Methods: Following IRB agreement we obtained data from a central military database of patients referred to biopsy of oral lesions during 2007-2010 .Compliance to biopsy, demographical details, relevant service information and medical profile were analyzed. The control group included a representative sample of military personnel. Results: Of 669 patients referred to biopsy 387 performed it. Univariate logistic regression analysis (LRA) revealed that factors significantly associated with referrals and actual performance of biopsy include age above 21 (OR 2.470, p<0.001 and OR 2.565, p<0.001, respectively ), male gender (OR 1.411, p<0.001 and OR 1.519, p<0.001 ), career soldier (OR 2.645, p<0.001, OR 2.665, p<0.001), non-combat service (OR 1.241, p<0.020 and OR 1.330, p<0.022 ) and above 12 years of schooling (OR 2.903, p<0.001 and OR 2.927, p<0.001). Ethnic group, birth country and medical profile were not significantly associated with referrals and performance of biopsy. Multivariate LRA revealed factors significantly associated with referrals and performance of biopsy include age above 21 (OR 1.681, p=0.000 and OR 1.524, p=0.005, respectively), career soldier (OR 1.440, p=0.002 and OR 1.439, p=0.023), and education above 12 years (OR 1.545, p=0.000 and OR 1.672, p=0.001).
Conclusion: Referrals and compliance to biopsy of oral lesions in IDF soldiers is significantly influenced by age, type of service and education. Health education programs should increase awareness to risk factors associated with oral lesions in high-risk groups with poor health behaviors.