Patient and clinician values and preferences in the early detection of oral potentially malignant disorders and oral cancer: A scoping review

Background: Understanding patient and clinician values and preferences is essential for implementing shared decision making in the screening and early detection of oral cancer. In this scoping review, the authors aimed to systematically map the existing evidence of patient and clinician perspectives, including values, preferences, acceptability, barriers, and concerns, regarding adjunct tests, referral pathways, and communication approaches for the screening and early detection of oral potentially malignant disorders (OPMDs) and oral cancer. Types of Studies Reviewed: The authors searched MEDLINE, Embase, Epistemonikos, and the Cochrane Controlled Register of Trials through June 2025 for primary studies reporting patients’ and clinicians’ values and preferences regarding oral cancer screening, OPMDs, and oral cancer diagnosis. Data were qualitatively analyzed using thematic analysis. Results: Forty studies were included. The results showed both patients’ and clinicians’ acceptance of using adjunct tests across multiple modalities (including 24 supporting quotes, illustrative verbatim excerpts drawn across multiple studies). Clinicians recognized their responsibility to refer suspected cases for biopsy (7 quotes), but expressed concerns about patient burden, leading some to prefer monitoring or adjunct testing first (5 quotes). Clinicians’ personal beliefs and confidence levels influenced referral decisions. Patients had high acceptance of less invasive adjunct tests (10 quotes), particularly brush cytology, although concerns about accuracy were reported. Clinicians attempted to balance diagnostic disclosure with mitigating patient distress (9 quotes). Standardized communication protocols were lacking. Researchers did not address values regarding novel adjunct technologies, including artificial intelligence, in any study. Conclusions and Practical Implications: Clinicians should engage patients in shared decision making regarding oral cancer tests and early detection pathways, acknowledge preferences for less invasive testing when discussing accuracy considerations, and use structured approaches to communicate OPMD diagnoses.