Capacity building of community health officers for optimizing the screening and early diagnosis of oral cancer in Jodhpur, Rajasthan, India

Abstract

Oral Cancer screening through the detection of Oral Potentially Malignant Disorders (OPMDs) reduces Oral Cancer mortality and the overall burden of Oral Cancer. However, the high cost and the low accessibility are the major barriers associated with Oral Cancer screening. The present study aims to optimize the screening and early diagnosis of Oral Cancer through the capacity building of Community Health Officers (CHOs) posted in Ayushman Arogya Mandir (erstwhile Health and Wellness Centers) in Jodhpur, Rajasthan, India. A quasi-experimental interventional study was conducted among CHOs of the Jodhpur district of Rajasthan, India. A total of 46 CHOs underwent one day of training on Oral Cancer screening through Oral Visual Examination (OVE). CHOs’ knowledge was assessed pre-training, post-training, and at a two-month follow-up. CHOs conducted screenings over eight months, and ENT specialists remotely validated their findings. This study evaluated the effectiveness of training CHOs in Oral Cancer screening and assessed their screening performance and diagnostic accuracy. The training on Oral Cancer screening resulted in significant and sustained knowledge gains among CHOs. CHOs with higher educational qualifications, previous job experience, and previous knowledge of Oral Cancer screening performed significantly better than others. The overall sensitivity and specificity of CHO screenings were 83.87% and 98.31%, respectively, with an overall diagnostic accuracy of 96.17%. Training CHOs in Oral Cancer screening significantly improved their knowledge and screening performance. CHO findings showed high diagnostic accuracy. The results of the study support the potential role of trained CHOs in community-based Oral Cancer screening programs. This can be a sustainable and effective implementation strategy to enhance Oral Cancer screening in resource-limited settings.