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Conducted from December 2023 to December 2024 across 35 primary health care (PHC) units in Rio de Janeiro, Brazil, the study included adults aged \u2265\u200935\u2009years identified as tobacco users in the public electronic medical record system and considered high\u2010risk for preventive oral examination (POE). PHC units were allocated to three groups: control (opportunistic screening without active invitation; 12\u2009units), experimental I (organized invitation for POE plus home\u2010visit support; 11\u2009units), and experimental II (organized invitation for POE plus an awareness campaign; 12\u2009units). The 23 PHC units implementing organized screening included 2735 registered tobacco users, whereas the 12\u2009units maintaining opportunistic screening included 1048. Consequently, POE coverage reached 77.2% in the organized screening arms versus 3.6% under opportunistic screening (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). POE adherence was higher with organized invitation plus community awareness (77.2%) than with home\u2010visit support (58.1%). A total of 15 biopsies were performed within the organized screening groups, identifying 6 cases of oral potentially malignant disorders and 5 cases of OC. In contrast, biopsies conducted outside the screening program demonstrated significantly lower detection rates (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). These findings demonstrate that organized, invitation\u2010based screening integrated into PHC can substantially expand access to early diagnosis among high\u2010risk and socially vulnerable individuals who would otherwise remain unscreened, reinforcing PHC as a strategic and equitable setting for sustainable early OC detection.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70511","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T10:05:33Z","timestamp":1776765933000},"page":"1750-1758","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Organized Strategies to Enhance Access to Preventive Oral Cancer Screening Among High\u2010Risk Individuals in Brazil: A Randomized Clinical Trial in Primary Care"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3567-8140","authenticated-orcid":false,"given":"Marcia Frias 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Serra","family":"da Cruz","sequence":"additional","affiliation":[{"name":"School of Dentistry Federal University of Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9687-791X","authenticated-orcid":false,"given":"Amanda Martins","family":"dos Santos Bessa","sequence":"additional","affiliation":[{"name":"School of Dentistry Federal University of Rio de Janeiro  Rio de Janeiro Brazil"},{"name":"Municipal Health Department of Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7853-5916","authenticated-orcid":false,"given":"M\u00e1rio Jos\u00e9","family":"Rom\u00e3nach","sequence":"additional","affiliation":[{"name":"School of Dentistry Federal University of Rio de Janeiro  Rio de Janeiro 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