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Oral leukoplakia – world prevalence – Nationwide Elf Service Get hold of US

The definition of oral leukoplakia has advanced through the years for the reason that 1978 definition of,  “a white patch or plaque that can not be characterised clinically or pathologically as every other illness”  to the 2020 World Well being Group (WHO) Collaborating Centre definition of oral leukoplakia as, “White plaques of questionable danger having excluded (different) identified ailments that carry no elevated danger for most cancers” (Warnakulasuriya et al., 2021). Oral leukoplakia is one among a gaggle of oral doubtlessly malignant issues (OPMD) with research reporting prevalence of 4.11% [95%CI: 1.98 to 6.97%] (Dental Elf – 8th Aug 2018) and a possible for malignant transformation of 9.8% [95%CI: 7.9 to 11.7%] (Dental Elf – 25th Jun 2021).

The intention of this overview was to evaluate the prevalence of oral leukoplakia (OLK) reported from 1996 to 2022, and to categorise the analysis into completely different teams by continent, definition, age, and dwelling habits.


The overview protocol was registered with PROSPERO. Searches had been performed within the PubMed, Embase, Scopus and Internet of Science databases from January 1996 to December 2022. Cross-section, case-control, or cohort research revealed in English reporting numbers of OLK sufferers and complete inhabitants had been thought-about.  Two reviewers independently looked for research with 3 reviewers deciding on research with 2 reviewers evaluating danger of bias utilizing the Joanna Briggs Institute (JBI) crucial appraisal instruments for prevalence research. Total crude prevalence of oral leucoplakia was derived together with meta-analyses for pooled estimates.


  • 69 research involving a complete inhabitants of 1,263,028; 17,524 with oral leukoplakia.
  • The crude general prevalence fee was 1.39%.
  • 28 nations from Asia, Africa, Europe, Oceania, South and North America had been represented.
  • Three broad teams of research had been recognized, population-based, clinic-based and particular inhabitants teams (e.g., Troopers, fisherman and so forth) and general prevalence estimates and group estimates from meta-analyses are proven within the desk beneath.
Sort of research No. of research Oral leukoplakia prevalence (95percentCI)
Inhabitants primarily based382.23% (1.44– 3.18%)
Clinic primarily based121.36% (0.82–2.02%)
Particular populations199.10% (4.85–14.47%)
Total693.41% (2.65–4.26%)
  • The prevalence of OLK in males was estimated to be between 3.9 and 1.8 instances greater than females with prevalence estimates for the completely different teams as proven within the desk beneath.
Sort of researchOral leukoplakia prevalence (95percentCI)
Inhabitants primarily based5.86% (1.71–12.20%)1.50% (0.44–3.14%)
Clinic primarily based2.29% (0.88–4.31%)1.27% (0.55–2.26%)
Particular populations4.69% (1.71–8.97%4.58% (1.24–9.69%)
  • 15 research investigated the correlation between leukoplakia and tobacco use with 180,898 folks out of 641,004 (28.2%) reporting a smoking behavior.
  • The estimated prevalence of leukoplakia in these reporting tobacco use (no matter variety or frequency was 9.48 (95percentCI: 3.98–16.96) in population-based research and 9.59 (95percentCI: 4.44–16.37) in particular populations.


The authors concluded: –

the prevalence of oral leukoplakia was decided as 1.39% and the pooling estimated world prevalence was 3.41%. The prevalence was comparatively constant and steady throughout completely different continents and completely different definitions. A better pooled estimated prevalence was discovered amongst males, these aged over 60 years previous, people who smoke, and alcohol customers.


Whereas a protocol for the overview was registered within the PROSPERO database ahtough the code quantity supplied in the primary publication is inaccurate and the proper hyperlink is supplied beneath. Searches had been performed in a number of main databases though just for a selected time interval. As well as, solely English language papers had been included so doubtlessly related research could have been excluded.   This new overview included 69 research offering an estimated pooled world prevalence of three.41% (95percentCI: 2.65 to 4.26%) which has similarities to findings from a broader overview of a OPMDs in 2018 by Mello et al., (Dental Elf – 8th Aug 2018) which included 22 research and located a prevalence of 4.11% (95percentCI: 1.98 to six.97%).  The authors spotlight important heterogeneity within the included research and an absence of element within the included research regarding definition of leukoplakia, geographical location age, intercourse, tobacco and alcohol use which must be considered in when deciphering the findings. Future main research ought to be reported consistent with the STROBE tips and there ought to be settlement on what elements ( eg age, intercourse, tobacco and alcohol use and so forth) ought to be reported.


Major Paper  

Zhang C, Li B, Zeng X, Hu X, Hua H. The global prevalence of oral leukoplakia: a systematic review and meta-analysis from 1996 to 2022. BMC Oral Well being. 2023 Sep 6;23(1):645. doi: 10.1186/s12903-023-03342-y. PMID: 37670255; PMCID: PMC10481497.

Review protocol on PROSPERO database

Different references

Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, Lodi G, Mello FW, Monteiro L, Ogden GR, Sloan P, Johnson NW. Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2021 Nov;27(8):1862-1880. doi: 10.1111/odi.13704. Epub 2020 Nov 26. PMID: 33128420.

Dental Elf – 8th Aug 2018

Oral doubtlessly malignant issues – how widespread are they?

Dental Elf – 25th Jun 2021

Oral leukoplakia and fee of malignant transformation

Photograph credit

By Unknown photographer – This picture was launched by the Nationwide Most cancers Institute, an company a part of the Nationwide Institutes of Well being, with the ID 2583. Public Domain


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