-fold (95% CI, 2.36-8.84; P 0.001) increased the risk of malignant transformation, when compared to the low-risk dysplastic lesions. […] High-risk dysplasia was a significant indicator for OL malignant transformation.

• #63 Malignant transformation of oral leukoplakia: a retrospective cohort study of 218 Chinese patients | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-10-685

  Oral leukoplakia (OL) is the best-known potentially malignant disorder. […] Pooled estimate of annual rate of OL malignant transformation is 1.36% (95% confidence interval, 0.69%-2.03%) in various populations and geographical areas. […] The risk factors of clinical features and lifestyle habits associated with transformation of OL into carcinoma have been evaluated in previous studies. […] Dysplasia was an independent risk factor for OL malignant transformation, but age, gender, site, diet habit, smoking and ethanol intake were not risk factors. […] The high-risk dysplastic lesions were associated with 4.57-fold (95% CI, 2.36-8.84; P 0.001) increased the risk of malignant transformation, when compared to the low-risk dysplastic lesions. […] High-risk dysplasia was a significant indicator for OL malignant transformation.

• #64 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  The use of different terminologies and definitions have made it difficult to properly evaluate the reported data on epidemiology, treatment results and rates of malignant transformation of oral leukoplakia. […] A high frequency of leukoplakia is observed in populations with a high prevalence of tobacco habits, particularly chewing, such as those in South and Southeast Asia. […] The risk of developing malignancies at lesion sites is greater in those with leukoplakia than in subjects without leukoplakia. […] A significant rate of regression of leukoplakia has been reported after stopping tobacco habits. […] An association between candida infection and leukoplakia, especially non-homogenous leukoplakia, has also been shown, and higher rates of malignant transformation have been reported in candida superimposed leukoplakias.

• #65 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. The incidence and prevalence of leukoplakia vary in different parts of the world. In general the reported prevalence ranges from 0.2 to 5%, with remarkable regional differences: India (0.2-4.9%), Sweden (3.6%), Germany (1.6%), Holland (1.4%). Leukoplakia is seen most frequently in middle-aged and older men. […] Any leukoplakia could transform into a carcinoma, even those which did not show epithelial dysplasia initially (or in which dysplasia happened to be absent from the biopsy taken). The main problem is that the malignant transformation cannot be reliably predicted yet. Nonetheless, some data could help identifying the possible risk. Leukoplakias show a high transformation risk when they: 1.- affect women; 2.- persist for long periods; 3.- appear in non smokers, 4.- are located on the floor of the mouth or tongue; 5.- are seen in patients with a previous head and neck carcinoma; 6.- are non-homogenous; 7.- are infected by Candida; 8.- show epithelial dysplasia, 9.- show DNA aneuploidy. […] Regular check-up of these patients is essential, probably every 3, 6 and then 12 months, both in treated and untreated patients.

• #66 Leukoplakia, Oral | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116350/0.0/Leukoplakia_Oral

  Most common in individuals who use tobacco (smoking and smokeless), heavy alcohol use, and areca nuts (Asian populations). […] Incidence 250,000 annual cases worldwide […] Age of onset is 40 years old with peak in the 60s. […] Males are 3 times more likely to be affected than females. […] Smokers are 6 times more likely to be affected than nonsmokers. […] Malignant transformation to carcinoma is more common in older patients. […] 70-90% of oral leukoplakia is related to tobacco, particularly smokeless tobacco or areca/betel nut use. […] Alcohol increases risk by 1.5-fold. […] Risk factors for malignant transformation of leukoplakia include long duration of leukoplakia, nonsmoker (idiopathic leukoplakia), located on tongue or floor of mouth, size 200 mm2, nonhomogeneous type, presence of epithelial dysplasia, presence of C. albicans.

• #67 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. The incidence and prevalence of leukoplakia vary in different parts of the world. In general the reported prevalence ranges from 0.2 to 5%, with remarkable regional differences: India (0.2-4.9%), Sweden (3.6%), Germany (1.6%), Holland (1.4%). Leukoplakia is seen most frequently in middle-aged and older men. […] Any leukoplakia could transform into a carcinoma, even those which did not show epithelial dysplasia initially (or in which dysplasia happened to be absent from the biopsy taken). The main problem is that the malignant transformation cannot be reliably predicted yet. Nonetheless, some data could help identifying the possible risk. Leukoplakias show a high transformation risk when they: 1.- affect women; 2.- persist for long periods; 3.- appear in non smokers, 4.- are located on the floor of the mouth or tongue; 5.- are seen in patients with a previous head and neck carcinoma; 6.- are non-homogenous; 7.- are infected by Candida; 8.- show epithelial dysplasia, 9.- show DNA aneuploidy. […] Regular check-up of these patients is essential, probably every 3, 6 and then 12 months, both in treated and untreated patients.

• #68 Proliferative Verrucous Leukoplakia – OPMDCARE

  https://opmdcare.com/proliferative-verrucous-leukoplakia/

  The overall prevalence of OL is estimated to range between 1.5% and 2.6%. PVL is less common than standard leukoplakia and data on its prevalence is not available. […] PVL is more common in elderly females without a racial predilection and it is not associated with the traditional risk factors for OL and oral squamous cell carcinoma (OSCC), i.e. tobacco and alcohol consumption. […] Approximately two-thirds of PVL cases are in never-smokers and patients who do not report alcohol abuse. […] Nevertheless, PVL is associated with the highest incidence of oral cancer amongst OPMDs, either verrucous carcinoma or squamous cell carcinoma. […] Approximately 61% of patients with PVL develop oral cancer over an average period of 7.4 years, though a systematic review estimated malignant transformation occurs in 49.5% (CI 26.7%-72.4%) of PVL cases (Spriano et al., 2020). […] The annual incidence is estimated to be 10.0% per year. […] PVL is associated with an overall mortality of 40%.

• #69 Proliferative Verrucous Leukoplakia – OPMDCARE

  https://opmdcare.com/proliferative-verrucous-leukoplakia/

  The overall prevalence of OL is estimated to range between 1.5% and 2.6%. PVL is less common than standard leukoplakia and data on its prevalence is not available. […] PVL is more common in elderly females without a racial predilection and it is not associated with the traditional risk factors for OL and oral squamous cell carcinoma (OSCC), i.e. tobacco and alcohol consumption. […] Approximately two-thirds of PVL cases are in never-smokers and patients who do not report alcohol abuse. […] Nevertheless, PVL is associated with the highest incidence of oral cancer amongst OPMDs, either verrucous carcinoma or squamous cell carcinoma. […] Approximately 61% of patients with PVL develop oral cancer over an average period of 7.4 years, though a systematic review estimated malignant transformation occurs in 49.5% (CI 26.7%-72.4%) of PVL cases (Spriano et al., 2020). […] The annual incidence is estimated to be 10.0% per year. […] PVL is associated with an overall mortality of 40%.

• #70 Proliferative Verrucous Leukoplakia – OPMDCARE

  https://opmdcare.com/proliferative-verrucous-leukoplakia/

  The overall prevalence of OL is estimated to range between 1.5% and 2.6%. PVL is less common than standard leukoplakia and data on its prevalence is not available. […] PVL is more common in elderly females without a racial predilection and it is not associated with the traditional risk factors for OL and oral squamous cell carcinoma (OSCC), i.e. tobacco and alcohol consumption. […] Approximately two-thirds of PVL cases are in never-smokers and patients who do not report alcohol abuse. […] Nevertheless, PVL is associated with the highest incidence of oral cancer amongst OPMDs, either verrucous carcinoma or squamous cell carcinoma. […] Approximately 61% of patients with PVL develop oral cancer over an average period of 7.4 years, though a systematic review estimated malignant transformation occurs in 49.5% (CI 26.7%-72.4%) of PVL cases (Spriano et al., 2020). […] The annual incidence is estimated to be 10.0% per year. […] PVL is associated with an overall mortality of 40%.

• #71 Proliferative Verrucous Leukoplakia – OPMDCARE

  https://opmdcare.com/proliferative-verrucous-leukoplakia/

  The overall prevalence of OL is estimated to range between 1.5% and 2.6%. PVL is less common than standard leukoplakia and data on its prevalence is not available. […] PVL is more common in elderly females without a racial predilection and it is not associated with the traditional risk factors for OL and oral squamous cell carcinoma (OSCC), i.e. tobacco and alcohol consumption. […] Approximately two-thirds of PVL cases are in never-smokers and patients who do not report alcohol abuse. […] Nevertheless, PVL is associated with the highest incidence of oral cancer amongst OPMDs, either verrucous carcinoma or squamous cell carcinoma. […] Approximately 61% of patients with PVL develop oral cancer over an average period of 7.4 years, though a systematic review estimated malignant transformation occurs in 49.5% (CI 26.7%-72.4%) of PVL cases (Spriano et al., 2020). […] The annual incidence is estimated to be 10.0% per year. […] PVL is associated with an overall mortality of 40%.

• #72 Leukoplakia and Erythroplakia – Premalignant Squamous Lesions of the Oral Cavity: Definition, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1840467-overview

  The prevalence of premalignant oral lesions is approximately 1%-5%. […] Overall, the rates of oral squamous dysplasia and subsequent squamous cell carcinoma (SCC) are decreasing, closely paralleling the reduction in cigarette smoking. […] Most cases of leukoplakia and erythroplakia are seen in adults older than 50 years who have risk factors (discussed in Etiology). […] Males are predominantly affected, with a male-to-female ratio of approximately 3:1; this difference becomes more pronounced with increasing age. […] Proliferative verrucous leukoplakia (PVL), in contrast, is seen much more often in women (male-to-female ratio, 1:4) in their seventh and eighth decades of life. […] Of note, this clinical diagnosis is associated with a high rate of malignant transformation, generally considered to be over 70%.

• #73 Leukoplakia and Erythroplakia – Premalignant Squamous Lesions of the Oral Cavity: Definition, Etiology, Epidemiology

  https://emedicine.medscape.com/article/1840467-overview

  The prevalence of premalignant oral lesions is approximately 1%-5%. […] Overall, the rates of oral squamous dysplasia and subsequent squamous cell carcinoma (SCC) are decreasing, closely paralleling the reduction in cigarette smoking. […] Most cases of leukoplakia and erythroplakia are seen in adults older than 50 years who have risk factors (discussed in Etiology). […] Males are predominantly affected, with a male-to-female ratio of approximately 3:1; this difference becomes more pronounced with increasing age. […] Proliferative verrucous leukoplakia (PVL), in contrast, is seen much more often in women (male-to-female ratio, 1:4) in their seventh and eighth decades of life. […] Of note, this clinical diagnosis is associated with a high rate of malignant transformation, generally considered to be over 70%.

• #74 Precancerous conditions of the mouth | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/oral/what-is-oral-cancer/precancerous-conditions

  The presence of leukoplakia does not necessarily mean cancer. The risk of developing oral cancer depends on how different the abnormal cells are in shape, size and appearance compared to normal mouth cells. This abnormality is called dysplasia. The healthcare team closely watches people who have leukoplakia to look for signs of cancer. […] There are no standard treatments for leukoplakia. It is managed by active surveillance. This means that your healthcare team watches your condition closely. They will use regular tests and exams to find any cancerous change early.

• #75 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  Oral leukoplakia (OLK) is a common mucosal pathology frequently encountered in general dental practice which belongs to a group of conditions known as oral potentially malignant disorders (OPMDs). […] While reported rates of oral leukoplakia vary among different geographic regions and demographical groups, a recent systematic review and meta-analysis reported a pooled prevalence of 4.11% globally. Oral leukoplakia is more commonly seen in men and is increasingly common with age. […] Patients must be informed that progression of oral leukoplakia to malignancy can occur and that recurrence of oral leukoplakia following excision is possible. […] There are no strict guidelines on the frequency of follow-up for patients with oral leukoplakia, with periodicity most often dictated by the degree of OED on biopsy. Although there is little evidence to indicate that follow-up of patients with OED has any influence on preventing the development of cancer, regular review facilitates early detection of OSCC in the event of malignant transformation, which is associated with less destructive surgical treatment and a significantly improved long-term prognosis. Given that it may take up to ten years for oral carcinoma to develop from oral leukoplakia, long-term follow-up is considered best practice, at three- to 12-month intervals, depending on the degree of OED and other risk factors.

• #76 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880

  Oral leukoplakia (OLK) is a common mucosal pathology frequently encountered in general dental practice which belongs to a group of conditions known as oral potentially malignant disorders (OPMDs). […] While reported rates of oral leukoplakia vary among different geographic regions and demographical groups, a recent systematic review and meta-analysis reported a pooled prevalence of 4.11% globally. Oral leukoplakia is more commonly seen in men and is increasingly common with age. […] Patients must be informed that progression of oral leukoplakia to malignancy can occur and that recurrence of oral leukoplakia following excision is possible. […] There are no strict guidelines on the frequency of follow-up for patients with oral leukoplakia, with periodicity most often dictated by the degree of OED on biopsy.

• #77 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  Oral leukoplakia (OLK) is a common mucosal pathology frequently encountered in general dental practice which belongs to a group of conditions known as oral potentially malignant disorders (OPMDs). […] While reported rates of oral leukoplakia vary among different geographic regions and demographical groups, a recent systematic review and meta-analysis reported a pooled prevalence of 4.11% globally. Oral leukoplakia is more commonly seen in men and is increasingly common with age. […] Patients must be informed that progression of oral leukoplakia to malignancy can occur and that recurrence of oral leukoplakia following excision is possible. […] There are no strict guidelines on the frequency of follow-up for patients with oral leukoplakia, with periodicity most often dictated by the degree of OED on biopsy. Although there is little evidence to indicate that follow-up of patients with OED has any influence on preventing the development of cancer, regular review facilitates early detection of OSCC in the event of malignant transformation, which is associated with less destructive surgical treatment and a significantly improved long-term prognosis. Given that it may take up to ten years for oral carcinoma to develop from oral leukoplakia, long-term follow-up is considered best practice, at three- to 12-month intervals, depending on the degree of OED and other risk factors.

• #78 Oral leukoplakia: an update for dental practitioners | Published in Journal of the Irish Dental Association

  https://jida.scholasticahq.com/article/93880-oral-leukoplakia-an-update-for-dental-practitioners

  Oral leukoplakia (OLK) is a common mucosal pathology frequently encountered in general dental practice which belongs to a group of conditions known as oral potentially malignant disorders (OPMDs). […] While reported rates of oral leukoplakia vary among different geographic regions and demographical groups, a recent systematic review and meta-analysis reported a pooled prevalence of 4.11% globally. Oral leukoplakia is more commonly seen in men and is increasingly common with age. […] Patients must be informed that progression of oral leukoplakia to malignancy can occur and that recurrence of oral leukoplakia following excision is possible. […] There are no strict guidelines on the frequency of follow-up for patients with oral leukoplakia, with periodicity most often dictated by the degree of OED on biopsy. Although there is little evidence to indicate that follow-up of patients with OED has any influence on preventing the development of cancer, regular review facilitates early detection of OSCC in the event of malignant transformation, which is associated with less destructive surgical treatment and a significantly improved long-term prognosis. Given that it may take up to ten years for oral carcinoma to develop from oral leukoplakia, long-term follow-up is considered best practice, at three- to 12-month intervals, depending on the degree of OED and other risk factors.

• #79 Leukoplakia – European Association of Oral Medicine

  https://eaom.eu/education/eaom-handbook/leukoplakia/

  Leukoplakia is the most common premalignant or „potentially malignant” lesion of the oral mucosa. The incidence and prevalence of leukoplakia vary in different parts of the world. In general the reported prevalence ranges from 0.2 to 5%, with remarkable regional differences: India (0.2-4.9%), Sweden (3.6%), Germany (1.6%), Holland (1.4%). Leukoplakia is seen most frequently in middle-aged and older men. […] Any leukoplakia could transform into a carcinoma, even those which did not show epithelial dysplasia initially (or in which dysplasia happened to be absent from the biopsy taken). The main problem is that the malignant transformation cannot be reliably predicted yet. Nonetheless, some data could help identifying the possible risk. Leukoplakias show a high transformation risk when they: 1.- affect women; 2.- persist for long periods; 3.- appear in non smokers, 4.- are located on the floor of the mouth or tongue; 5.- are seen in patients with a previous head and neck carcinoma; 6.- are non-homogenous; 7.- are infected by Candida; 8.- show epithelial dysplasia, 9.- show DNA aneuploidy. […] Regular check-up of these patients is essential, probably every 3, 6 and then 12 months, both in treated and untreated patients.

• #80 Premalignant Lesions – Oral Cancer Foundation | Information and Resources about Oral Head and Neck Cancer

  https://oralcancerfoundation.org/cdc/premalignant-lesions/

  About 5-18% of epithelial dysplasias become malignant. […] A greater risk of malignant change in an epithelial dysplasia has been associated with the following factors: (1) erythroplakia within a leukoplakia, (2) a proliferative verrucous appearance, (3) location at a high-risk anatomic site such as the tongue or floor of mouth, (4) the presence of multiple lesions, and, paradoxically, (5) a history of not smoking cigarettes. […] The time from initial diagnosis of either epithelial dysplasia or hyperkeratosis to carcinoma ranged from 6 months to 39 years. […] Reported recurrence rates for premalignant lesions are as high as 34.4%. […] The hyperkeratotic lesion is difficult to manage because it has potential for malignant change but is not yet considered dysplastic; Silverman and colleagues found that 37 out of 235 hyperkeratotic lesions (15.7%) underwent malignant change.

• #81 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  Follow-up studies have clearly established that oral leukoplakia is a precancerous lesion for cancers of the oral cavity. […] Treatment may be effective in the resolution of lesions; however, relapses and adverse effects are common. […] Long-term follow-up, even after removal, is essential because recurrences are frequent and additional leukoplakias may occur.

• #82 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?lang=1&cat=Az

  The frequency of malignant transformation is lower in cohort studies compared to hospital based studies and the rate of malignant transformation increases over time. […] A higher risk of malignant transformation is observed in non-homogeneous leukoplakia compared to homogeneous leukoplakia. […] The malignant potential is almost 7 times higher for non-homogeneous leukoplakia compared to homogeneous type. […] All leukoplakias should be viewed with suspicion because even small, subtle lesions can manifest significant dysplasia or harbour unsuspected carcinoma. […] Follow-up studies have clearly established that oral leukoplakia is a precancerous lesion for cancers of the oral cavity. […] Although several management regimes have been suggested, results in term of preventing malignant transformation are highly variable, particularly due to the field cancerisation effect. […] Stopping the use of tobacco and alcohol and management of superadded fungal infection may result in the regression of lesions. […] Long-term follow-up, even after removal, is essential because recurrences are frequent and additional leukoplakias may occur.

• #83 Recurrence rates after surgical removal of oral leukoplakia—A prospective longitudinal multi-centre study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225682

  Oral leukoplakia (OL) is a potentially malignant oral disorder. The Gold Standard treatment is to remove surgically the OL. Despite optimal surgery, the recurrence rates are estimated to be 30%. The aim of this study was to investigate the clinical factors that correlate with recurrence after surgical removal of OL. The global prevalence of OL is approximately 2.6%. The cumulative incidence of recurrence of OL was 45% after 4 years and 49% after 5 years. A non-homogeneous type of OL and the use of snuff were significantly associated with recurrence after surgical excision (P = 0.021 and P = 0.003, respectively). The present study shows that a high proportion (42%) of OL cases recurred despite complete surgical removal. Parameters that predict the recurrence of OL are non-homogeneous clinical type and the use of snuff. There are no significant differences in recurrence between OL with or without dysplasia, lesion size, multiple OL vs. solitary OL, sites of the lesions, alcohol consumption or smoking. OL that recurs has a significantly higher risk of transforming into OSCC.

• #84 Recurrence rates after surgical removal of oral leukoplakia—A prospective longitudinal multi-centre study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225682

  Oral leukoplakia (OL) is a potentially malignant oral disorder. The Gold Standard treatment is to remove surgically the OL. Despite optimal surgery, the recurrence rates are estimated to be 30%. The aim of this study was to investigate the clinical factors that correlate with recurrence after surgical removal of OL. The global prevalence of OL is approximately 2.6%. The cumulative incidence of recurrence of OL was 45% after 4 years and 49% after 5 years. A non-homogeneous type of OL and the use of snuff were significantly associated with recurrence after surgical excision (P = 0.021 and P = 0.003, respectively). The present study shows that a high proportion (42%) of OL cases recurred despite complete surgical removal. Parameters that predict the recurrence of OL are non-homogeneous clinical type and the use of snuff. There are no significant differences in recurrence between OL with or without dysplasia, lesion size, multiple OL vs. solitary OL, sites of the lesions, alcohol consumption or smoking. OL that recurs has a significantly higher risk of transforming into OSCC.

• #85 Recurrence rates after surgical removal of oral leukoplakia—A prospective longitudinal multi-centre study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225682

  Oral leukoplakia (OL) is a potentially malignant oral disorder. The Gold Standard treatment is to remove surgically the OL. Despite optimal surgery, the recurrence rates are estimated to be 30%. The aim of this study was to investigate the clinical factors that correlate with recurrence after surgical removal of OL. The global prevalence of OL is approximately 2.6%. The cumulative incidence of recurrence of OL was 45% after 4 years and 49% after 5 years. A non-homogeneous type of OL and the use of snuff were significantly associated with recurrence after surgical excision (P = 0.021 and P = 0.003, respectively). The present study shows that a high proportion (42%) of OL cases recurred despite complete surgical removal. Parameters that predict the recurrence of OL are non-homogeneous clinical type and the use of snuff. There are no significant differences in recurrence between OL with or without dysplasia, lesion size, multiple OL vs. solitary OL, sites of the lesions, alcohol consumption or smoking. OL that recurs has a significantly higher risk of transforming into OSCC.

• #86 Oral Leukoplakia for Otolaryngologists | AAO-HNS Bulletin

  https://bulletin.entnet.org/clinical-patient-care/article/22865154/oral-leukoplakia-for-otolaryngologists

  Due to the high prevalence of oral leukoplakia, there is a need for established protocols and guidelines. […] Some studies reporting a prevalence of oral leukoplakia up to 4% in the general population, with a high number of annual visits to otolaryngologists (up to 23% of providers seeing 30 or more cases of oral leukoplakia each year). […] Given the variable rates of malignant conversion and poorly understood predictive factors for transformation of oral leukoplakia to malignancy, consensus guidelines on treatment recommendations are limited. There are no current guidelines for indications for biopsy, considerations of biopsy techniques, and recommendations for clinical surveillance. […] Despite the large volume of cases seen each year, the variable and unpredictable behavior of oral leukoplakia has made it difficult to establish guidelines for management. However, with recently suggested algorithms and survey responses, there is increasing interest to establish protocols and guidelines for management of oral leukoplakia in the future.

• #87 Oral Leukoplakia for Otolaryngologists | AAO-HNS Bulletin

  https://bulletin.entnet.org/clinical-patient-care/article/22865154/oral-leukoplakia-for-otolaryngologists

  Due to the high prevalence of oral leukoplakia, there is a need for established protocols and guidelines. […] Some studies reporting a prevalence of oral leukoplakia up to 4% in the general population, with a high number of annual visits to otolaryngologists (up to 23% of providers seeing 30 or more cases of oral leukoplakia each year). […] Given the variable rates of malignant conversion and poorly understood predictive factors for transformation of oral leukoplakia to malignancy, consensus guidelines on treatment recommendations are limited. There are no current guidelines for indications for biopsy, considerations of biopsy techniques, and recommendations for clinical surveillance. […] Despite the large volume of cases seen each year, the variable and unpredictable behavior of oral leukoplakia has made it difficult to establish guidelines for management. However, with recently suggested algorithms and survey responses, there is increasing interest to establish protocols and guidelines for management of oral leukoplakia in the future.

• #88 Oral Leukoplakia for Otolaryngologists | AAO-HNS Bulletin

  https://bulletin.entnet.org/clinical-patient-care/article/22865154/oral-leukoplakia-for-otolaryngologists

  Due to the high prevalence of oral leukoplakia, there is a need for established protocols and guidelines. […] Some studies reporting a prevalence of oral leukoplakia up to 4% in the general population, with a high number of annual visits to otolaryngologists (up to 23% of providers seeing 30 or more cases of oral leukoplakia each year). […] Given the variable rates of malignant conversion and poorly understood predictive factors for transformation of oral leukoplakia to malignancy, consensus guidelines on treatment recommendations are limited. There are no current guidelines for indications for biopsy, considerations of biopsy techniques, and recommendations for clinical surveillance. […] Despite the large volume of cases seen each year, the variable and unpredictable behavior of oral leukoplakia has made it difficult to establish guidelines for management. However, with recently suggested algorithms and survey responses, there is increasing interest to establish protocols and guidelines for management of oral leukoplakia in the future.

• #89 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?cat=az&lang=1

  The use of different terminologies and definitions have made it difficult to properly evaluate the reported data on epidemiology, treatment results and rates of malignant transformation of oral leukoplakia. […] A high frequency of leukoplakia is observed in populations with a high prevalence of tobacco habits, particularly chewing, such as those in South and Southeast Asia. […] The risk of developing malignancies at lesion sites is greater in those with leukoplakia than in subjects without leukoplakia. […] A significant rate of regression of leukoplakia has been reported after stopping tobacco habits. […] An association between candida infection and leukoplakia, especially non-homogenous leukoplakia, has also been shown, and higher rates of malignant transformation have been reported in candida superimposed leukoplakias.

• #90 A digital manual for the early diagnosis of oral neoplasia

  https://screening.iarc.fr/atlasoral_list.php?lang=1&cat=Az

  The use of different terminologies and definitions have made it difficult to properly evaluate the reported data on epidemiology, treatment results and rates of malignant transformation of oral leukoplakia. […] A high frequency of leukoplakia is observed in populations with a high prevalence of tobacco habits, particularly chewing, such as those in South and Southeast Asia. […] The risk of developing malignancies at lesion sites is greater in those with leukoplakia than in subjects without leukoplakia. […] A significant rate of regression of leukoplakia has been reported after stopping tobacco habits. […] An association between candida infection and leukoplakia, especially non-homogenous leukoplakia, has also been shown, and higher rates of malignant transformation have been reported in candida superimposed leukoplakias.

• #91 Leukoplakia, oral cavity cancer risk, and cancer survival in the U.S. elderly – Kaiser Permanente Division of Research

  https://divisionofresearch.kaiserpermanente.org/publications/leukoplakia-oral-cavity-cancer-risk-and-cancer-survival-in-the-u-s-elderly/

  Screening for oral leukoplakia, an oral cavity cancer (OCC) precursor, could lead to earlier detection of OCC. […] However, the progression rate from leukoplakia to OCC and the benefits of leukoplakia screening for improving OCC outcomes are currently unclear. […] We identified leukoplakia diagnoses through Medicare claims, and OCC diagnoses through SEER cancer registries. […] Among 470,266 individuals in the SEER-Medicare subcohort, 1,526 (0.3%) had a leukoplakia diagnosis. […] Among people with leukoplakia, the cumulative OCC incidence was 0.7% at 3 months and 2.5% at 5 years. OCC risk was most increased.

• #92 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10481497/

  The overall prevalence of OPMD worldwide was 4.47%, with OLK ranking second with 4.11%. […] The global prevalence of OLK lacks support from epidemiological data. […] The overall estimated prevalence of OLK was 3.41% with high heterogeneity. The pooled estimated prevalence of the specific population studies (9.10%) was the highest among the population-based studies (2.23%) and clinic-based studies (1.36%). […] The prevalence of OLK in population-based studies was 2.53% in Asia, 1.82% in Europe, 1.15% in South America, and 0.33% in North America. […] The prevalence of OLK was relatively consistent and stable across different continents and different definitions. The pooled estimated prevalence of males was higher than in females, with statistically significant differences in clinic-based studies. A higher pooled estimated prevalence was found among people aged over 60 years old, the smoking population, and those consuming alcohol. […] More study is required to develop early treatment and clinical surveillance strategies, as well as to effect habit intervention in these populations.

• #93 The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022 | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03342-y

  Overall, the global prevalence of OLK is relatively stable across continents and definitions. […] Future studies are warranted to assess the prevalence accurately, to assess the clinical and financial burden of OLK worldwide, and test new strategies for OLK prevention and control, especially in populations with a high prevalence of OLK.

• #94 Global Public Health Responses to Oral Precancerous Lesions

  https://ostrowonline.usc.edu/global-public-health-responses-to-oral-precancerous-lesions/

  Despite progress, significant challenges remain: Limited funding for public health initiatives in developing countries, healthcare workforce shortages in rural areas, cultural stigmas preventing individuals from seeking care, lack of standardized management guidelines. […] Future efforts should focus on developing evidence-based treatment protocols, increasing funding for prevention programs, training more healthcare providers in oral pathology, conducting clinical trials with histopathological assessment, addressing healthcare disparities in vulnerable populations.

• #95 A standalone approach to utilize telomere length measurement as a surveillance tool in oral leukoplakia | medRxiv

  https://www.medrxiv.org/content/10.1101/2020.09.25.20193946.full

  Oral Squamous Cell Carcinoma (OSCC) is often preceded by white patch, called oral leukoplakia (OL). Assessing relative telomere length (TL) in OL could be a predicting biomarker. […] The approach of analyzing TL attrition of oral mucosa, eliminating requirement of external reference DNA, will enable the TL data universally comparable and provide a useful marker to define high risk OL group for follow-up program. […] Therefore we propose that TL can potentially be used for surveillance of individuals with high risk habits or in pre-cancerous conditions like oral leukoplakia. […] The evaluation of relative TL of oral mucosa normalized to paired PBMC sample is also expected to serve as a standalone and universally comparable clinical marker of oral health and also would be comparable within heterogeneous population without requirement of complicated matched control and reference DNA for every analysis.

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