This living guideline, published on 28 September 2026 with a GRADE evidence-to-decision process, assessed commercially available salivary adjunct tests in the United States for two uses: screening adults with no visible lesion, and deciding whether a visible oral or lip lesion needs biopsy.
For both uses the panel made research-only recommendations: the tests should not be used in routine practice or as public health screening outside research. It added three good practice statements. Every adult should have a clinical oral examination, and any persistent mucosal abnormality should be biopsied or referred. Biopsy remains the reference standard.
Oral cancer is among the commonest cancers in Indian men, strongly linked to tobacco chewing. The message fits Indian practice directly: look in the mouth, and biopsy what persists.
- Examine the oral cavity and lips of every adult, particularly those who chew tobacco, areca nut or smoke.
- Biopsy or refer any white, red or ulcerated lesion that persists beyond two to three weeks after removing an obvious cause.
- Do not use a salivary test to screen patients or to decide against biopsy.
- Advise tobacco and areca nut cessation at every contact.
Why it matters
A negative test could falsely reassure a patient with an early cancer and delay the biopsy that would find it.
Don't overread it
The guideline assessed tests marketed in the United States; other assays were not evaluated.
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