TOPLINE

Mobile screening units in rural Hungary identified oral mucosal lesions in 1 in 20 adults screened between June 2021 and March 2023; however, only 3.8% of those who screened positive attended specialist follow-up, resulting in six confirmed malignant neoplasms

METHODOLOGY

• Researchers conducted a retrospective cross-sectional analysis of a large observational oral cancer screening study in Hungary using mobile screening units equipped with visual oral examination (VOE) stations.
• A total of 8266 adults aged 18 years or older participated, of whom 4275 (51.7%) were from converging municipalities (rural, low-density, socioeconomically challenged areas) and 3991 (48.3%) were from other geographic locations across Hungary.
• Dental hygiene students and graduates from the University of Szeged, trained in the VOE, performed the screenings between June 2021 and March 2023.
• Participants underwent examination of the face, lymph nodes, lips, oral cavity, dentition, tongue, gums, tonsils, floor of the mouth, and oropharyngeal region; a risk assessment questionnaire captured data on smoking, alcohol consumption, oral hygiene habits, and sociodemographics.
• Primary outcomes included the detection of oral mucosal lesions, referral to specialist care, and histologically confirmed diagnoses of malignant neoplasms.

TAKEAWAY

• Oral mucosal lesions were detected in 1725 individuals (20.9%), with similar rates in men (21.1%) and women (20.8%); of those referred, only 66 (3.8%; 13 men and 53 women) who screened positive visited a specialist, and six of them were diagnosed with malignant neoplasms (three oral cavity cancers and three pharyngeal cancers).
• Individuals who screened positive for oral mucosal lesions were more likely to be current or former smokers than those who screened negative (33.6% vs 27%; P < .001); the median age was 61 years for those who screened positive compared with 54 years for those who screened negative (P <.00001).
• Age (RR, 1.029; P < .00001), smoking (RR, 1.746; P < .00001), and residence in converging municipalities (RR, 1.273; P = .004) were significant risk factors associated with oral mucosal lesions.
• Oral lesions were more common among individuals with lower education compared with those with secondary or higher education (36.4% vs 25.0% and 16.2%, respectively; P < .001), and among those who never visited a dentist than those who visited regularly or when dental problems occurred (41.0% vs 19.9% and 23.1%, respectively; P < .001).

IN PRACTICE

"Mobile screening units can be an effective tool in secondary prevention, especially in rural, socioeconomically challenging settings to screen high-risk groups," wrote the authors of the study. "However, low compliance of screen-positive individuals to attend follow-up visits poses a threat to the effectiveness of screening programs, and must be addressed."

SOURCE

The study was led by Edit Marosi, International Relations Department, National Institute of Oncology, Budapest, Hungary. It was published online on July 12, 2026 in the European Journal of Public Health.

LIMITATIONS

The study defined screen-positive cases broadly as any abnormality in the oral mucosal soft tissue, potentially leading to a higher referral rate. Only 3.8% of screen-positive individuals attended specialist follow-up. Missing data on education levels, tobacco use, and alcohol consumption resulted in was also a limitation.

DISCLOSURES

The study was supported by grants from the Complex Public Health Screening project and the Hungarian Mobile Health Screening Program, the Innovative Partnership on Action Against Cancer project co-funded by the Health Programme of the European Union, the National Research, Development and Innovation Fund of the Ministry of Culture and Innovation under the National Laboratories Program, the Hungarian Thematic Excellence Program, and the European Network of Comprehensive Cancer Centres Joint Action co-funded by the European Union. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.