Oral Cancer: How to Optimize Training for Earlier Diagnosis?

The challenge of early diagnosis: a training issue

Le pronostic du carcinome épidermoïde buccal (CEB) dépend d'une équation simple mais redoutable : la précocité du diagnostic. Malgré ce consensus clinique, les délais d'orientation restent critiques. Aujourd’hui, 53 % des patients se tournent d'abord vers leur médecin généraliste et 42 % vers leur chirurgien-dentiste, plaçant ces praticiens en première ligne d'une pathologie qu'ils peinent parfois à identifier. Les chiffres rapportés par la littérature sont préoccupants : en Australie, le taux de précision diagnostique des lésions muqueuses plafonne à 65,9 % chez les professionnels dentaires, tandis qu'au Royaume-Uni, 95 % des étudiants en médecine en fin de cursus s'estiment mal informés sur le sujet.

This scoping review aims to evaluate current teaching modalities for oral cancer and oral potentially malignant disorders (OPMD). The authors examine the effectiveness of traditional pedagogical formats — didactic and clinical — within university curricula and continuing education programs. The study seeks to identify structural gaps in current approaches while exploring the potential of emerging technologies, such as immersive virtual reality and artificial intelligence, to optimize the learning curve and strengthen the clinical confidence of healthcare practitioners.

Review methodology

This scoping review is based on the PCC (Population, Concept, Context) framework and follows the PRISMA-ScR guidelines. The authors searched the Medline, Web of Science, Embase, and Scopus databases for all literature published up to September 30, 2025. This search was supplemented by an exploration of grey literature via Google Scholar and a rigorous manual check of the bibliographies of the selected articles to ensure no relevant references were missed.

Out of a total of 1,808 citations identified, the team reviewed 65 full-text articles to finally include 39 studies meeting the inclusion criteria (English language, less than 30 years old). The final corpus is broken down as follows:

• Study design: 20 cross-sectional studies, 16 interventional studies (pre/post-test), 1 retrospective study and 2 review articles.
• Target populations: 25 studies exclusively concern the dental sphere (dentists, students, hygienists), 8 the medical sphere, 2 nursing care and 4 focus on multi-professional cohorts (pharmacists, midwives, nutritionists).

The analysis focused on the modes of teaching delivery (didactic, virtual, clinical) and their respective effectiveness in screening for oral cancer and oral potentially malignant disorders (OPMD).

Analysis of study selection and typology

Out of a total of 1,808 studies screened, 39 met the inclusion criteria for this scoping review. The disciplinary distribution shows a marked predominance of work focused on the dental profession (64.1%, n=25), far ahead of medicine (20.5%, n=8), multidisciplinary approaches (10.2%, n=4), and nursing care (5.1%, n=2). Methodologically, cross-sectional studies (n=20) and interventional pre-test/post-test studies (n=16) constitute the bulk of the corpus.

Current state of initial and continuing education

The extracted data reveal a structural deficiency in the number of hours dedicated to the screening of oral cancers (OSCC) and oral potentially malignant disorders (OPMD). The study by Abbott et al. (2018) highlights that in Australia, the average teaching time is less than one hour, with a median of only 0.22 h. More alarmingly, 37.5% of the medical schools studied provide no training on the subject, and none offer clinical practical training.

In the UK, the situation is similar among general practitioners (GPs). According to Ahluwalia et al. (2016):

• 71.2% of program directors report a lack of structured formal education in oral health.
• Only 18.8% of programs include structured training.
• 27.3% of trainees do not complete any hospital rotation in ENT or oral and maxillofacial surgery services.

Diagnostic skills and practitioners' perception

The lack of training results in limited clinical confidence and heterogeneous diagnostic accuracy. The summaries reported in the review highlight critical figures:

The Brazilian study also specifies that 67.1% of dentists and 52.7% of students believe they did not receive adequate training during their curriculum, particularly regarding the palpation of lymph nodes and the identification of associated lymphadenopathies.

Clinical findings: training out of step with diagnostic urgency

This review highlights a concerning reality: while 53% of patients with oral squamous cell carcinoma initially consult their general practitioner, diagnostic skills remain heterogeneous. Idrees' study reports an identification accuracy for mucosal lesions of only 65.9% among Australian dental professionals. Even more alarming, 95% of final-year British medical students consider themselves poorly informed about oral cancer. This training deficit explains why, despite better patient awareness, professional diagnostic delays are not significantly improving.

Outdated teaching models?

The analysis of the compiled data reveals a predominance of the classic academic format (didactic) at the expense of clinical exposure. The authors note a flagrant lack of practical exercises, such as the palpation of lymph nodes, which is nevertheless essential. This pedagogical deficiency generates a sense of diagnostic insecurity affecting between 38% and 94% of general practitioners. The transition from a purely theoretical model to immersive methods, including virtual reality (IVR) and artificial intelligence, appears to be a promising avenue for personalizing learning, although their rigorous evaluation in this context remains to be finalized.

Limits and perspectives for the practice

The main weakness identified lies in the disparity of pedagogical approaches and the lack of program standardization. Studies show that the time interval for professional diagnosis remains a major bottleneck. For the practitioner, these results validate the need to strengthen systematic clinical examination and to move towards continuing education based on clinical experience rather than the accumulation of passive knowledge.

In concrete terms, for the practitioner:

• Strengthening the systematic clinical examination: Do not neglect lymph node palpation and meticulous inspection of high-risk areas (tongue borders, floor of the mouth), as these steps are statistically the most overlooked despite their critical nature.
• Promote specialized continuing education: Prioritize training programs based on clinical cases (problem-based learning) or immersive technologies (virtual reality), identified as more effective than passive didactic methods for the memorization of precancerous lesions.
• Coordinate the local network: Knowing that 53% of patients first consult their general practitioner for an oral lesion, establish rapid referral protocols with your local medical colleagues to compensate for their reported diagnostic gaps.

Technical lexicon of the study

OSCC (Oral Squamous Cell Carcinoma): Oral Squamous Cell Carcinoma. This malignant neoplasm represents the primary endpoint of the study, where early detection is correlated with a significant reduction in morbidity and mortality.

OPMD (Oral Potentially Malignant Disorders): Oral potentially malignant disorders. A term grouping clinical conditions (such as lichen planus or submucous fibrosis) presenting a risk of malignant transformation and requiring precise identification by the practitioner.

PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews): Rigorous reporting standard used by the authors to structure this scoping review and ensure the reproducibility of the analysis of teaching methods.

PCC Framework (Population, Concept, Context): Methodological framework specific to scoping reviews used here to precisely define the population (students and practitioners), the concept (teaching effectiveness), and the context (academic or continuing education).

Randomised controlled trials: High-level clinical study design included in the selection criteria of this review to evaluate the impact of different pedagogical methods on diagnostic skills.

Grey literature: Unpublished documents outside conventional academic circuits (theses, official reports, Google Scholar) that the authors analyzed to avoid publication bias in the evaluation of educational programs.

Information intended for healthcare professionals. This content may contain errors or truncated summaries. We recommend always verifying with the original source article. Delynov disclaims all responsibility regarding the use of this information. This document is not intended for patients or the general public.