Diagnostic Accuracy of Oral Scrape Cytology for Detection of Premalignant and Malignant Oral Lesions: A Cross-Sectional Comparative Study

Background: Oral scrape cytology has emerged as a simple, cost-effective, and minimally invasive diagnostic tool for the evaluation of oral mucosal lesions. The present study was undertaken to evaluate the diagnostic efficacy of oral scrape cytology in detecting premalignant and malignant oral cavity lesions by correlating cytological findings with histopathological diagnoses. Methods: Our study was a hospital-based cross-sectional study conducted in the Departments of Pathology and Dentistry at Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, from July 2024 to January 2026. A total of 129 patients with clinically suspicious oral cavity lesions underwent oral scrape cytology followed by histopathological evaluation. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using histopathology as the reference standard. Results: The mean age of the study population was 51.47±15.94 years, with a male predominance and a high prevalence of tobacco exposure. Oral scrape cytology demonstrated a sensitivity of 80.4%, a specificity of 80.7%, a PPV of 69.8%, a NPV of 88.2%, and an overall diagnostic accuracy of 80.6%. There was a statistically significant correlation between cytological and histopathological diagnoses. Conclusion: Our findings demonstrate that oral scrape cytology is a reliable, minimally invasive, and cost-effective adjunctive diagnostic modality for the evaluation of clinically suspicious oral lesions. Although histopathological examination remains the gold standard for definitive diagnosis, oral scrape cytology may serve as an effective screening and triage tool, especially in resource-constrained settings and high-risk populations with significant tobacco exposure.