Global Prevalence of Oral Potentially Malignant Disorders: An Updated Systematic Review and Meta-Analysis.

BACKGROUND

Oral potentially malignant disorders (OPMDs) represent a diverse group of mucosal disorders with varying risks of progression to oral cancer.

OBJECTIVE

This updated systematic review (SR) and meta-analysis (MA) estimated the global prevalence of histopathologically confirmed OPMDs, excluding oral lichen planus and lichenoid lesions.

METHODS

A comprehensive literature search was conducted using predefined eligibility criteria. A total of 108 studies were included, comprising 86 additional studies and 22 from a previous SR.

RESULTS

The overall pooled prevalence of OPMDs was 4.67% (95% CI: 3.62-5.84). Prevalence of OPMDs was as follows: Asia (5.44%), followed by South America/Caribbean (5.21%), and Europe (4.89%). Considering OPMD cases, the proportion was higher among males (62.87%) and individuals aged ≥ 50 years (68.1%). Histopathological evidence of epithelial dysplasia was present in 46.21% of cases. Oral leukoplakia (OL), oral submucous fibrosis (OSMF), and actinic cheilitis (AC) emerged as the most prevalent lesions, with relevant differences considering the geographic regions. OL and OSMF were the most common OPMDs in Asia, while OL and AC predominated in South America/Caribbean, and in Europe OL remains the most frequently encountered OPMD.

CONCLUSIONS

The global prevalence of OPMDs, estimated at approximately 5%, should be interpreted as a broad summary measure, given the substantial heterogeneity driven by regional variations possibly related to behavioral, biological, and/or environmental risk factors. Future preventive efforts should focus on the type of OPMD prevalent in the region/country. The heterogeneity across studies highlights the need for standardized, population-based studies using WHO nomenclature to better define the global burden.