OLP Malignant Transformation Rate — MFDS Part 1 MCQ

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ModerateOral MedicineOLP Malignant Transformation RateMFDS Part 1

For oral lichen planus overall, considered separately from lesions already showing epithelial dysplasia, which range most closely reflects the current pooled malignant transformation proportion?

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Correct answer: A — 1–2%

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

A is correct. A 2024 systematic review and meta-analysis of 101 studies involving 38,083 patients found a pooled malignant transformation proportion of 1.43% for oral lichen planus, placing the best estimate within 1–2%. This is a pooled proportion, not an annual transformation rate. The risk is higher in association with epithelial dysplasia, atrophic or erosive disease, tongue involvement, tobacco or alcohol use, and hepatitis C infection. Option B approximates the reported 5.13% pooled proportion for oral lichen planus with epithelial dysplasia, which the stem specifically excludes. Options C and D substantially overestimate the overall risk, while option E incorrectly implies that malignant transformation is negligible.

Reference: González-Moles MA, Ramos-García P. An Evidence-Based Update on the Potential for Malignancy of Oral Lichen Planus and Related Conditions: A Systematic Review and Meta-Analysis. Cancers. 2024;16(3):608. https://pubmed.ncbi.nlm.nih.gov/38339358/