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Fei-Zhang DJ, Park AC, Chelius DC, Smith SS, Samant S, Patel UA, Sheyn AM, Rastatter JC. Influence of Social Vulnerability in Treatment and Prognosis of Squamous Cell Carcinoma of the Tongue. Otolaryngol Head Neck Surg 2024; 170:1338-1348. [PMID: 38353303 DOI: 10.1002/ohn.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/20/2023] [Accepted: 12/23/2023] [Indexed: 04/30/2024]
Abstract
OBJECTIVE To investigate the association of social determinants of health (SDoH) in squamous cell carcinoma of the tongue in the United States and to evaluate the real-world contribution of specific disparities. STUDY DESIGN Retrospective cohort study. SETTING United States. METHODS The Centers for Disease Control and Prevention-Social Vulnerability Index (SVI) and National Cancer Institute-Surveillance, Epidemiology, and End Results Program database were used to study 62,103 adult tongue squamous cell carcinoma patients from 1975 to 2017. Regression analysis assessed trends in months of follow-up and survival across social vulnerability and 4 subcategories of social vulnerability. RESULTS As overall SVI score increases (increased social vulnerability), there is a significant decrease in the average length of follow-up (22.95% decrease from 63.99 to 49.31 months; P < .001) across patients from the lowest and highest social vulnerability groups. As overall SVI score increases, there is a significant decrease in the average months of survival (28.00% decrease from 49.20 to 35.43 months; P < .001). There is also a significantly greater odds ratio (OR = 1.05; P < .001) of advanced cancer staging upon presentation at higher SVI scores. Patients with higher SVI scores have a lower OR (0.93; P < .001) of receiving surgery as their primary treatment when compared to patients with lower SVI scores. Patients with higher SVI scores also have a significantly greater OR (OR = 1.05; P < .001) of receiving chemotherapy as their primary treatment when compared to patients with lower SVI scores. CONCLUSION Increased social vulnerability is shown to have a detrimental impact on the treatment and prognosis of patients with squamous cell carcinoma of the tongue.
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Affiliation(s)
- David J Fei-Zhang
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Asher C Park
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Daniel C Chelius
- Department of Otolaryngology-Head and Neck Surgery, Pediatric Thyroid Tumor Program and Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Stephanie S Smith
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sandeep Samant
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Urjeet A Patel
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anthony M Sheyn
- Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Department of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jeffrey C Rastatter
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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2
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Koyama S, Morishima T, Saito MK, Ma C, Nishimura N, Aoki K, Nishio M, Otsuka T, Tabuchi T, Ishibashi M, Miyashiro I. Faster surgery initiation in oral cancer patients during the COVID-19 pandemic in Osaka, Japan. Oral Dis 2024; 30:307-312. [PMID: 36691715 DOI: 10.1111/odi.14518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/10/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated the impact of the COVID-19 pandemic on oral cancer (OC), comparing diagnosis and number of pre-operative days in the diagnosis of OC in 2019 (pre-COVID-19) and that in 2020 (during the COVID-19 pandemic). METHODS Using data from a cancer registry-based study on the impact of COVID-19 on cancer care in Osaka (CanReCO), we collected details of sex, age, residential area, cancer site, date of diagnosis, clinical stage at first treatment and number of pre-operative days in OC patients. RESULTS A total of 1470 OC cases were registered. Incidence of OC before and during COVID-19 was 814 and 656 cases, respectively. During the first wave of the pandemic (March to May 2020), incidence was about half that in the same period in 2019 (2019; n = 271, 2020; n = 145). Number of pre-operative days (median number of days between the first hospital visit and surgery date) was significantly shorter during the COVID-19 year (24.5 days) than in the pre-COVID-19 year (28 days, p = 0.0015). CONCLUSIONS Incidence of OC during the COVID-19 pandemic was lower than in pre-COVID-19. Despite disruption in the healthcare system, the number of pre-operative days for OC cases was shorter during the pandemic.
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Affiliation(s)
- Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | | | - Chaochen Ma
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Nao Nishimura
- Department of Dentistry, Osaka International Cancer Institute, Osaka, Japan
| | - Kengo Aoki
- Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Minako Nishio
- Department of Medical Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tomoyuki Otsuka
- Department of Medical Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Miki Ishibashi
- Department of Dentistry, Osaka International Cancer Institute, Osaka, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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3
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Bai X, Cui C, Yin J, Li H, Gong Q, Wei B, Lu Y. The association between oral hygiene and head and neck cancer: a meta-analysis. Acta Odontol Scand 2023; 81:374-395. [PMID: 36538375 DOI: 10.1080/00016357.2022.2158129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/17/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Oral hygiene has been suspected to contribute to the aetiology of head and neck cancer (HNC). Based on the meta-analysis, we evaluated the impact of oral hygiene on head and neck cancer (HNC) and its survival. MATERIALS AND METHODS Relevant case-control and cohort studies reporting survival data, oral hygiene data were searched via PubMed, Embase, Cochrane Library, and Web of Science databases. The odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) were used. Subgroup analysis was performed. RESULTS Oral hygiene was associated with HNC. Tooth brushing ≥2 a day, dental floss use, denture wearing, caries ≥3, and dental visit ≥1 reduced the risk of oral cavity cancer while mouth wash use, missing teeth >5, gum bleeding, and periodontal disease increased the risk of oral cavity cancer. For oropharynx cancer, tooth brushing ≥2 and caries ≥3 were associated with reduced risk of it. Tooth brushing ≥2 and dental visits ≥1 decreased the risk of pharynx cancer risk and larynx cancer risk, however, missing teeth >5 increased both of them. CONCLUSION Oral hygiene was associated with HNC and its sub sites. Oral hygiene should be strengthened, a dental floss use and dentist's visits can be recommended.
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Affiliation(s)
- Xue Bai
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Chunyan Cui
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Jiajia Yin
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Hua Li
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Qiwei Gong
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Bo Wei
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Yifan Lu
- Department of Stomatology, The Third Hospital of Shijiazhuang, Shijiazhuang, P.R. China
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4
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Sahni V. Is there an association between oral hygiene and head and neck cancer? Evid Based Dent 2023; 24:57-58. [PMID: 37142769 DOI: 10.1038/s41432-023-00879-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/16/2023] [Indexed: 05/06/2023]
Abstract
DATA SOURCES PubMed, Web of Science, the Cochrane Library and Embase were utilised as databases from inception till November 2021. STUDY SELECTION The inclusion criteria consisted of cohort and case-control studies published in the English language, which dealt with diagnosed cases of head and neck cancer reporting survival, oral hygiene and comparative data. Studies pertaining to animal experiments along with case reports, conference proceedings, reviews, letters, editorials, errata and protocols were excluded. DATA EXTRACTION AND SYNTHESIS Data such as publication year, authors' names, country, sources, study groups, age, gender, participant number, education, alcohol, tobacco, study quality, cancer site and outcomes were extracted for each included study. A modified Newcastle-Ottawa Scale was utilized to evaluate the quality of these studies. RESULTS A total of forty-four studies were included, of which forty were case-control and four were cohort in nature. These comprised of a total of 52,863 patients of which 33,000 were devoid of head and neck cancer (HNC) while, 19,863 had a confirmed diagnosis of HNC. Oral hygiene and HNC were found to be associated. CONCLUSIONS Poor oral hygiene was concluded to be associated with HNC and the subsites thereof.
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Affiliation(s)
- Vaibhav Sahni
- Infectious Disease and Immunology, The Forsyth Institute, Cambridge, MA, 02142, USA.
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5
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Semprini J. Estimating the Within-Person Change in Dental Service Access Measures during the COVID-19 Pandemic in the United States. Int J Dent 2023; 2023:5601447. [PMID: 37143852 PMCID: PMC10154088 DOI: 10.1155/2023/5601447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/01/2023] [Accepted: 04/07/2023] [Indexed: 05/06/2023] Open
Abstract
Background American adults delay dental care more than any other healthcare service. Unfortunately, the COVID-19 pandemic may have stalled efforts to address dental service delays. Early evidence has suggested substantial declines in dental service visits in the early phase of the pandemic; however, our study is among the first to measure within-person changes from 2019 to 2020 and conduct subgroup analyses to examine if changing dental patterns were mediated by exposure to the pandemic, risk of adverse COVID-19 outcomes, or dental insurance. Methods We analyzed a National Health Interview Survey panel of individuals initially surveyed in 2019, with subsequent follow-up in 2020. The outcomes included dental service access measures and the interval of a most recent dental visit. By constructing a probability-weighted linear regression model with fixed-effects, we estimated the average within-person change from 2019 to 2020. Robust standard errors were clustered within each respondent. Results From 2019 to 2020, adults reported a 4.6%-point reduction in the probability of visiting the dentist (p < 0.001). Significantly higher declines were found in Northeast and West regions compared to Midwest and South regions. We find no evidence that declining dental services in 2020 were associated with more chronic diseases, older age, or lack of dental insurance coverage. Adults did not report more financial or nonfinancial access barriers to dental care in 2020 compared to 2019. Conclusions The long-term effects of the COVID-19 pandemic on delayed dental care warrant continued monitoring as policymakers aim to mitigate the pandemic's negative consequences on oral health equity.
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Affiliation(s)
- Jason Semprini
- University of Iowa College of Public Health, Iowa City, USA
- University of Iowa College of Dentistry, Iowa City, USA
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6
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Park BY, Cho HA, Shin H. Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study. BMC Oral Health 2023; 23:213. [PMID: 37060034 PMCID: PMC10102694 DOI: 10.1186/s12903-023-02948-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/06/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND People with disabilities face difficulties in oral health management and gaining access to dental care. The availability of a regular source of dental care (RSDC) is an important factor that influences the access to health services and care management. The purpose of this study was to determine the effect of the availability of RSDC on the number of annual dental visits and dental expenses per visit among people with disabilities. METHODS Data of 7,896,251 patients with dental problems in South Korea were analyzed using the 2002-2018 National Health Insurance claims data. A generalized estimating equation was applied to analyze the repeated-measurement data, and the interaction effect between RSDC and the disability severity was evaluated. RESULTS The number of annual dental visits was higher among people with (2.62) than among those without (2.23) disabilities. Despite their increased dental needs, both annual dental visits and dental expenses per visit were low among older individuals (p < 0.001). The proportion and frequency of annual dental visits was lower among women than among men with disabilities. RSDC had differential effects on the severity of disability. Compared to people without disabilities, RSDC increased the number of annual dental visits (p = 0.067) and the dental expenses per visit (p < 0.05) among those with severe disabilities, but the effect on the number of annual dental visits was not significant among those with mild disabilities (p = 0.698). CONCLUSIONS Our results suggest a need for a special dental care system for people with disabilities, to ensure an RSDC, particularly for women and for older people with disabilities.
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Affiliation(s)
- Bo-Young Park
- Department of Dental Hygiene, Shinhan University, Uijeongbu-Si, Republic of Korea
| | - Han-A Cho
- Department of Dental Hygiene, Shinhan University, Uijeongbu-Si, Republic of Korea
| | - Hosung Shin
- Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan Dearo, Iksan, 54538, North Jula, Korea.
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7
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Tranby EP, Heaton LJ, Tomar SL, Kelly AL, Fager GL, Backley M, Frantsve-Hawley J. Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data. Cancer Epidemiol Biomarkers Prev 2022; 31:1849-1857. [PMID: 35732291 PMCID: PMC9437560 DOI: 10.1158/1055-9965.epi-22-0114] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/17/2022] [Accepted: 06/16/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This study compared prevalence, incidence, mortality rates, treatment costs, and risk factors for oral and oropharyngeal cancer (OC/OPC) between two large United States adult cohorts in 2012-2019. METHODS Medicaid and commercial claims data came from the IBM Watson Health MarketScan Database. Logistic regression analyses estimated incidence and risk factors for OC/OPC. Mortality was calculated by merging deceased individuals' files with those of the existing cancer cohort. Summing costs of outpatient and inpatient services determined costs. RESULTS Prevalence of OC/OPC in Medicaid enrollees decreased each year (129.8 cases per 100,000 enrollees in 2012 to 88.5 in 2019); commercial enrollees showed a lower, more stable prevalence (64.7 per 100,000 in 2012 and 2019). Incidence trended downward in both cohorts, with higher incidence in the Medicaid (51.4-37.6 cases per 100,000) than the commercial cohort (31.9-31.0 per 100,000). Mortality rates decreased for Medicaid enrollees during 2012-2014 but increased in the commercial cohort. OC/OPC treatment costs were higher for commercial enrollees by $8.6 million during 2016-2019. OC/OPC incidence was higher among adults who were older, male, and white; used tobacco or alcohol; or had prior human immunodeficiency virus/acquired immune deficiency syndrome diagnosis and lower among those who had seen a dentist the prior year. CONCLUSIONS Medicaid enrollees experienced higher OC/OPC incidence, prevalence, and mortality compared with commercially insured adults. Having seen a dentist within the prior year was associated with a lower risk of OC/OPC diagnosis. IMPACT Expanding Medicaid dental benefits may allow OC/OPC to be diagnosed at earlier stages through regular dental visits.
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Affiliation(s)
- Eric P. Tranby
- Analytics and Evaluation, CareQuest Institute for Oral Health, Boston, Massachusetts
| | - Lisa J. Heaton
- Analytics and Evaluation, CareQuest Institute for Oral Health, Boston, Massachusetts.,Corresponding Author: Lisa J. Heaton, Science Writer, Analytics and Evaluation, CareQuest Institute for Oral Health, 465 Medford Street, Boston, MA 02129. Phone: 617-886-1047; E-mail:
| | - Scott L. Tomar
- Division of Prevention and Public Health Sciences, College of Dentistry, University of Illinois, Chicago, Illinois
| | | | | | - Mary Backley
- Maryland Dental Action Coalition, Columbia, Maryland
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8
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Emerson MA, Farquhar DR, Lenze NR, Sheth S, Mazul AL, Zanation AM, Hackman TG, Weissler MC, Zevallos JP, Yarbrough WG, Brennan P, Abedi-Ardekani B, Olshan AF. Socioeconomic status, access to care, risk factor patterns, and stage at diagnosis for head and neck cancer among black and white patients. Head Neck 2022; 44:823-834. [PMID: 35044015 PMCID: PMC8904304 DOI: 10.1002/hed.26977] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Little is known about how factors combine to influence progression of squamous cell carcinoma of the head and neck (HNSCC). We aimed to evaluate multidimensional influences of factors associated with HNSCC stage by race. METHODS Using retrospective data, patients with similar socioeconomic status (SES), access to care (travel time/distance), and behavioral risk factors (tobacco/alcohol use and dental care) were grouped by latent class analysis. Relative frequency differences (RFD) were calculated to evaluate latent classes by stage, race, and p16 status. RESULTS We identified three latent classes. Advanced T-stage was higher for black (RFD = +20.2%; 95% CI: -4.6 to 44.9) than white patients (RFD = +10.7%; 95% CI: 2.1-19.3) in the low-SES/high-access/high-behavioral risk class and higher for both black (RFD = +29.6%; 95% CI: 4.7-54.5) and white patients (RFD = +23.9%; 95% CI: 15.2-32.6) in the low-SES/low-access/high-behavioral risk class. CONCLUSION Results suggest that SES, access to care, and behavioral risk factors combine to underly the association with advanced T-stage. Additionally, differences by race warrant further investigation.
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Affiliation(s)
- Marc A. Emerson
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Douglas R. Farquhar
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Nicholas R. Lenze
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Siddharth Sheth
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Divison of Medical Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Angela L. Mazul
- Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO
| | - Adam M. Zanation
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Trevor G. Hackman
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mark C. Weissler
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jose P. Zevallos
- Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO
| | - Wendell G. Yarbrough
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Pathology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Paul Brennan
- International Agency for Research on Cancer, WHO, Lyon, France
| | | | - Andrew F. Olshan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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9
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Kolenko YG, Timokhina TO, Lynovytska OV, Mialkivskyi KO, Khrol NS. EPIDEMIOLOGICAL SITUATION OF PRE-CANCER DISEASES OF THE ORAL MUCOUS IN UKRAINE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1453-1458. [PMID: 35907215 DOI: 10.36740/wlek202206105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: To conduct a prospective clinical study to assess the prevalence, structure, risk factors and features of clinical manifestations of precancerous diseases of oral mucosa and red lip in Kyiv residents and to analyze opportunities to improve the quality of their primary diagnosis. PATIENTS AND METHODS Materials and methods: The examination of 423 patients with precancerous diseases of oral mucosa and red lip included clarification of the main complaints and anamnesis of the disease, objective assessment of the state of oral mucosa and red border of the lips according to visual, stomatoscopic, luminescent analysis, cyto-, histological studies. RESULTS Results: Attention is drawn to the prevalence among precancerous diseases of patients with leukoplakia - 41.37% and lichen planus - 44.21%. The levels of detection of precancerous diseases of the oral mucosa due to the current and preliminary history for individual nosological forms are almost identical, which indicates the reliability of the above indicators. CONCLUSION Conclusions: Promotion between the people about timely dental treatment for precancerous diseases of the oral mocosa and the use of radical technologies in their treatment will not only increase the effectiveness of treatment, but significantly limit the malignancy of these diseases.
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Affiliation(s)
| | | | | | | | - Nina S Khrol
- BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE
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10
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Chawla J, Yerragudi N. Could Tele-Oral medicine help in early diagnosis of oral cancer? JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Naavaal S, Garcia DT, Deng X, Bandyopadhyay D. Association between periodontal disease and oral cancer screening among US adults: NHANES 2011-2014. Community Dent Oral Epidemiol 2021; 50:216-224. [PMID: 34032297 DOI: 10.1111/cdoe.12655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/07/2021] [Accepted: 04/18/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD. MATERIALS AND METHODS We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥30 years. PD status was classified as no PD, mild/moderate PD and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral or both types of oral cancer screenings among adults with PD. Control variables included age, sex, race/ethnicity, health insurance, education, income level, smoking status, alcohol use and last dental visit. RESULTS The analytic sample included 6962 adults weighted to the national population of adults who had a periodontal examination during 2011-2014. Overall, 31.5%, 26.8% and 20.9% of adults reported receipt of intraoral, extraoral and both types of oral cancer screening, respectively. Almost 40% of adults had some form of PD (7.6% severe and 32.4% mild/moderate PD). A higher proportion of 45-64-year-olds, males, non-Hispanic Blacks, those with less than high school education, with income level less than 200% federal poverty level, or those with no insurance had severe PD than no PD. In adjusted analyses, adults with severe PD were significantly more likely to report no receipt of intraoral (RR = 1.25, 95% CI = 1.12-1.40), extraoral (RR = 1.17, 95% CI = 1.07-1.27) or both types of oral cancer screenings (RR = 1.18, 95% CI = 1.10-1.27) than those with no PD. CONCLUSIONS Significantly low proportion of adult's age ≥30 years with severe PD reported receiving any type of oral cancer screening. The association between PD and risk of oral cancers points to the need to improve oral cancer screening rates among adults with PD.
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Affiliation(s)
- Shillpa Naavaal
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.,Oral Health Equity Core, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA
| | - Dina T Garcia
- Oral Health Equity Core, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA.,Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Xiaoyan Deng
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Dipankar Bandyopadhyay
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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12
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Wong TJ, Li Q, Dodd V, Wang W, Bian J, Guo Y. Oral cancer knowledge and screening behavior among smokers and non-smokers in rural communities. BMC Cancer 2021; 21:430. [PMID: 33879128 PMCID: PMC8056680 DOI: 10.1186/s12885-021-08198-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research suggests having an oral and pharyngeal cancer (OPC) examination for early diagnosis can increase survival rate. However, the OPC screening rate is low in certain populations. To improve OPC screening rate, this study identified factors that are associated with having an OPC examination. METHODS Participants with landlines and aged 25 years and older were recruited from six northern Florida counties. Bivariate and logistic regressions were used to predict the outcome of whether the participants had ever had an OPC examination as well as whether participants had ever heard of an OPC examination. RESULTS Of 2260 participants with a mean age of 55.9 ± 15.0 years, the majority of participants never smoked (53.4%), self-identified as Whites (70.6%), and had some college or 2-year degree education (30.3%). Smokers were significantly less likely to have ever heard of an OPC examination than those who never smoked. Significant interaction between smoking status and race, and smoking status and social support interaction were found. Whites who never smoked were more likely to have had an OPC examination than non-Whites who never smoked. Former and current smokers with greater social support were more likely to have had an OPC examination than those with lower social support. CONCLUSION The findings from this study inform the need to enhance the awareness of having an OPC examination among smokers and to reduce barriers for racial minority populations to receive an OPC examination. Future research is warranted to develop interventions to target certain populations to improve the rate of OPC examination.
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Affiliation(s)
- Tzu-Jung Wong
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
| | - Qian Li
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, PO Box 100177, 2004 Mowry Road, Suite 2251, Gainesville, FL, 32610-0177, USA
| | - Virginia Dodd
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Wei Wang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, PO Box 100177, 2004 Mowry Road, Suite 2251, Gainesville, FL, 32610-0177, USA
- Cancer Informatics Shared Resources, University of Florida Health Cancer Center, Gainesville, Florida, USA
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, PO Box 100177, 2004 Mowry Road, Suite 2251, Gainesville, FL, 32610-0177, USA.
- Cancer Informatics Shared Resources, University of Florida Health Cancer Center, Gainesville, Florida, USA.
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13
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Alhareky M, Nazir MA. Dental Visits and Predictors of Regular Attendance Among Female Schoolchildren in Dammam, Saudi Arabia. Clin Cosmet Investig Dent 2021; 13:97-104. [PMID: 33762854 PMCID: PMC7982434 DOI: 10.2147/ccide.s300108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 02/27/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Regular dental visits are important for the maintenance of optimal oral health and improved quality of life. The purpose of the study was to evaluate patterns of dental visits and factors associated with routine dental attendance among female schoolchildren in Dammam, Saudi Arabia. Patients and Methods This cross-sectional study was performed on 449 female primary schoolchildren (6–11 years old) in Dammam, Saudi Arabia. The study included clinical examination for decay in the first permanent molars in children and questionnaire administration among their parents. The World Health Organization’s oral health questionnaire was used to collect data about children’s dental visits, oral hygiene behaviors, dental problems, and dietary practices. Bivariate and multivariate analyses were performed to evaluate factors associated with routine dental visits. Results Most children (64.1%) visited the dentist during the past one year, 22.1% performed no dental visit during the past one year, and 8.3% never visited the dentist. Among children who visited the dentist, the pain was the most common reason for dental visits (39.10%, N=170), followed by routine dental check-ups (18.60%, N=81). In bivariate analysis, education of parents, family income, daily tooth brushing, no decay in the first permanent molar, no toothache, no consumption of soft drinks, biscuits, cakes, and cream were significantly associated with routine dental attendance (P <0.05). However, the final logistic regression model showed that university education of mothers (OR 2.52, P = 0.005), not having toothache or discomfort (OR 2.88, P = 0.001), tooth brushing once or twice daily (OR 2.43, P= 0.034), and not consuming soft drinks (OR 1.96, P= 0.027) were significant predictors of routine dental visits. Conclusion The study found that higher education of mothers, daily tooth brushing, not having dental pain, and not consuming soft drinks were significantly associated with routine dental visits in this sample of female schoolchildren. Routine dental attendance may be used to improve oral hygiene and reduce dental pain and consumption of soft drinks in children.
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Affiliation(s)
- Muhanad Alhareky
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Ashraf Nazir
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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14
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Haynes DA, Vanison CC, Gillespie MB. The Impact of Dental Care in Head and Neck Cancer Outcomes: A Systematic Review and Meta-Analysis. Laryngoscope 2021; 132:45-52. [PMID: 33635587 DOI: 10.1002/lary.29494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE/HYPOTHESIS The objective of this study was to perform a systematic review and meta-analysis to determine the impact of dental care on head and neck (H&N) cancer survival. METHODS A comprehensive literature search was performed using PubMed, MEDLINE, and CINAHL to find all relevant studies from the date of inception to March 2020. Systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and meta-analysis was performed using the random effects logistic regression model. Primary outcomes of interest were 5-year survival and hazard ratios comparing survival between dental care subgroups. RESULTS H&N cancer survival rates strongly correlate with dental care adherence. Patients with good dental care had significantly better survival than patients with poor dental care (HR = 0.67, 95% CI: 0.55-0.83), with similar improved survival among patients with moderate versus poor dental care (HR = 0.67, 95% CI: 0.57-0.80). In addition, patients with good dental care had significantly decreased mortality than those with moderate dental care (HR = 0.81, 95% CI: 0.69-0.96), indicating an exposure-response gradient. CONCLUSIONS For patients with H&N cancer, survival is significantly higher in those who receive recommended dental care compared with those who do not. LEVEL OF EVIDENCE N/A Laryngoscope, 2021.
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Affiliation(s)
- David Aaron Haynes
- Department of Otolaryngology -Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A
| | | | - M Boyd Gillespie
- Department of Otolaryngology -Head and Neck Surgery, UTHSC, Memphis, Tennessee, U.S.A
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15
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Wimardhani YS, Warnakulasuriya S, Wardhany II, Syahzaman S, Agustina Y, Maharani DA. Knowledge and Practice Regarding Oral Cancer: A Study Among Dentists in Jakarta, Indonesia. Int Dent J 2021; 71:309-315. [PMID: 33612266 PMCID: PMC9275102 DOI: 10.1016/j.identj.2020.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objective To assess Indonesian dentists' knowledge of risk factors and diagnostic procedures related to oral cancer (OC) and to determine the factors that influenced their level of knowledge. Methods A modified version of a questionnaire that had been used to assess dentists’ knowledge regarding OC in Canada was used. A total of 816 dentists were invited to participate in the study. Results The total response rate was 49.2%; however, the number of dentists from 5 regions in Jakarta were equally represented. Use of tobacco or alcohol and history of previous OC were the top 3 risk factors that were answered correctly by dentists, but there was a high proportion of dentists who considered some without any evidence as risk factors. Almost half of the dentists did not know the early signs of OC and that erythroplakia and leukoplakia were associated with increased risks of developing OC. Only about 27% of dentists had a high level of knowledge of risk factors and fewer dentists demonstrated a good knowledge of diagnostic procedures. Dentists’ age group, year of graduation, and experience of continuing education significantly influenced the level of knowledge of diagnostic procedures (P < .05). Conclusion Dentists in Jakarta had a considerable level of knowledge of major risk factors of OC, although some gaps in their knowledge, especially in diagnostic procedures, were present. Increasing these competencies may aid in the prevention and early detection of OC.
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Affiliation(s)
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK; World Health Organization, Collaborating Centre for Oral Cancer, London, UK
| | | | - Selvia Syahzaman
- Oral Medicine Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Yohana Agustina
- Oral Medicine Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Diah Ayu Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
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16
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Sheth S, Farquhar DR, Lenze NR, Mazul A, Brennan P, Anantharaman D, Abedi-Ardekani B, Zevallos JP, Hayes DN, Olshan F. Decreased overall survival in black patients with HPV-associated oropharyngeal cancer. Am J Otolaryngol 2021; 42:102780. [PMID: 33152576 PMCID: PMC7988501 DOI: 10.1016/j.amjoto.2020.102780] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Racial disparities for overall survival (OS) in head and neck cancer have been well described. However, the extent to which these disparities exist for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC), and the contribution of demographic, clinical, and socioeconomic status (SES) variables, is unknown. MATERIALS AND METHODS Patients were identified from the Carolina Head and Neck Cancer Epidemiology Study (CHANCE), a population-based study in North Carolina. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for OS in black versus white patients with sequential adjustment sets. RESULTS A total of 157 HPV-associated OPSCC patients were identified. Of these, 93% were white and 7% were black. Black patients with HPV-associated OPSCC were more likely to be younger, have an income <$20,000, live farther away from clinic where biopsy was performed, and have advanced T stage at diagnosis. Black patients had worse OS in the unadjusted analysis (HR 4.9, 95% CI 2.2-11.1, p < 0.0001). The racial disparity in OS slightly decreased when sequentially adjusting for demographic, clinical, and SES variables. However, HR for black race remained statistically elevated in the final adjustment set which controlled for age, sex, stage, smoking, alcohol use, and individual-level household income, insurance, and education level (HR 3.4, 95% CI 1.1-10.1, p = 0.028). CONCLUSION This is the first population-based study that confirms persistence of racial disparities in HPV-associated OPSCC after controlling for demographic, clinical, and individual-level socioeconomic factors.
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Affiliation(s)
- Siddharth Sheth
- Division of Medical Oncology, Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Douglas R Farquhar
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Nicholas R Lenze
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Angela Mazul
- Department of Otolaryngology, Washington University in Saint Louis, School of Medicine, St. Louis, MO 63110, USA
| | - Paul Brennan
- International Agency for Research on Cancer, France
| | | | | | - Jose P Zevallos
- Department of Otolaryngology, Washington University in Saint Louis, School of Medicine, St. Louis, MO 63110, USA
| | - D Neil Hayes
- Department of Medicine, Division of Hematology-Oncology, University of Tennessee Health Science Center, Memphis, TN 38163, USA; UTHSC Center for Cancer Research, University of Tennessee, Memphis, TN 38163, USA
| | - F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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17
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Jassal JS, Cramer JD. Explaining Racial Disparities in Surgically Treated Head and Neck Cancer. Laryngoscope 2020; 131:1053-1059. [PMID: 33107610 DOI: 10.1002/lary.29197] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES/HYPOTHESIS To assess the causative factors that contribute to racial disparities in head and neck squamous cell carcinoma (HNSCC) and establish the role of hospital factors in racial disparities. STUDY DESIGN Retrospective database analysis. METHODS Patients with surgically treated HNSCC were identified using the National Cancer Database (2004-2014). Logistic and proportional-hazard regression models were used to characterize the factors that contribute to racial disparities. Differences in quality of care received were compared among black and white patients using previously validated metrics. RESULTS We identified 69,186 eligible patients. Black patients had a 48% higher mortality than white patients (HR 1.48; 95% confidence interval [CI], 1.41-1.54). Black patients had a lower mean quality score (67.6%; 95% CI, 66.8%-69.4%) compared with white patients (71.2%: 95% CI, 71.0%-71.4%) for five quality metrics. After adjusting for differences in patient, oncologic, and hospital factors we were able to explain 60% of the excess mortality for black patients. Oncologic factors at presentation accounted for 57.7% of observed mortality differences, whereas hospital characteristics and quality of care accounted for 11.5%. After adjusting for these factors, black patients still had a 19% higher mortality (HR 1.19; 95% CI, 1.14-1.24). CONCLUSIONS Oncologic factors at presentation are a major contributor to racial disparities in outcomes for HNSCC. Hospital factors, such as quality, volume, and safety-net status, constitute a minor factor in the mortality difference. Resolving existing disparities will require detecting head and neck cancer at an earlier stage and improving the quality of care for black patients. LEVEL OF EVIDENCE 3. Laryngoscope, 131:1053-1059, 2021.
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Affiliation(s)
- Japnam S Jassal
- Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - John D Cramer
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
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18
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Rosso MT, Sharma A. Willingness of Adults in the United States to Receive HIV Testing in Dental Care Settings: Cross-Sectional Web-Based Study. JMIR Public Health Surveill 2020; 6:e17677. [PMID: 32706732 PMCID: PMC7404012 DOI: 10.2196/17677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/28/2020] [Accepted: 05/24/2020] [Indexed: 01/30/2023] Open
Abstract
Background The Centers for Disease Control and Prevention estimates that 1.1 million people in the United States are living with HIV and 1 in 8 are estimated to be unaware of their serostatus. Little is known about whether individuals would consider being tested for HIV in nontraditional health care settings such as a dentist’s office. Studies in selected US cities have indicated high acceptability of receiving an HIV test among people attending dental clinics. However, we are not aware of studies that have assessed willingness to receive HIV testing in dental care settings at a national level. Objective Using a web-based sample of adult residents of the United States, we sought to assess the self-reported willingness to receive any type of HIV testing (ie, oral fluid rapid testing, finger-stick blood rapid testing, or venipuncture blood testing) in a dental care setting and evaluate independent associations of willingness with the extent to which dental care providers were perceived as knowledgeable about HIV and how comfortable participants felt discussing HIV with their dental care providers. Methods Participants were recruited using banner advertisements featured on social networking platforms (Facebook and Instagram) from December 2018 to February 2019. Demographic and behavioral data including information on sexual behaviors in the past 6 months, HIV testing history, and dental/health care–seeking history were collected using an anonymous web-based survey. Willingness to receive any type of HIV testing in a dental care setting was assessed on 4-point scale from very willing to very unwilling. Factors independently associated with participants’ willingness were identified using a multivariable logistic regression model. Results Of the 421 participants in our study aged 18 to 73 years, 271 (64.4%) reported having oral sex, 197 (46.8%) reported having vaginal sex, and 136 (32.3%) reported having anal sex in the past 6 months. Approximately one-third had never been tested for HIV (137/421, 32.5%), and the same proportion had not been tested in the past year (137/421, 32.5%). Most participants had dental insurance coverage (356/421, 84.6%), and more than three-fourths reported being very or somewhat willing (326/421, 77.4%) to receive any type of HIV testing in a dental care setting. Higher levels of willingness were associated with being 18 to 24 years versus ≥35 years (aOR 3.22, 95% CI 1.48-6.98), 25 to 34 years versus ≥35 years (aOR 5.26, 95% CI 2.52-10.98), believing that one’s dental care provider is knowledgeable about HIV (aOR 2.04, 95% CI 1.06-3.92), and feeling comfortable discussing HIV with one’s dental care provider (aOR 9.84, 95% CI 3.99-24.27). Conclusions Our data indicate high acceptability of receiving HIV testing in a dental care setting, especially among those who report having a positive patient-provider relationship. Future research should focus on assessing dental care providers’ attitudes, self-efficacy, and beliefs about whether HIV testing fits into the scope of dentistry.
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Affiliation(s)
- Matthew T Rosso
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Akshay Sharma
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States.,Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
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19
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Farquhar DR, Lenze NR, Masood MM, Divaris K, Tasoulas J, Blumberg J, Lumley C, Patel S, Hackman T, Weissler MC, Yarbrough W, Zanation AM, Olshan AF. Access to preventive care services and stage at diagnosis in head and neck cancer. Head Neck 2020; 42:2841-2851. [DOI: 10.1002/hed.26326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/17/2020] [Accepted: 05/27/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Douglas R. Farquhar
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Nicholas R. Lenze
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Maheer M. Masood
- Department of Otolaryngology‐Head and Neck Surgery University of Kansas Medical Center Kansas City Kansas USA
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry University of North Carolina Chapel Hill North Carolina USA
- Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Jason Tasoulas
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Jeffrey Blumberg
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Catherine Lumley
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Samip Patel
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Trevor Hackman
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Mark C. Weissler
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Wendell Yarbrough
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Adam M. Zanation
- Department of Otolaryngology/Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina USA
| | - Andrew F. Olshan
- Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
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20
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Koyama S, Tabuchi T, Okawa S, Morishima T, Ishimoto S, Ishibashi M, Miyashiro I. Oral cavity cancer incidence rates in Osaka, Japan between 2000 and 2014. Oral Oncol 2020; 105:104653. [PMID: 32272382 DOI: 10.1016/j.oraloncology.2020.104653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/27/2020] [Accepted: 03/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND We investigated trends in oral cavity cancer incidence from 2000 to 2014 in Osaka, Japan. METHODS Using Osaka Cancer Registry (OCR) data, oral cavity cancer incidence number and age-standardized incidence rates were calculated according to three 5-year-time-periods: 2000-2004, 2005-2009 and 2010-2014. We calculated the distribution of clinical stage for each 5-year period and the proportion of oral cavity cancer among all cancers. RESULTS A total of 6,086 oral cavity cancers were registered in OCR in 2000-2014. Across the period, between 55.6% and 65.0% were 65 years+ and approximately 60% were men. Tongue cancer accounted for 30.4% to 43.8% of the registrations, while gum accounted for 30.7% to 34.7%. 36.3% to 37.3% were regional, while 1.8% to 2.8% were distant. The age-standardized incidence rate of oral cavity cancer increased from 2.1/100,000 in 2000 to 3.8/100,000 in 2014, although the proportion of oral cavity cancer among all cancers only increased slightly from 0.71% in 2000 to 0.92% in 2014. Proportion of localized stage cancer was 60.8%-67.5% for tongue and 31.0%-49.5% for gum or floor of mouth. Proportion of distant stage cancer was 0.3%-1.0% for tongue and 2.5%-4.2% for gum or floor of mouth. CONCLUSIONS Age-standardized incidence rate of oral cavity cancer increased, but was not higher than other countries. The proportion of localized stage tongue cancer was higher, while that of distant stage cancer was lower than other sites. Tongue cancer might be easier to detect in its earlier stages than other sites.
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Affiliation(s)
- Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan.
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Sumiyo Okawa
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Toshitaka Morishima
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Shunsuke Ishimoto
- Dentistry, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Miki Ishibashi
- Dentistry, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
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21
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Berenson AB, Hirth JM, Southerland JH. Knowledge of human papillomavirus among dental providers: A mixed methods study. Vaccine 2020; 38:423-426. [PMID: 31690468 DOI: 10.1016/j.vaccine.2019.10.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/14/2019] [Accepted: 10/25/2019] [Indexed: 01/29/2023]
Abstract
Dental professionals are encouraged by the American Dental Association (ADA) to recommend the HPV vaccine to eligible patients. To better understand their comfort level in following this recommendation, we conducted a mixed methods study of dentists and dental hygienists. A total of 173 providers were surveyed and 8 interviewed. The majority felt they had an important role in preventing HPV-related OPC and that they should educate their patients and encourage HPV vaccination. However, most providers had low knowledge about HPV and expressed a need to obtain more information on the topic. In particular, they desired information about the HPV vaccine, its connection to cancer and where to refer patients for vaccination. They also wanted access to visual aids to help them bring up the topic. This study demonstrates the need to develop and disseminate educational programs for dental providers so they can assist with efforts to raise HPV vaccination rates.
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Affiliation(s)
- Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health, Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, TX, United States.
| | - Jacqueline M Hirth
- Center for Interdisciplinary Research in Women's Health, Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, TX, United States
| | - Janet H Southerland
- Interprofessional Education, Institutional Effectiveness & Health Education Center, University of Texas Medical Branch, Galveston, TX, United States
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22
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Stamm T, Ritschl V, Platzer A, Omara M, Mosor E, Reichardt B, Schmitl L, Behanova M, Bekes K. Regional and gender differences in population-based oral health insurance data. Clin Oral Investig 2019; 24:2331-2339. [PMID: 31664593 DOI: 10.1007/s00784-019-03090-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Early dental monitoring contributes substantially to good oral health in children. However, little is known on whether children from different geographical regions and gender are equally reached with current preventive and curative oral health strategies. The aim of our study therefore was to explore regional and gender differences in a population-based oral health dataset of Austrian children up to the age of 14. MATERIALS AND METHODS We extracted the first electronically available health insurance data of children aged up to 14 years on dental services within a 4-year observation period in Austria and performed a separate analysis in up to 6-year-old children. In addition, we used a smaller randomly selected sample dataset of 3000 children as the large numbers would result in significant, but very small effects. RESULTS In a total of 130,895 children, of whom 77,173 children (59%) were up to the age of six, we detected an east-west gradient: The eastern regions of Austria showed an older age at first contact and a higher number of dental services. A child aged up to 6 years who needed more than four dental services had a likelihood of 40% to be from Vienna, Austria's capital city located in the east. The smaller random sample did not show significant gender differences. CONCLUSIONS Even in regions with a high density of dentists, such as Vienna, we obviously did not reach young children in the same extent as in other regions. CLINICAL RELEVANCE Stratified interventions could be developed to overcome regional inequalities.
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Affiliation(s)
- Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| | - Valentin Ritschl
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Alexander Platzer
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Maisa Omara
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.,Ludwig Boltzmann Cluster Arthritis & Rehabilitation, Vienna, Austria
| | - Erika Mosor
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | | | - Lina Schmitl
- Burgenländische Gebietskrankenkasse, Eisenstadt, Burgenland, Austria
| | - Martina Behanova
- Ludwig Boltzmann Institute for Osteology, Hanusch Hospital of the WGKK and AUVA Trauma Center, 1st Medical Department at Hanusch Hospital, Vienna, Austria
| | - Katrin Bekes
- Department of Pediatric Dentistry, School of Dentistry, Medical University of Vienna, Vienna, Austria
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23
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Gupta A, Sonis S, Uppaluri R, Bergmark RW, Villa A. Disparities in Oral Cancer Screening Among Dental Professionals: NHANES 2011-2016. Am J Prev Med 2019; 57:447-457. [PMID: 31443957 DOI: 10.1016/j.amepre.2019.04.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION As early detection of oral cancers is associated with better survival, oral cancer screening should be included in dental visits for adults. This study examines the rate and predictors of oral cancer screening exams among U.S. adults with a recent dental visit. METHODS Individuals aged ≥30 years who received a dental visit in the last 2 years, in the 2011-2016 National Health and Nutrition Examination Survey were analyzed in December 2018. Weighted multivariable logistic regression models examined the likelihood of intraoral and extraoral oral cancer screening exams, adjusting for age, sex, race/ethnicity, education, marital status, poverty income ratio, health insurance, tobacco smoking, and alcohol consumption. Subgroup analyses were conducted among races/ethnicities, smokers, and alcohol consumers. Statistical significance was set at p<0.01. RESULTS A total of 37.6% and 31.3% reported receiving an intraoral and extraoral oral cancer screening exam, respectively. Minority racial/ethnic groups versus white, non-Hispanics, less-educated versus more-educated, uninsured and Medicaid-insured versus privately insured, and low-income versus high-income participants were less likely to have received intraoral or extraoral oral cancer screening exams. There was no difference in the likelihood of being screened based on smoking status. Alcohol consumers were more likely to be screened. Among subgroups, less-educated and low-income individuals were less likely to be screened. CONCLUSIONS A significantly higher proportion of minority race/ethnicity and low SES individuals report not receiving an oral cancer screening exam, despite a recent dental visit. This selective screening by dental professionals is incompliant with guidelines and concerning because these groups are more likely to present with an advanced stage of oral cancer at diagnosis. An understanding of the reasons for discriminatory oral cancer screening practices could help develop effective interventions.
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Affiliation(s)
- Avni Gupta
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Stephen Sonis
- Division of Oral Medicine, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Ravindra Uppaluri
- Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
| | - Regan W Bergmark
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts; Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts; Patient Reported Outcomes, Value, and Experience Center, Brigham and Women's Hospital, Boston, Massachusetts
| | - Alessandro Villa
- Division of Oral Medicine, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
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Nazir MA. Predictors of Routine Dental Check-up Among Male Adolescents in Saudi Arabia. Acta Stomatol Croat 2019; 53:255-263. [PMID: 31749457 PMCID: PMC6820442 DOI: 10.15644/asc53/3/7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective To evaluate the association of socioeconomic factors and self-perceived oral conditions with routine dental check-up among male adolescents. Methods This cross-sectional study was conducted on male children (grade 10-12) from public schools in different cities of the Eastern province of Saudi Arabia. A multistage random sampling was used for the recruitment of study participants. A piloted questionnaire translated into the Arabic language was used for data collection. Results There were 586 students with mean age 16.86±0.87 years. The prevalence of routine dental visit within last year was 18.9%. Half of the entire sample had dental cavities (50.5%) and tooth sensitivity (50%) followed by dental pain (42.2%). Bivariate analyses found that the children with dental cavities (OR 0.4, 95% CI 0.26, 0.61), dental pain (OR 0.63, 95% CI 0.41, 0.97), and malodor (OR 0.41, 95% CI 0.23, 0.71) had significantly lower odds of routine dental visits than those without these conditions. The final model of multivariable logistic regression showed that dental cavities (OR 0.42, 95% CI 0.27, 0.66) and malodor (OR 0.45, 95% CI 0.25, 0.78) were significantly associated with lower likelihood of visiting dental office for a regular dental check-up. No significant influence of socioeconomic factors on routine dental attendance was observed. Conclusions A small proportion of children performed routine dental visits. The children with dental cavities and malodor were less likely to perform routine dental visits. The awareness about the importance of regular dental check-up should be raised to reduce the burden of oral diseases in schoolchildren.
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Peterson CE, Gordon SC, Le Hew CW, Dykens JA, Jefferson GD, Tampi MP, Urquhart O, Lingen M, Watson KS, Buscemi J, Fitzgibbon ML. Society of Behavioral Medicine position statement: Society of Behavioral Medicine supports oral cancer early detection by all healthcare providers. Transl Behav Med 2019; 9:819-822. [PMID: 30007335 PMCID: PMC7184875 DOI: 10.1093/tbm/iby075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Indexed: 11/12/2022] Open
Abstract
In response to the increasing incidence of certain oral and oropharyngeal cancers, the Society of Behavioral Medicine (SBM) calls on healthcare providers and legislators to expand awareness of oral and oropharyngeal cancer risk factors, increase early detection, and support policies that increase utilization of dental services. SBM supports the American Dental Association's 2017 guideline for evaluating potentially malignant oral cavity disorders and makes the following recommendations to healthcare providers and legislators. We encourage healthcare providers and healthcare systems to treat oral exams as a routine part of patient examination; communicate to patients about oral/oropharyngeal cancers and risk factors; encourage HPV vaccination for appropriate patients based on recommendations from the Advisory Committee on Immunization Practices; support avoidance of tobacco use and reduction of alcohol consumption; and follow the current recommendations for evaluating potentially malignant oral cavity lesions. Because greater evidence is needed to inform practice guidelines in the primary care setting, we call for more research in collaborative health and dental services. We encourage legislators to support policies that expand Medicaid to cover adult dental services, increase Medicaid reimbursement for dental services, and require dental care under any modification of, or replacement of, the Affordable Care Act.
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Affiliation(s)
- Caryn E Peterson
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA
| | - Sara C Gordon
- School of Dentistry, University of Washington, Seattle, WA, USA
| | - Charles W Le Hew
- College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - J A Dykens
- Center for Global Health and College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | | | - Mark Lingen
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | | | | | - Marian L Fitzgibbon
- Institute for Health Research and Policy and Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
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Rosen EB, Drew A, Huryn JM. Oncology Curricula in Postgraduate General Dentistry Programs: a Survey of Residency Program Directors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:329-333. [PMID: 29196905 DOI: 10.1007/s13187-017-1306-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Management of patients undergoing treatment for cancer requires a multidisciplinary team including general dentistry providers; however, the relative knowledge and training of general dentists in the management of this patient population are relatively unknown. The purpose of this study was to assess the oncology curricula of postgraduate general dentistry training programs, from the perspective of the program directors, to better understand the opportunities for and/or barriers to dental care for cancer patients. A cross-sectional survey was sent to the 275 Commission on Dental Accreditation-accredited programs; 82 program directors responded (response rate, 30%). More than 50% of respondents indicated "none" or "little" curricular emphasis on cancer biology, bone marrow transplantation, immunotherapy, or prosthetics for use during head and/or neck surgery. Conversely, more than 50% of respondents indicated "moderate" or "substantial" emphasis on acute oral effects of cancer-related therapy, long-term oral effects of cancer-related therapy, antiresorptive medication pharmacology, radiotherapy techniques and biological effects, and osteonecrosis of the jaw. Residents had the most experience with radiotherapy patients and the least with bone marrow or transplantation patients. Overall, general dentistry program directors were enthusiastic to participate in the multidisciplinary team but reported challenges to including oncology curricula in residency training programs. Training for general dentistry providers in formalized postgraduate residency programs may be variable or limited-as a result, communication regarding patient management is critical. Opportunities exist to enhance the general dentistry curricula and, thereby, improve access to dental care for patients receiving treatment for cancer.
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Affiliation(s)
- Evan B Rosen
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - Alexander Drew
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Joseph M Huryn
- Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
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Gigliotti J, Madathil S, Makhoul N. Delays in oral cavity cancer. Int J Oral Maxillofac Surg 2019; 48:1131-1137. [PMID: 30878273 DOI: 10.1016/j.ijom.2019.02.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 02/23/2019] [Indexed: 01/27/2023]
Abstract
While the prognosis for early-stage oral cavity cancer is relatively good; the majority of patients are still diagnosed with advanced-stage disease on presentation with an associated poorer prognosis. The aims of this review are to summarize our current understanding of delays in oral cavity cancer and their impact on stage at diagnosis and survival. The delays pathway can be subdivided into three components: patient, professional, and treatment delays. Patient delay represents the longest interval in the delays pathway usually lasting between 2 and 5 months and being most influenced by cognitive and psychosocial factors. Professional and treatment delays are shorter in most studies, but highly variable depending on the respective healthcare system. Most studies indicate that advanced stage at diagnosis, primary treatment with radiotherapy, treatment at an academic center, and transitions in care are associated with an increased treatment delay. Based on our current understanding, a delay between definitive diagnosis and treatment of 4-6 weeks seems acceptable from an oncologic perspective. Further studies are needed to better define what a 'safe' waiting time is and to understand the psychological impact of delays for patients.
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Affiliation(s)
- J Gigliotti
- Department of Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - S Madathil
- Department of Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - N Makhoul
- Department of Oral and Maxillofacial Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
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Gupta B, Kumar N, Johnson NW. Evidence of past dental visits and incidence of head and neck cancers: a systematic review and meta-analysis. Syst Rev 2019; 8:43. [PMID: 30717784 PMCID: PMC6360721 DOI: 10.1186/s13643-019-0949-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 01/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Regular/frequent dental visits, at least annually, can aid in reducing the public health burden of head and neck cancers (HNCs) by facilitating earlier detection of the disease. The aim of this study was to conduct a quantitative assessment of any independent association between past dental visits/check-ups and incidence of cancers of HN/upper aerodigestive tract (UADT) and oral cavity worldwide. METHODS PubMed, CINAHL, and Cochrane databases were searched for all observational studies published until August 2017 in any language that assessed an association of past dental visits/dental check-ups among the incident cases of HNC/UADT cancers. Screening and quality assessment of the articles was performed by two independent reviewers. Three different meta-analyses were conducted: two based on the incident cancer reported in the studies (HNCs/cancers of UADT and oral cavity); another included all studies irrespective of the type of cancer reported with the frequency of past dental visits as subgroups. RESULTS Searches retrieved 3164 titles: after removing duplicates, 1377 remained. Of these, 62 were reviewed in full, but only 38 were eligible for inclusion. Under the random effects model, odds of past never/irregular/not frequent dental visits were greater in HNC cases and oral cancer cases as compared to the hospital-based/population-based controls [HNCs-unadjusted odds ratio (OR) 2.24; 95% confidence interval (CI) 1.89 to 2.65) and (oral cancers-OR 1.93; 95% CI 1.47 to 2.52]. Similar results were observed for all cancers with frequency of past dental visits as subgroup analysis (OR 2.01; 95% CI 1.76 to 2.30). Meta-regression findings indicate that none of the subgroup influenced the effect estimates for incidence of cancers. There was no publication bias in our study. CONCLUSION This systematic review and meta-analysis indicates that individuals with never/irregular/not frequent dental visits are more likely to be incident cases of HNCs/UADT cancers.
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Affiliation(s)
- Bhawna Gupta
- Torrens University, Adelaide, South Australia, 5000, Australia.
| | - Narinder Kumar
- Department of Orthopaedics, Base Hospital, Lucknow, India
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
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Wimardhani YS, Warnakulasuriya S, Subita GP, Soegyanto AI, Pradono SA, Patoni N. Public awareness of oral cancer among adults in Jakarta, Indonesia. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2019; 10:e12379. [PMID: 30499194 DOI: 10.1111/jicd.12379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/06/2018] [Indexed: 01/02/2023]
Abstract
AIM The aim of the present study was to investigate the awareness of oral cancer among adults in Jakarta, Indonesia, and explore the factors influencing it. METHODS A previously-tested questionnaire on 1000 adults in Jakarta was used in the present study. The data included sociodemographic factors and answers to assess the awareness of oral cancer, early signs and symptoms, risks factors, lifestyles, and history of dental visits. RESULTS Only 53.2% of participants were aware of oral cancer. The level of awareness significantly differed by level of education, occupation, and experience of dental visits. Only 30% of patients had been asked about their tobacco and alcohol habits, and had been informed about the hazards of these by their dentists. All of the smokers knew that tobacco increased the risk for oral cancer. However, only a few participants considered alcohol, betel quid chewing, UV light exposure, poor diet, and genetics to play role in the development of oral cancer. Health warnings were the main source of information about oral cancer; the role of health professionals is still quite low and needs to be emphasized. CONCLUSION Oral cancer awareness is still low among adults in Jakarta; this finding was consistent with other studies conducted in Asia. Educational material suited to particular communities is warranted.
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Affiliation(s)
- Yuniardini S Wimardhani
- Department of Oral Medicine, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia
| | - Saman Warnakulasuriya
- Department of Oral Medicine, King's College London, London, UK
- World Health Organization Collaborating Centre for Oral Cancer, London, UK
| | - Gus P Subita
- Department of Oral Medicine, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia
| | - Anandina I Soegyanto
- Department of Oral Medicine, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia
| | - Siti A Pradono
- Department of Oral Medicine, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia
| | - Nurfianti Patoni
- Oral Medicine Residency Program, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia
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Sharma AS, Sheth SA, Dhaduk PJ, Chovateeya SR, Mistry BJ, Jogi MR. Oral Hygiene Practices and Factors Affecting Oral Health Service Utilization among Children (11-14 Years) of Government School of Nikol Ward of East Zone of Ahmedabad, Gujarat, India. Contemp Clin Dent 2019; 10:299-303. [PMID: 32308294 PMCID: PMC7145258 DOI: 10.4103/ccd.ccd_549_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Oral hygiene practices and factors affecting oral health service utilization among the children of 10-16 years of age play a vital role in achieving comprehensive dental care. AIMS This study was done to assess oral hygiene practices, creating oral hygiene awareness, and to analyze the overt hurdles in getting basic and timely dental care among children. MATERIALS AND METHODS It was a cross-sectional survey conducted among 200 schoolchildren aged 11-14 years using a pretested, semistructured questionnaire, and clinical examination was done to assess dental caries. Convenience sampling method was used, and the sample size for the study was equal to the total number of participants. The logistic regression analysis along with odds ratios with 95% confidence interval and P < 0.05 was also reported. Chi-square test was used for statistical analysis of dental caries prevalence. RESULTS Around 70% of the study participants had the habit of brushing their teeth once daily, whereas only 30% of them used to brush their teeth twice daily. The prevalence of dental caries shows an upward trend with increasing age from 11 to 14 years. Cost of dental treatment, transportation, and dental taboos followed by fear of dental treatment are the major constraints for the students in accessing dental treatment. CONCLUSION School-based tooth brushing and oral health education programs should be regularly organized to promote healthy tooth brushing practices. The cost-effective and timely transportation services along with proper oral health education in alleviating fear of dental treatment and dental taboos should be provided to these children for enhancing the utilization of dental services.
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Affiliation(s)
- Ashish S. Sharma
- Department of Public Health Dentistry, A.M.C. Dental College & Hospital, Ahmedabad, Gujarat, India,Address for correspondence: Dr. Ashish S. Sharma, 30 Kunj Homes, Near Rameshwar School, Nava Nikol, Ahmedabad - 382 350, Gujarat, India. E-mail:
| | - Sona A. Sheth
- Department of Public Health Dentistry, A.M.C. Dental College & Hospital, Ahmedabad, Gujarat, India
| | - Parshad J. Dhaduk
- Department of Public Health Dentistry, A.M.C. Dental College & Hospital, Ahmedabad, Gujarat, India
| | - Siddhi R. Chovateeya
- Department of Public Health Dentistry, A.M.C. Dental College & Hospital, Ahmedabad, Gujarat, India
| | - Bansri J. Mistry
- Department of Public Health Dentistry, A.M.C. Dental College & Hospital, Ahmedabad, Gujarat, India
| | - Megha R. Jogi
- Department of Public Health Dentistry, A.M.C. Dental College & Hospital, Ahmedabad, Gujarat, India
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Berkowitz C, Allen D, Tenhover J, Zullig L, Fischer J, Pollak K, Hicks M, Hillson J, Koontz B. Head and Neck Cancer Survivors: Specific Needs and Their Implications for Survivorship Care Planning. Clin J Oncol Nurs 2018; 22:523-528. [DOI: 10.1188/18.cjon.523-528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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LeHew CW, Weatherspoon DJ, Peterson CE, Goben A, Reitmajer K, Sroussi H, Kaste LM. The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016. Epidemiol Rev 2018; 39:132-147. [PMID: 28402398 DOI: 10.1093/epirev/mxw001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 09/26/2016] [Indexed: 12/19/2022] Open
Abstract
Oral cavity and oropharyngeal cancers are typically grouped under the general term, "oral cancer." Yet, the incidence of oropharyngeal cancers is increasing in the United States, while the incidence of oral cavity cancers has declined. These 2 distinct but conflated groups of oral cancers are attributed to different risk factors. Incidence and survival trends were examined across US population groups and by anatomical subsite. Disparities in incidence and survival by sex, race/ethnicity, and subsite were identified. Risk factors are complex, interactive, and not fully identified. Cancer control research illustrates health disparities in access to care and patient outcomes. Database and supplemental searches yielded 433 articles published between 1995 and 2016 characterizing aspects of oral cancer epidemiology relating to incidence, survival, risk, disparities, and cancer control. Oral cavity cancer survival in black men remains the most intractable burden. Although understanding of oral cancer etiology is improving, application to policy is limited. Cancer control efforts are diverse, sporadic, limited in scope, and generally lacking in success, and they need stratification by oral cavity cancers/oropharyngeal cancers. Further intervention and epidemiologic research, improved workforce capacity, and integrated care delivery are identified as important directions for public health policy. Sustained, multilevel campaigns modeled on tobacco control success are suggested.
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John JR, Mannan H, Nargundkar S, D'Souza M, Do LG, Arora A. Predictors of dental visits among primary school children in the rural Australian community of Lithgow. BMC Health Serv Res 2017; 17:264. [PMID: 28399864 PMCID: PMC5387289 DOI: 10.1186/s12913-017-2232-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/05/2017] [Indexed: 12/31/2022] Open
Abstract
Background Regular dental attendance is significant in maintaining and improving children’s oral health and well-being. This study aims to determine the factors that predict and influence dental visits in primary school children residing in the rural community of Lithgow, New South Wales (NSW), Australia. Methods All six primary schools of Lithgow were approached to participate in a cross-sectional survey prior to implementing water fluoridation in 2014. Children aged 6–13 years (n = 667) were clinically examined for their oral health status and parents were requested to complete a questionnaire on fluoride history, diet, last dental visit, and socio-demographic characteristics. Multiple logistic regression analyses were employed to examine the independent predictors of a 6-monthly and a yearly dental visit. Results Overall, 53% of children visited a dentist within six months and 77% within twelve months. In multiple logistic regression analyses, age of the child and private health insurance coverage were significantly associated with both 6-monthly and twelve-month dental visits. In addition, each serve of chocolate consumption was significantly associated with a 27% higher odds (OR = 1.27, 95% CI: 1.05-1.54) of a 6-monthly dental visit. Conclusion It is imperative that the socio-demographic and dietary factors that influence child oral health must be effectively addressed when developing the oral health promotion policies to ensure better oral health outcomes.
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Affiliation(s)
- James Rufus John
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia
| | - Haider Mannan
- Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Subrat Nargundkar
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia
| | - Mario D'Souza
- Clinical Research Centre, Sydney Local Health District, Camperdown, NSW, Australia
| | - Loc Giang Do
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
| | - Amit Arora
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia. .,Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia. .,Discipline of Paediatrics and Child Health, Sydney Medical School, Westmead, NSW, Australia. .,Collaboration for Oral Health Outcomes Research, Translation, and Evaluation (COHORTE) Research Group, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
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Willink A, Schoen C, Davis K. Dental Care And Medicare Beneficiaries: Access Gaps, Cost Burdens, And Policy Options. Health Aff (Millwood) 2016; 35:2241-2248. [DOI: 10.1377/hlthaff.2016.0829] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Amber Willink
- Amber Willink is an assistant scientist in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland
| | - Cathy Schoen
- Cathy Schoen is a senior scholar at the New York Academy of Medicine, in New York City
| | - Karen Davis
- Karen Davis is the Eugene and Mildred Lipitz Professor in and director of the Roger C. Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
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Gbotolorun OM, Emeka CI, Effiom O, Adewole RA, Ayodele AS. An Audit of Malignant Oro-facial Tumors Presenting at a Tertiary Hospital in Lagos. Ann Med Health Sci Res 2016; 6:133-6. [PMID: 27213098 PMCID: PMC4866367 DOI: 10.4103/2141-9248.181840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Oro-facial malignancies are reported to have a high mortality and morbidity, this is further worsened when patient report late. To analyze the malignant oro-facial lesions seen at a Hospital in the Lagos, Nigeria. Successive patients that presented in the hospital and met criteria of study during 15 months period were recruited into the study. Demographics, clinical variables, and treatment provided for each patient in the hospital was recorded. Data collected were presented as tables and percentages. There were 36 cases seen, their ages ranged from 10 to 72 years (median 49 years), and there were 21 males and 15 females. Time lapse before presentation to the clinic ranged from 2 to 30 months, mean (9.9 (±5.5 months and the largest dimension of lesions at presentation ranged from 2 cm to 12 cm (mean 6.4 ± 2.0 cm). Most common site of presentation was posterior tongue (16.7%; 6/36) and Squamous cell carcinoma (41.6%; 15/36) was the most common histopathologic diagnosis. Twenty-three patients (63.9%; 23/36) had primary surgeries in the hospital. Patients seen in this case series generally reported late with large lesions.
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Affiliation(s)
- O M Gbotolorun
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - C I Emeka
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
| | - O Effiom
- Department of Oral Pathology, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - R A Adewole
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - A S Ayodele
- Department of Oral and Maxillofacial Surgery, General Hospital Lagos, Lagos, Nigeria
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Enomoto LM, Bann DV, Hollenbeak CS, Goldenberg D. Trends in the Incidence of Oropharyngeal Cancers in the United States. Otolaryngol Head Neck Surg 2016; 154:1034-40. [DOI: 10.1177/0194599816633690] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/29/2016] [Indexed: 11/17/2022]
Abstract
Objective The incidence of oropharyngeal squamous cell carcinoma (SCCa) has increased in the United States despite a decrease in tobacco usage, and it may be driven by an increase in oral human papilloma virus (HPV) infection. We studied the incidence of tongue base and tonsillar SCCa over time to understand the changing epidemiology of oropharyngeal SCCa. Setting Large national tumor registry. Subjects and Methods We studied patients diagnosed with oropharyngeal SCCa in SEER data (Surveillance, Epidemiology, and End Results) from 1973 to 2009. Age-adjusted incidence rates standardized to the 2000 US population were computed, with stratifications for age, sex, race, and stage. Results The sample included 10,061 tongue base and 11,515 tonsillar oropharyngeal cancers. When stratified by age, the incidence of oropharyngeal SCCa in patients ≤55 years of age more than doubled over 30 years. While the incidence rate in females remained stable, the rate in males more than doubled, from 2 per 100,000 persons in 1973 to >4 per 100,000 persons in 2009. The age-adjusted incidence of oropharyngeal SCCa in patients of black race/ethnicity remained consistently elevated, but the incidence in patients of white race/ethnicity rose from 1.3 per 100,000 persons to >2.5 per 100,000 persons, surpassing the incidence in black patients starting in 2002. Conclusion The observation that the incidence of oropharyngeal SCCa is increasing among younger white males, despite a reduction in tobacco usage in the United States, is consistent with HPV as the source. Primary and secondary prevention strategies may be warranted in this population.
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Affiliation(s)
- Laura M. Enomoto
- Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Darrin V. Bann
- Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Christopher S. Hollenbeak
- Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - David Goldenberg
- Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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Tax CL, Haslam SK, Brillant M, Doucette HJ, Cameron JE, Wade SE. Oral cancer screening: knowledge is not enough. Int J Dent Hyg 2015; 15:179-186. [PMID: 26333090 DOI: 10.1111/idh.12172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The purpose of this cross-sectional study was to investigate whether dental hygienists are transferring their knowledge of oral cancer screening into practice. This study also wanted to gain insight into the barriers that might prevent dental hygienists from performing these screenings. METHODS A 27-item survey instrument was constructed to study the oral cancer screening practices of licensed dental hygienists in Nova Scotia. A total of 623 practicing dental hygienists received the survey. The response rate was 34% (n = 212) yielding a maximum margin of error of 5.47 at a 95% confidence level. Descriptive statistics were calculated using IBM SPSS Statistics v21 software (Armonk, NY:IBM Corp). Qualitative thematic analysis was performed on any open-ended responses. RESULTS This study revealed that while dental hygienists perceived themselves as being knowledgeable about oral cancer screening, they were not transferring this knowledge to actual practice. Only a small percentage (13%) of respondents were performing a comprehensive extra-oral examination, and 7% were performing a comprehensive intra-oral examination. The respondents identified several barriers that prevented them from completing a comprehensive oral cancer screening. CONCLUSIONS Early detection of oral cancer reduces mortality rates so there is a professional responsibility to ensure that comprehensive oral cancer screenings are being performed on patients. Dental hygienists may not have the authority in a dental practice to overcome all of the barriers that are preventing them from performing these screenings. Public awareness about oral cancer screenings could increase the demand for screenings and thereby play a role in changing practice norms.
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Affiliation(s)
- C L Tax
- School of Dental Hygiene, Dalhousie University, Halifax, NS, Canada
| | - S Kim Haslam
- School of Dental Hygiene, Dalhousie University, Halifax, NS, Canada
| | - Mgs Brillant
- Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - H J Doucette
- School of Dental Hygiene, Dalhousie University, Halifax, NS, Canada
| | - J E Cameron
- School of Dental Hygiene, Dalhousie University, Halifax, NS, Canada
| | - S E Wade
- School of Dental Hygiene, Dalhousie University, Halifax, NS, Canada
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Gibberd A, Supramaniam R, Dillon A, Armstrong BK, O'Connell DL. Are Aboriginal people more likely to be diagnosed with more advanced cancer? Med J Aust 2015; 202:195-9. [PMID: 25716602 DOI: 10.5694/mja14.00701] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/09/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether Aboriginal people in New South Wales were diagnosed with more advanced cancer than non-Aboriginal people. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study of cancer cases, excluding lymphohaematopoietic cancers and cancers of unknown primary site, diagnosed in NSW in 2001-2007. MAIN OUTCOME MEASURE Spread of disease at time of cancer diagnosis. RESULTS Overall, 40.3% of 2039 cancers in Aboriginal people and 46.6% of 191 954 cancers in non-Aboriginal people were localised at diagnosis. After adjusting for age, sex, year of diagnosis, area of residence and socioeconomic status, Aboriginal people had significantly higher risks of regional or distant spread for head and neck cancer, relative to localised spread, than non-Aboriginal people (regional: adjusted relative risk ratio [RRR], 1.89; 95% CI, 1.21-2.98; distant: adjusted RRR, 3.40; 95% CI, 1.85-6.05; P < 0.001). For breast, cervical and prostate cancers and melanoma, the risks of regional or distant spread were higher for Aboriginal people, but these differences were not statistically significant. For lung, colorectal, upper gastrointestinal tract, other gynaecological, and eye, brain and central nervous system cancers, the risks of regional, distant and unknown spread of cancer were similar for Aboriginal and non-Aboriginal people. CONCLUSION Aboriginal people were more likely than non-Aboriginal people to be diagnosed with more advanced cancer for only a few cancer types, most notably head and neck cancers. Differences in spread of disease at diagnosis are unlikely to explain much of the survival differences observed across a wide range of cancers between Aboriginal and non-Aboriginal people in NSW.
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Jiang Y, Liao L, Shrestha C, Li D, Li M, Mu Y, Crumrine D, Wang L, Xie Z. Inhibition of 4-nitroquinoline-1-oxide-induced oral carcinogenesis by dietary calcium. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:3529-3542. [PMID: 26097536 PMCID: PMC4466923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 03/30/2015] [Indexed: 06/04/2023]
Abstract
Calcium is a strong inducer of keratinocyte differentiation. We have previously demonstrated that extracellular calcium promotes keratinocyte differentiation via E-cadherin-catenin complex-mediated phospholipase C-γ1 (PLC-γ1) activation in the plasma membrane. However, it is unclear whether dietary calcium regulates keratinocyte proliferation, differentiation or carcinogenesis. To address this issue, the rates of oral tumor and levels of proliferation and differentiation in the oral epithelium were assessed in mice on different calcium diets and the carcinogen 4-nitroquinoline-1-oxide. The results showed that mice on the high calcium diet had lower rates of oral tumors, lower levels of proliferation and higher levels of differentiation in the normal oral epithelium than those on the normal calcium diet. Higher levels of E-cadherin, β-catenin, p120-catenin (p120), epidermal growth factor receptor (EGFR), and calcium and lower levels of PLC-γ1 were also noted in the normal oral epithelium in mice on high calcium diet than the control mice. In contrast, mice on low calcium diet had opposite effects. However, dietary calcium had no effect on the proliferation, differentiation or the levels of E-cadherin, β-catenin, p120, PLC-γ1 and EGFR in oral tumors. These data indicate that dietary calcium increases calcium levels in oral epithelium, suppresses oral carcinogenesis, inhibits proliferation and promotes differentiation of normal oral epithelium. Increased E-cadherin, β-catenin, p120 and EGFR and decreased PLC-γ1 may participate in the inhibitory effect of dietary calcium in oral carcinogenesis.
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Affiliation(s)
- Yi Jiang
- Department of Endocrinology and Metabolism, The Second Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Liyan Liao
- Department of Endocrinology and Metabolism, The Second Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Chandrama Shrestha
- Department of Endocrinology and Metabolism, The Second Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Daiqiang Li
- Department of Pathology, The Second Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Meirong Li
- Department of Pathology, The Second Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Ying Mu
- Department of Pathology, The Second Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Debra Crumrine
- Endocsrine Unit, Veterans Affairs Medical Center, Northern California Institute for Research and Education and University of CaliforniaSan Francisco, CA 94121, USA
| | - Larry Wang
- Department of Pathology, Children’s Hospital Los Angeles, University of Southern CaliforniaLos Angeles, CA 90027, USA
| | - Zhongjian Xie
- Department of Endocrinology and Metabolism, The Second Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
- Endocsrine Unit, Veterans Affairs Medical Center, Northern California Institute for Research and Education and University of CaliforniaSan Francisco, CA 94121, USA
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González-Arriagada WA, de Andrade MAC, Ramos LMA, Bezerra JRS, Santos-Silva AR, Lopes MA. Evaluation of an educational video to improve the understanding of radiotherapy side effects in head and neck cancer patients. Support Care Cancer 2013; 21:2007-15. [DOI: 10.1007/s00520-013-1730-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 01/28/2013] [Indexed: 11/28/2022]
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