No Biopsy Needed? IIT Indore Develops Saliva-Based Oral Cancer Screening Method

Researchers at the Indian Institute of Technology (IIT) Indore have developed a promising non-invasive approach that could help identify molecular signs of oral cancer using saliva and a swab from the inner lining of the mouth.

The technique could eventually support faster and more accessible screening, particularly in rural and remote areas where specialised cancer diagnostic services remain limited.

The study examined oral squamous cell carcinoma (OSCC), the most common form of oral cancer, along with oral submucous fibrosis (OSMF), a potentially precancerous condition associated with areca nut, gutkha and tobacco use. Researchers analysed samples from 15 OSCC patients, 20 OSMF patients and 27 healthy individuals using metabolomic and proteomic techniques.

The researchers found molecular changes associated with fat metabolism, oxidative stress, energy pathways, tissue changes and immune activity. Combining saliva and oral-swab information produced biomarker panels that showed AUC values of 0.96 or higher when distinguishing OSMF from OSCC. However, this should not be interpreted as a 96% overall accuracy rate for detecting oral cancer.

Importantly, the study does not yet establish a specific cancer stage at which the technique can reliably detect disease. Its findings point to molecular changes across the progression from healthy tissue through OSMF to OSCC, suggesting potential for early detection, but larger studies are required to determine stage-specific performance.

The technology is currently better described as a potential screening or monitoring tool rather than a diagnostic replacement for biopsy. The study did not report a head-to-head sensitivity, specificity or “success rate” against biopsy. A biopsy with histopathological examination remains the clinical standard for confirming oral cancer, and existing evidence does not support replacing it with saliva-based testing.

The research was led by IIT Indore professor Hem Chandra Jha and has been published in the British Journal of Cancer. Provisional patent applications have also been filed. The team plans further validation in larger and more diverse patient groups before developing practical tests for routine clinical use.