Mental Health

Oral submucous fibrosis and malignant transformation

Oral submucous is a power oral mucosal illness that’s considered one of a bunch of circumstances recognised as oral doubtlessly malignant issues (OPMD). The prevalence of oral submucous fibrosis is estimated to be between 2.3% to eight.6% with a latest evaluation (Dental Elf – 12th Dec 2022) estimating a malignant transformation fee of 6% (95percentCI: 2- 10%).

This umbrella evaluation of systematic evaluations aimed to find out the proportion of oral most cancers improvement in oral submucous fibrosis sufferers.


Searches had been performed within the Cochrane library, PubMed, Scopus and Net of science databases with no language restrictions. Systematic evaluation with or with out meta-analyses evaluating malignant transformation in oral submucous fibrosis (OSF) sufferers had been thought-about. Two reviewers independently screened and chosen research and extracted information. Examine high quality was assessed utilizing A Measurement Device to Assess Systematic Critiques (AMSTAR 2 ). A story abstract was supplied.


  • 4 systematic evaluations had been included.
  • Assessment pattern sizes ranged from 4 research 3986 sufferers to 16 research 8516 sufferers.
  • 3 evaluations had registered protocols on PROSPERO.
  • All 4 evaluations undertook meta-analyses.
  • Two evaluations had been thought-about to be of top quality and a couple of of critically low high quality utilizing the AMASTAR 2 software.
  • Imply values for malignant transformation for the 4 included evaluations ranged from 4.2% to six% (see desk beneath).
Publication No. of research (sufferers)% Malignant transformation (95percentCI) *
Murthy V et al 202216 (8516)6% (2% to 10%)
Nayanar et al 202210 (5428)5.5% (3.9% to 7.2%)
Kujan O et al 20219 (6337)4.2% (2.7% to five.6%)
Iocca O et al 20194 (3986)5.2% (99% CI: 2.9% to eight.0%)

*Except the place indicated


The authors concluded: –

There’s lack of high quality of proof and critically low methodological high quality amongst systematic evaluations (SRs) and meta-analyses, resulting in substantial heterogeneity. The outcomes recommend the estimated charges of malignant transformation (MT) assorted broadly throughout the included SRs attributable to variations in examine designs and definitions of OSF. Threat components related to MT might embody the period and severity of the illness, the presence of epithelial dysplasia and tobacco use.


No protocol was registered for this umbrella evaluation. Searches had been performed in 4 main databases with no language restrictions. Solely 4 evaluations had been included and whereas they had been printed over a short while scale 2019 to 2022 there was a large variation within the variety of included research, from 2 to 16.  We checked out the latest evaluation by Murthy et al., in a earlier weblog (Dental Elf – 12th Dec 2022) the place we additionally printed a desk summarising the malignant transformation information for the 4 evaluations included on this umbrella evaluation. The authors point out that the standard of proof was not assessed in any of the included papers, though the Murthy evaluation did use the Newcastle-Ottawa scale to high quality and included a desk of their assessments.

This umbrella evaluation helpfully pulls collectively the info from 4 earlier evaluations and features a helpful dialogue sectio. Nevertheless, it might have been useful if the authors had additionally assessed the diploma of overlap of research throughout the included evaluations. This overview and the unique systematic evaluations spotlight various points with the standard of the first research. Effectively designed and reported long-term potential research are wanted to make clear malignant transformation charges in sufferers with submucous fibrosis.


Major Paper  

Gondivkar SM, Yuwanati M, Sarode SC, Gadbail AR, Gondivkar R, Mohsin SF, Gaikwad R. Malignant transformation in oral submucous fibrosis: Tertiary level evidence: An umbrella review. Oral Dis. 2023 Aug 31. doi: 10.1111/odi.14718. Epub forward of print. PMID: 37650364.

Different references

 Dental Elf – 12th Dec 2022

Oral submucous fibrosis – malignant transformation rate

Murthy V, Mylonas P, Carey B, Yogarajah S, Farnell D, Addison O, Cook dinner R, Escudier M, Diniz-Freitas M, Limeres J, Monteiro L, Silva L, Fricain JC, Catros S, Fenelon M, Lodi G, Lombardi N, Brailo V, Ariyaratnam R, López-López J, Albuquerque R. Malignant Transformation Rate of Oral Submucous Fibrosis: A Systematic Review and Meta-Analysis. J Clin Med. 2022 Mar 24;11(7):1793. doi: 10.3390/jcm11071793. PMID: 35407401; PMCID: PMC8999767.

Nayanar, G, Reddy, MGS, Kakodkar, P & Dony, EC Malignant transformation fee of oral submucous fibrosis: A scientific evaluation and meta-analysis. Oral Surg. 2022; 00: 1– 8.

 Kujan O, Mello FW, Warnakulasuriya S. Malignant transformation of oral submucous fibrosis: A systematic review and meta-analysis. Oral Dis. 2021 Nov;27(8):1936-1946. doi: 10.1111/odi.13727. Epub 2020 Dec 9. PMID: 33205543.

Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, De Virgilio A, Di Maio P, Spriano G, Pardiñas López S, Shanti RM. Potentially malignant disorders of the oral cavity and oral dysplasia: A systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck. 2020 Mar;42(3):539-555. doi: 10.1002/hed.26006. Epub 2019 Dec 5. PMID: 31803979.

Image Credit

Picture by National Cancer Institute on Unsplash


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