Early detection and risk stratification in Oral Cancer: an Epidemiologic perspective

Oral cancer remains a major public health challenge, with many cases still diagnosed at late stages when treatment is more intensive, and outcomes are poorer. Earlier detection can reduce morbidity, improve survival, and limit long-term functional and psychosocial impacts. However, “early detection” is not a single intervention; it encompasses public awareness, opportunistic examination, diagnostic pathways, surveillance for oral potentially malignant disorders, and effective referral systems. Oral epidemiology is central to this agenda because it can quantify disease burden and inequalities, identify high-risk groups, test and validate risk models, and evaluate the real-world performance of emerging tools such as biomarkers, imaging adjuncts, and AI-enabled decision support.The goal of this Research Topic is to reduce the burden of oral cancer by strengthening, integrating, and translating the epidemiologic evidence that underpins earlier diagnosis. Key problems include heterogeneity in screening practices, limited external validation of risk tools, variable diagnostic performance across settings, and persistent inequalities in risk factor exposure, socioeconomic status, and geography. Recent advances, including data linkage, large-scale electronic health records, improved statistical learning methods, molecular biomarkers, and deployable imaging/AI tools, create new opportunities, but also require careful evaluation to avoid biased, non-generalizable, or low-value implementation. We aim to define what “works” for early detection, for whom, and under what conditions, emphasising clinically meaningful outcomes (e.g., stage shift, appropriate referral, time-to-diagnosis, patient-centred outcomes) and real-world feasibility. Ultimately, this Topic seeks to inform evidence-based policy and practice, supporting scalable detection pathways that are accurate, equitable, and sustainable.This Research Topic welcomes contributions that advance the evidence base for early detection across community, dental, and primary care settings. We invite manuscripts addressing:(i) trends in incidence, stage at diagnosis, and survival;(ii) diagnostic intervals and “missed opportunities” along the patient and health-system pathway;(iii) risk prediction and stratified approaches (development, validation, calibration, and equity/fairness assessments);(iv) evaluation of screening and case-finding strategies, including pragmatic trials and natural experiments;(v) performance and clinical utility of adjunctive tests (e.g., salivary or blood biomarkers, cytology, optical tools, imaging);(vi) AI/ML tools for detection or triage with robust epidemiologic evaluation; and(vii) implementation, health services research, and health economics. Topic editors: Alex Douglas McMahon, Catriona M Douglas, Leandro Machado Oliveira Source: https://www.frontiersin.org/research-topics/79454/early-detection-and-risk-stratification-in-oral-cancer-an-epidemiologic-perspective