Comprehensive Summary
Rapado-Bonzález et al. write a systematic review summarizing the performance of DNA methylation marks in non-invasive and minimally invasive samples for oral cancer (OC) detection. The research followed the PRISMA guidelines and used PubMed’s MEDLINE, Scopus, Embase, and Cochrane Library databases to search for relevant articles up to October 2023. Two reviewers independently extracted and assessed data quality using the QUADAS-2 tool. The review showed that non-invasive DNA methylation markers in saliva, oral rinse, oral brush, or blood have strong potential for successful early detection of OC. Additionally, combining multiple gene methylation markers improved accuracy compared to single gene markers, but larger studies are still needed to validate their reliability for clinical screening.
Outcomes and Implications
OC is a global public health problem with more than 50% of patients being diagnosed with advanced-stage disease, leading to a poor prognosis and quality of life. The current methods for screening OPMDs include tissue biopsy, which is both invasive and unsuitable for large population screenings, and visual oral exams, which have low sensitivity for reliably detecting early-stage OC lesions. This work is important in showing that DNA methylation testing in non-invasive or minimally invasive samples offers a promising tool for early OC screening, promoting an alternative to invasive biopsies for high-risk populations. The approach also uses easily collected and cost-effective biopsy samples, which have a higher diagnostic performance compared to other non-invasive markers like microRNAs. However, the authors emphasize the need for larger studies to be performed before implementing DNA methylation markers as reliable early screening tools.