New Oral Brush Test Detects Oral Cancer with Over 95% Accuracy, May Reduce the Need for Surgical Biopsies

Researchers led by Queen Mary University of London have developed a non-invasive brush biopsy test that can help identify oral squamous cell carcinoma from suspicious oral lesions in under an hour, providing a quicker alternative to conventional surgical biopsies.

Published in the journal Biomarker Research, the study reports that the new diagnostic approach may help reduce the need for invasive scalpel biopsies. According to the researchers, the test could potentially prevent more than 90% of unnecessary biopsies among patients with low-risk oral lesions while enabling faster evaluation of suspicious mouth abnormalities.¹

How the New Oral Cancer Brush Test Works

The diagnostic method, known as qMIDS V3 (quantitative Malignancy Index Diagnostic System), involves gently brushing the surface of a suspicious oral lesion to collect cells. Unlike a conventional biopsy, the procedure does not require cutting tissue.

The collected cells are analyzed using reverse transcription quantitative polymerase chain reaction (RT-qPCR) to measure the activity of four messenger RNA (mRNA) biomarkers, INHBA, S100A16, YAP1, and POLR2A, to determine whether cancer-associated molecular changes are present. Because this automated molecular assay bypasses the days of laboratory processing and slide staining required for traditional pathology, it can deliver results in under an hour.

Study Evaluated the Oral Brush Test in 545 Patients

The cross-continental study was a collaborative effort between the Queen Mary University of London and leading Indian institutions, including the All India Institute of Medical Sciences (AIIMS), King George's Medical University (KGMU), and Modern Dental College & Research Centre. To validate the test, researchers analyzed 1,090 oral brush samples collected from 545 adults between October 2021 and June 2024.

The cross-continental study was a collaborative effort between the Queen Mary University of London and leading Indian institutions, including the All India Institute of Medical Sciences (AIIMS), King George's Medical University (KGMU), and Modern Dental College & Research Centre. To validate the test, researchers analyzed 1,090 oral brush samples collected from 545 adults between October 2021 and June 2024. Each participant provided paired brush samples from the suspicious lesion and the contralateral clinically normal oral mucosa, resulting in two samples per participant.

The participants included individuals diagnosed with:

• Oral squamous cell carcinoma

• Oral leukoplakia

• Oral lichen planus

• Healthy oral mucosa (control group)

The researchers compared the brush test results with confirmed clinical diagnoses to evaluate the test's performance.

Oral Brush Test Achieved Over 95% Accuracy in Detecting Oral Cancer

The study found that the four-gene qMIDS V3 test accurately distinguished oral cancer from common low-risk oral lesions.

The reported performance included:

• 95.7% sensitivity

• 95.1% specificity

• 95.5% overall diagnostic accuracy

• Area under the curve (AUC): 0.975

These findings indicate that the test correctly identified most patients with oral cancer while also correctly excluding many patients without the disease.

According to The ASCO Post, lead researcher Muy-Teck Teh said,

Oral Brush Test Could Reduce More Than 90% of Unnecessary Surgical Biopsies

Researchers estimate that more than 90% of patients with low-risk oral lesions could avoid unnecessary surgical biopsies if the brush test is used as an initial screening tool before tissue confirmation.

Many patients with suspicious mouth lesions undergo surgical biopsies that ultimately do not show cancer. According to the researchers, the new brush test could help identify patients who are at lower risk, potentially avoiding unnecessary invasive procedures.

The study estimated that more than 90% of patients with low-risk oral lesions could avoid surgical biopsy if the test is used as an initial screening tool before tissue confirmation.

Because the brush collects cells from a larger area of the lesion, it can also be repeated during follow-up visits with minimal discomfort.

A faster and less invasive diagnostic approach could support earlier evaluation of suspicious oral lesions, particularly in regions where oral cancer is common.

Why Early Detection of Oral Cancer Matters

Oral cancer remains a significant public health challenge worldwide. According to data cited in the study, an estimated 422,000 new cases of lip and oral cavity cancer and approximately 229,000 deaths occurred globally in 2023. Asia accounts for more than two-thirds of newly diagnosed cases.

Early diagnosis allows patients to begin treatment sooner, which is associated with better clinical outcomes.

MedBound Times spoke with Dr. Bhuvan Nagpal, an oral and maxillofacial pathologist, clinical biochemist, and medico-legal consultant, to understand the importance of early detection of oral cancer.

Dr. Bhuvan Nagpal emphasized the importance of regular oral self-examinations and routine dental screenings for detecting oral cancer at an early stage.

He further elaborated,

Further Studies Needed Before Routine Clinical Use

The researchers noted that additional studies involving larger and more diverse populations are needed before the test can be adopted widely in routine clinical practice.

The current findings indicate that qMIDS V3 could serve as a rapid, non-invasive method for assessing suspicious oral lesions and helping clinicians decide which patients require confirmatory biopsy.

References

1. Teh, Min T., Rajashri Patil, Shubham A. Tekade, et al. "INHBA–S100A16 Dysregulation Enables a Non-Invasive Molecular Stratification Platform for Rapid Detection of Oral Squamous Cell Carcinoma: Results from a Large Diagnostic Case-Control Study." Biomarker Research 14, no. 76 (2026). https://doi.org/10.1186/s40364-026-00963-7.

(Rh/SS/MSM)