Betting on Blue Light: VELscope Versus Conventional Oral Examination in the High-Stakes Game of Oral Lesion Detection among Gujarat’s Tobacco Users

Abstract Introduction: Oral cancer is a significant health burden in India, with 143,759 new cases in 2022. In Gujarat state, where tobacco consumption is 25.1% among adults, early detection of oral lesions has been a challenge with conventional oral examination methods. Objective: This study assessed the use of VELscope (Visual Enhanced Light scope) as an adjunctive tool to Conventional Oral Examination (COE) for identifying oral lesions among tobacco users. Materials and Methods: This observational cross-sectional diagnostic study at The Gujarat Cancer and Research Institute enrolled 310 tobacco users through consecutive sampling during January to February 2024. Participants underwent standardized COE under white light, followed by VELscope examination. Primary outcomes were oral lesion detection by COE and VELscope. This study did not confirm the oral lesions with histopathological examination. Results: Among 310 participants, 96.8% were males and 3.2% were females. The mean age of participants was 42.3 ± 11.7 years. VELscope detected 659 areas of fluorescence alteration, while COE detected 245 lesions. VELscope showed 414 additional lesions which were not appreciated during COE, including Discoloration (63%), OSMF (62.9%), Leukoplakia (62.6%), Erythroplakia (63.3%). Conclusion: VELscope identified more visual changes than Conventional Oral Examination and may serve as an adjunctive tool in oral cancer screening programs. Further studies with histopathological correlation are warranted.