OBJECTIVES: Individuals diagnosed with oral potentially malignant disorders (OPMDs) are recommended to receive regular surveillance in addition to oral screening once every two years through the National Oral Screening Program in Taiwan. However, their adherence to regular surveillance after the OPMD diagnosis is poor, and some of them are diagnosed with oral cavity cancer at an advanced stage nonetheless. This study, therefore, aimed to examine factors associated with non-persistent surveillance.

METHODS: Individuals who were diagnosed with OPMDs through the oral screening program were identified from the oral screening database. Patterns of surveillance after the diagnosis of OPMDs and use of health services were retrieved from their National Health Insurance claims database. Persistence of surveillance was defined as regular follow-up physician visits or oral screening without a gap longer than seven months. Cox proportional hazards regression model was adopted to identify factors associated with the risk of non-persistent surveillance.

RESULTS: Of 11,341 subjects identified in this study, the mean age was 53 years old, and 93% of them were male. Female, poverty, Charlson Comorbidity Index < 2, living in city area, betel nut chewing, cigarette smoking, and no dental attendance in one year prior to the OPMD diagnosis were associated with a higher risk of non-persistence surveillance.

CONCLUSIONS: This study identified factors associated with the risk of non-persistent surveillance after the diagnosis of OPMDs. The information is of importance for planning interventions to improve persistent surveillance in order to detect development of oral cavity cancer at an earlier stage.