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Sari EF, Hidayat W, Dewi TS, Rezeki S, Krimadi R, McCullough MJ, Cirillo N. General dentists' knowledge, perceptions, and practices regarding oral potentially malignant disorders and oral cancer in Indonesia. Clin Exp Dent Res 2024; 10:e807. [PMID: 38009492 PMCID: PMC10860440 DOI: 10.1002/cre2.807] [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: 07/07/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION The most effective means for reducing oral cancer (OC) mortality is by preventing late-stage disease. Early diagnosis can be improved by increasing awareness among healthcare providers, specifically general dental practitioners (GDP). Therefore, our study aimed to assess GDPs' knowledge of OC risk factors and perceived competence in performing conventional oral examination (COE) in routine dental practice. MATERIAL AND METHODS This was a cross-sectional study conducted in five provinces of Indonesia, namely: Aceh, Banda Aceh (BA); Bandung, West Java (WJ); special district Jakarta (JKT), JKT; Pontianak, West Kalimantan (WK); and Sorong, West Papua (WP). The local Dental Association or Faculty of Dentistry invited the GDPs to attend an education program and complete the survey. RESULTS One hundred seventy-seven GDPs completed the survey (WJ, n = 63; BA, n = 44, JKT, n = 27; WP, n = 23; and WP, n = 20). A large proportion (164 out of 177, 92.66%) of GDPs felt they had received insufficient training to equip them to diagnose OC and as many as 22.6% (n = 40) did not refer to specialists when they found suspicious mucosal lesions. Notwithstanding the significant regional variations, the majority of Indonesian GDPs self-reported inadequate knowledge and awareness of OC and scarce confidence in performing COE. CONCLUSION GDP knowledge of OC risk factors and COE is key to improving early diagnosis of OC at a community level. Therefore, it is suggested that the lack of knowledge and confidence of GDPs reported here should be addressed through the national dental curriculum in Indonesia.
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Affiliation(s)
- Elizabeth Fitriana Sari
- Melbourne Dental SchoolThe University of MelbourneCarltonVictoriaAustralia
- Dentistry Discipline, Department of Rural Clinical ScienceLa Trobe Rural Health SchoolBendigoAustralia
- Faculty of DentistryUniversitas PadjadjaranBandungIndonesia
| | - Wahyu Hidayat
- Faculty of DentistryUniversitas PadjadjaranBandungIndonesia
| | | | - Sri Rezeki
- Faculty of DentistryUniversitas Syiah KualaBanda AcehIndonesia
| | | | | | - Nicola Cirillo
- Melbourne Dental SchoolThe University of MelbourneCarltonVictoriaAustralia
- School of DentistryUniversity of JordanAmmanJordan
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Lan R, Galieri AC, Catherine JH, Tardivo D. Oral cancer: Current status and public health perspectives. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:93-105. [PMID: 38040651 DOI: 10.3917/spub.hs1.2023.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Despite advances in surgical and oncological treatments, the incidence and five-year survival rates (~50 percent) of oral cancers (OC) have not improved over the last decades and remain a major public health problem. Seventy percent are still diagnosed at a late stage (T3 or T4), with an average delay in diagnosis of two to five months. As the cure and survival of patients are directly related to the development stage of the tumor at the time of diagnosis, the objective of this work was to analyze all the determinants related to oral cancer and to propose new clinical approaches for diagnosis and screening. A proposal for new models of screening, training, and concrete action to improve public awareness of the major global problem of OC is made. The strengths and weaknesses of OC screening studies need to be objectively understood to effectively guide and energize testing in primary care settings, with the prospect of using new and emerging technologies that can help improve the discriminatory accuracy of case detection. Most national organizations have not, to date, recommended population-based mass screening, due to a lack of sufficient scientific evidence of associated mortality reduction. Where health care resources are high, opportunistic individual screening is recommended, although the low diagnostic capacity of front-line clinicians is alarming.
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Antoranz-Pereda A, de Pedro M, Navarrete N, Vizoso-Noval B, Cidoncha-Cabrerizo G, Pérez R, Casañas E, Muñoz-Corcuera M. Evaluation of the diagnostic ability of oral lesions on clinical images among undergraduate dental students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:1109-1116. [PMID: 36970773 DOI: 10.1111/eje.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/02/2023] [Accepted: 03/11/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The dentist should be able to carry out systematic oral examinations of the mucosa of patients in order to diagnose any alterations at an early stage. MATERIALS AND METHODS An observational, analytical, prospective, and longitudinal study was carried out. 161 students were evaluated at the beginning of their clinical practice in their 4th year of dental school (September 2019), at the beginning and at the end of their 5th year of dental school (June 2021). Thirty oral lesions were projected, and the students were asked to provide an answer; if the lesions were benign, malignant, or potentially malignant, whether they should be biopsied and/or treated and a presumptive diagnosis. RESULTS Significant improvement (p < .001) was obtained between the 2019 and 2021 results, in relation to the classification, need for biopsy and treatment of lesions. For differential diagnosis, no significant difference (p = .985) was obtained between the 2019 and 2021 responses. Malignant lesions and PMD obtained mixed results, with the best results corresponding to OSCC. DISCUSSION In this study, a correct lesion classification by the students was over 50%. As for the OSCC, the results were superior to the rest of the images, reaching more than 95% correct. CONCLUSION Theoretical-practical training from universities and continuing education for graduates in relation to oral mucosal pathologies should be further promoted.
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Affiliation(s)
- Ana Antoranz-Pereda
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
| | - Miguel de Pedro
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
| | - Natalia Navarrete
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
| | - Beatriz Vizoso-Noval
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
| | - Gema Cidoncha-Cabrerizo
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
| | - Ruth Pérez
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
| | - Elisabeth Casañas
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
| | - Marta Muñoz-Corcuera
- Faculty of Biomedical Sciences, Department of Dentistry, Universidad Europea de Madrid, Madrid, Spain
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Achan J, Kasujja FX, Opito R, Wabinga H, Orach CG, Mwaka AD. Factors associated with diagnostic and pre-treatment intervals among breast cancer patients attending care at the Uganda Cancer Institute: A cross-sectional study. Cancer Med 2023; 12:19701-19713. [PMID: 37787090 PMCID: PMC10587984 DOI: 10.1002/cam4.6618] [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: 01/26/2023] [Revised: 08/09/2023] [Accepted: 09/23/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Most breast cancer (BC) patients in Uganda are diagnosed with advanced-stage disease and experience poor outcomes. This study examined the diagnostic and pre-treatment intervals and factors associated with these intervals among BC patients attending care at the Uganda Cancer Institute (UCI). METHODS This was a cross-sectional, facility-based study. Data were collected using structured questionnaire administered by trained research assistants and analyzed using STATA version 14.0. Modified Poisson regressions models were used to determine the strength of associations between independent variables and diagnostic and pre-treatment intervals. RESULTS The mean age (±SD) of the 401 participants was 47.1 ± 11.7 years. Four in 10 participants had stage III (41.9%; n = 168) and over a third (34.7%; n = 140) stage IV cancers. The median interval from first consultation to diagnosis, i.e. diagnostic interval (DI) was 5.6 months (IQR: 1.5-17.0), while the median interval from histological diagnosis to start of chemotherapy, i.e. pre-treatment interval (PTI) was 1.7 months (IQR: 0.7-4.5). Majority (85%, n = 341) of participants were diagnosed at ≥3 months from first consultation with clinicians. Participants with tertiary education and those who lived within 100-199 km from the UCI were about four times and twice more likely to be diagnosed early (DI <3 months from first consultation) ([aPR = 3.88; 95% CI: 1.15-13.0] and [aPR = 2.19; 95% CI: 1.06-4.55]), respectively. About half (48.3%; n = 176) of participants started chemotherapy within 1 month of cancer diagnosis. Patients who lived more than 300 km from the UCI were less likely to start chemotherapy within 1 month of histology diagnosis of cancer. [Correction added on October 17, 2023 after first online publication. The term ', i.e.' has been included in the results section in this version.] CONCLUSION: Majority of breast cancer patients are diagnosed late and in advanced stages. There is need to promote all efforts toward timely diagnosis when cancers are still in early stages by identifying factors responsible for prolonged diagnostic intervals among breast cancer patients.
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Affiliation(s)
- Jennifer Achan
- Department of Community Health & Behavioral Sciences, School of Public HealthCollege of Health Sciences, Makerere UniversityKampalaUganda
| | - Francis Xavier Kasujja
- Department of Community Health & Behavioral Sciences, School of Public HealthCollege of Health Sciences, Makerere UniversityKampalaUganda
| | - Ronald Opito
- Department of Public Health, School of Health SciencesSoroti UniversitySorotiUganda
| | - Henry Wabinga
- Department of Pathology, School of Biomedical SciencesCollege of Health Sciences, Makerere UniversityKampalaUganda
| | - Christopher Garimoi Orach
- Department of Community Health & Behavioral Sciences, School of Public HealthCollege of Health Sciences, Makerere UniversityKampalaUganda
| | - Amos Deogratius Mwaka
- Department of Medicine, School of MedicineCollege of Health Sciences, Makerere UniversityKampalaUganda
- Department of Medicine, Faculty of MedicineGulu UniversityGuluUganda
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Fernández-Martínez NF, Petrova D, Špacírová Z, Barrios-Rodríguez R, Pérez-Sayáns M, Martín-delosReyes LM, Pérez-Gómez B, Rodríguez-Barranco M, Sánchez MJ. The duration of intervals on the oral cancer care pathway and implications for survival: a systematic review and meta-analysis. Front Public Health 2023; 11:1183244. [PMID: 37614446 PMCID: PMC10442570 DOI: 10.3389/fpubh.2023.1183244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/19/2023] [Indexed: 08/25/2023] Open
Abstract
Introduction Previous studies measuring intervals on the oral cancer care pathway have been heterogenous, showing mixed results with regard to patient outcomes. The aims of this research were (1) to calculate pooled meta-analytic estimates for the duration of the patient, diagnostic and treatment intervals in oral cancer, considering the income level of the country, and (2) to review the evidence on the relationship of these three intervals with tumor stage at diagnosis and survival. Materials and methods We conducted a systematic review with meta-analysis following PRISMA 2020 guidelines (pre-registered protocol CRD42020200752). Following the Aarhus statement, studies were eligible if they reported data on the length of the patient (first symptom to first presentation to a healthcare professional), diagnostic (first presentation to diagnosis), or treatment (diagnosis to start of treatment) intervals in adult patients diagnosed with primary oral cancer. The risk of bias was assessed with the Aarhus checklist. Results Twenty-eight studies reporting on 30,845 patients met the inclusion criteria. The pooled median duration of the patient interval was 47 days (95% CI = 31-73), k = 18, of the diagnosis interval 35 days (95% CI = 21-38), k = 11, and of the treatment interval 30 days (95% CI = 23-53), k = 19. In lower-income countries, the patient and treatment intervals were significantly longer, and longer patient intervals were related to later stage at diagnosis. In studies with a lower risk of bias from high-income countries, longer treatment intervals were associated with lower survival rates. Conclusion Interval duration on the oral cancer care pathway is influenced by the socio-economic context and may have implications for patient outcomes.
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Affiliation(s)
- Nicolás Francisco Fernández-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Zuzana Špacírová
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rocío Barrios-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Luis Miguel Martín-delosReyes
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Pérez-Gómez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology for Chronic Diseases, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - María José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Shamala A, Halboub E, Al-Maweri SA, Al-Sharani H, Al-Hadi M, Ali R, Laradhi H, Murshed H, Mohammed MM, Ali K. Oral cancer knowledge, attitudes, and practices among senior dental students in Yemen: a multi-institution study. BMC Oral Health 2023; 23:435. [PMID: 37391820 PMCID: PMC10314541 DOI: 10.1186/s12903-023-03149-x] [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: 04/29/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The "Knowledge, attitude, and practice (KAP)" approach is crucial in health system. Appreciating the current KAP status will reveal the extent of the efficiency of applied health strategies, and subsequently help to determine the appropriate health policy to be employed for improving the health indicators of a given disease/condition, including Oral Cancer (OC). This large-scale cross-sectional study aimed to assess knowledge, attitude, and practice on OC among senior dental students in Yemen. METHODS A pre-validated online questionnaire was used for data collection. It consisted of a series of close-ended questions on knowledge, attitudes and practices related to OC. Yemeni dental students in clinical levels (4th and 5th years) from nine dental schools based in four major cities were invited to complete the survey. The SPSS Version 28.0 was used for data analysis. Differences by different grouping factors were assessed by Chi-squared and Mann Whitney-U tests, as appropriate. RESULTS A total of 927 students completed the questionnaire: a response rate of 43%. While the majority identified smoking (93.8%), and smokeless tobacco (92.1%) as potential risk factors of OC, only 76.2% recognized sun exposure as a risk factor for lip cancer and only 50% were aware of old age as a risk factor of OC. Regarding clinical signs of OC, 84.1% reported that OC can present as non-healing ulcer, but only two thirds of the participants recognized that OC can present as a white and/or red lesion. With respect to practices, although 92.1% reported asking their patients regarding oral habits, only 78% reported they regularly carry out a soft tissue examination. Only 54.5% of the participants considered themselves to be well-trained to provide smoking cessation advice, and 21% were confident regarding their knowledge on OC. The 5th year students showed significantly better knowledge and practices than the 4th year students did (p < 0.01). CONCLUSION The study suggests significant gaps in knowledge, attitudes, and practices of senior dental students in Yemen regarding OC. The findings also underscore the urgent need to improve OC teaching and training of undergraduate dental students, and to provide periodic well-structured continuing professional development activities for dental professionals.
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Affiliation(s)
- Anas Shamala
- Department of Preventive and Biomedical Science, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Hesham Al-Sharani
- Faculty of Dentistry, Department of maxillofacial surgery, Ibb University, Ibb, Yemen
| | - Mona Al-Hadi
- Dental Medicine Postgraduate Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Raheq Ali
- Internship program, College of Dentistry, University of Science & Technology, Sanaa, Yemen.
| | - Hajer Laradhi
- Internship program, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | - Heba Murshed
- Internship program, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | - Marwan Mansoor Mohammed
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Kamran Ali
- College of dental medicine, QU health, Qatar University, Doha, Qatar
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González-Ruiz I, Ramos-García P, Ruiz-Ávila I, González-Moles MÁ. Early Diagnosis of Oral Cancer: A Complex Polyhedral Problem with a Difficult Solution. Cancers (Basel) 2023; 15:3270. [PMID: 37444379 DOI: 10.3390/cancers15133270] [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: 05/05/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Oral and oropharyngeal cancers are a growing problem, accounting for 377,713 and 98,412 new cases per year all over the world and 177,757 and 48,143 deaths annually, respectively. Despite the substantial improvement in diagnostic procedures and treatment techniques in recent years, the mortality rate has not decreased substantially in the last 40 years, which is still close to 50% of cases. The major cause responsible for this high mortality is associated with the high percentage of oral cancers diagnosed in advanced stages (stages III and IV) where the treatment harbors poor efficacy, resulting in challenges, mutilations, or disability. The main reason for cancer to be diagnosed at an advanced stage is a diagnostic delay, so it is critical to reduce this delay in order to improve the prognosis of patients suffering from oral cancer. The causes of oral cancer diagnostic delay are complex and concern patients, healthcare professionals, and healthcare services. In this manuscript, oral cancer diagnostic delay is critically reviewed based on current evidence, as well as their major causes, main problems, and potential improvement strategies.
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Affiliation(s)
- Isabel González-Ruiz
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Isabel Ruiz-Ávila
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Hospital Universitario San Juan de Reus, CAP Marià Fortuny, 43204 Tarragona, Spain
| | - Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Costa AASD, Caldeira PC, Sousa AA, Tibúrcio JD, Belligoli LDQG, Santos VBD, Bretas PMC, Nunes LL, Prado Neto SCD, Silva GW, Soares JMA. Oral and oropharyngeal cancer: time from first symptoms to treatment initiation and associated factors. Braz Oral Res 2023; 37:e054. [PMID: 37255074 DOI: 10.1590/1807-3107bor-2023.vol37.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 09/19/2022] [Indexed: 06/01/2023] Open
Abstract
The aim of this study was to evaluate the time elapsed from first symptoms to the treatment of oral and oropharyngeal cancer (OOC) and to identify variables associated with treatment delay. This is an observational study with retrospective and prospective data collection. Patients with a diagnosis of OOC seen at the Head and Neck Surgery outpatient clinic of a Brazilian public hospital were included and followed up to treatment initiation. Participants answered a questionnaire for the collection of socioeconomic, demographic, cultural, and clinical information, as well as information about the time elapsed from first symptoms to the first appointment with a head and neck surgeon. Time to treatment was classified into four intervals: 1- first symptoms to first medical appointment; 2- first medical appointment to specialized medical care; 3- specialized medical care to preparation for treatment; and 4- preparation for treatment to treatment initiation. Bivariate statistics were computed. Out of 100 participants, nine died before treatment. Mean time to treatment was 217 days. Highest mean time was observed for interval 2 (94 days), followed by interval 1 (63 days), interval 4 (39 days), and interval 3 (21 days). At interval 1, a longer time was associated with severe alcohol consumption, severe smoking, and family history of cancer. At interval 2, the delay was associated with appointment with a general practitioner, clinical diagnosis of disease other than cancer, and antibiotic prescription. At interval 4, delay in treatment was associated with surgical treatment. Patients with OOC experience delays from symptom onset to treatment initiation. The longest interval was associated with professional delay, followed by patient delay in help-seeking.
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Affiliation(s)
- Adriana Aparecida Silva da Costa
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Pathology and Surgery, Belo Horizonte - MG, Brazil
| | - Patrícia Carlos Caldeira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Pathology and Surgery, Belo Horizonte - MG, Brazil
| | - Alexandre Andrade Sousa
- Universidade Federal de Minas Gerais - UFMG, Hospital das Clínicas, Instituto Alfa de Gastroenterologia, Belo Horizonte - MG, Brazil
| | | | | | - Viviane Bigodeiro Dos Santos
- Universidade Federal de São João Del-Rey - UFSJ, School of Medicine, Department of Surgery, Divinópolis, MG, Brazil
| | | | - Louise Lanna Nunes
- Universidade Federal de São João Del-Rey - UFSJ, School of Medicine, Department of Surgery, Divinópolis, MG, Brazil
| | | | - Gustavo Waldolato Silva
- Universidade Federal de São João Del-Rey - UFSJ, School of Medicine, Department of Surgery, Divinópolis, MG, Brazil
| | - João Marcos Arantes Soares
- Universidade Federal de São João Del-Rey - UFSJ, School of Medicine, Department of Surgery, Divinópolis, MG, Brazil
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Shadid RM, Habash G. Knowledge, Opinions, and Practices of Oral Cancer Prevention among Palestinian Practicing Dentists: An Online Cross-Sectional Questionnaire. Healthcare (Basel) 2023; 11:healthcare11071005. [PMID: 37046929 PMCID: PMC10094010 DOI: 10.3390/healthcare11071005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/07/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Oral-health professionals play a critical role in the early recognition and prevention of oral cancer; however, most patients are diagnosed in the advanced stages that demonstrate poor prognosis. Therefore, this study aimed to investigate the knowledge, opinions, and clinical practices of practicing dentists related to oral cancer prevention and oral mucosal screening in Palestine. This research used an online cross-sectional questionnaire design. Practicing dentists in Palestine completed the 44-item questionnaire encompassing the following four sections: (a) personal data (6 items); (b) oral cancer knowledge (21 items); (c) opinions and beliefs related to oral cancer (10 items); and (d) clinical practices related to oral cancer (7 items). The questionnaire was sent to all eligible participants (N = 650) between July and September of 2022. The response rate was 39.1% (N = 254). About 70.1% of the respondents had poor knowledge of oral cancer and its risk factors, and almost 84.3% had positive opinions related to oral cancer prevention and oral mucosal screening. Concerning the clinical practices, only 29.9% routinely examined their patients every time their patients visited. More experienced dentists showed significantly more positive opinions and better clinical practices related to oral cancer prevention and screening; however, they had significantly lower knowledge scores compared with the younger dentists (p < 0.05). Inadequate training was the most reported perceived boundary against routine oral cancer screening. Palestinian dentists appeared to have positive opinions related to oral cancer prevention and oral mucosal screening. However, the assessment of the knowledge and clinical practices revealed deficiencies in this regard.
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Affiliation(s)
- Rola Muhammed Shadid
- Department of Prosthodontics, Faculty of Dentistry, Arab American University, Jenin P.O. Box 240, Palestine
- American Academy of Implant Dentistry (Private Practice), Irbid 21163, Jordan
| | - Ghassan Habash
- Department of Dental Sciences, Faculty of Graduate Studies, Arab American University, Ramallah P.O. Box 240, Palestine
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Zhang H, Wang Z, Zhang Z. Hsa_circ_0009128 mediates progression of oral squamous cell carcinoma by influencing MMP9. Oral Dis 2023; 29:661-671. [PMID: 34514700 DOI: 10.1111/odi.14019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The objective of this study was to explore the role and mechanism of an abnormally expressed circRNA (hsa_circ_0009128) in the progression of oral squamous cell carcinoma. MATERIALS AND METHODS We conducted quantitative real-time PCR (qRT-PCR) to assess the expression of hsa_circ_0009128 in 51 paired OSCC tissues and analyzed the correlation between clinical features and aberrant expression of hsa_circ_0009128 in OSCC. CCK-8 assays, colony formation assays, transwell assays, and wound healing assays were used to analyze the effect of hsa_circ_0009128 on cell proliferation and migration. Furthermore, epithelial-mesenchymal transition (EMT)-related proteins were evaluated by Western blotting. RESULTS Hsa_circ_0009128 was upregulated in both OSCC tissues and cell lines, and high hsa_circ_0009128 correlated with advanced TNM stage (p = 0.046) and lymph node metastasis (p = 0.018) in OSCC patients. Knockdown of hsa_circ_0009128 inhibited cell proliferation and migration. Mechanistically, hsa_circ_0009128 downregulation decreased EMT in OSCC cells as shown by elevated levels of E-cadherin and decreased N-cadherin, vimentin, and MMP9. CONCLUSIONS The circRNA hsa_circ_0009128 correlates with malignant progression of OSCC. Hsa_circ_0009128 stimulates proliferation and migration in OSCC cells by targeting MMP9 to activate EMT.
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Affiliation(s)
- Hong Zhang
- Department of Physiology, School of Life Sciences, China Medical University, Shenyang, China
| | - Zhenhua Wang
- Department of Physiology, School of Life Sciences, China Medical University, Shenyang, China
| | - Zhongti Zhang
- The VIP Department, School and Hospital of Stomatology, China Medical University, Shenyang, China
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Gijón-Soriano AL, Argueta-Figueroa L, Pérez-Cervera Y, Acevedo-Mascarúa AE, González-Arratia-López-Fuentes NI, Torres-Muñoz MA, Moyaho-Bernal MDLA, Torres-Rosas R. Association between sociodemographic characteristics and level of knowledge about oral cancer among Mexican dental health professionals: a cross-sectional online survey. BMC MEDICAL EDUCATION 2022; 22:874. [PMID: 36527021 PMCID: PMC9756605 DOI: 10.1186/s12909-022-03952-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND A good level of knowledge in dentists is crucial for an early diagnosis of oral cancer (OC). In Latin America there are a few studies of OC knowledge among dentist, those has been performed in Brazil, Colombia, and Chile, and their results showed low level of OC knowledge. On the other hand, there is no publication in which the level of knowledge of dentists in Mexico has been addressed. Therefore, this study aimed to assess knowledge of OC and to determine the association of the level of knowledge with sociodemographic characteristics among dentists in Mexico. METHODS A cross-sectional online survey was designed to obtain information via questionnaire. The questionnaire was developed in the Spanish language, and the content validity was determined. The study was conducted among Mexican dentists with a 23-item questionnaire that was designed to be anonymous. The sample size was calculated using the finite population formula. Based on the responses, the level of knowledge of OC was categorized as very low, low, regular, good, or excellent. Additionally, the association between sociodemographic characteristics and the level of knowledge about OC was evaluated. RESULTS This research was conducted on a sample of 387 dentists. Most of the respondents were general dentists and worked in urban zones. The majority of dentists lacked a specialty (76.7%). Additionally, most of the respondents were students (44.2%). The level of knowledge of the participants was between regular and good (77.8%). On the other hand, concerning self-evaluation, most of the participants considered their knowledge of OC to be regular (50.6%). In addition, there was no association between sociodemographic characteristics and knowledge about OC. CONCLUSIONS This research identified some weaknesses in most Mexican dentists' knowledge of OC.
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Affiliation(s)
- Ana Lilia Gijón-Soriano
- División de posgrado, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca, Av. Universidad S/N, Ex-Hacienda 5 Señores, 68120, Oaxaca de Juárez, Mexico
| | - Liliana Argueta-Figueroa
- CONACyT - Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca, Av. Universidad S/N, Ex-Hacienda 5 Señores, 68120, Oaxaca de Juárez, Mexico.
| | - Yobana Pérez-Cervera
- Laboratorio de Inmunología asociado al Centro de Estudios en Ciencias de la Salud y la Enfermedad, División de Posgrado, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca, Av. Universidad S/N, Ex-Hacienda 5 Señores, 68120, Oaxaca de Juárez, Mexico
| | - Alfonso Enrique Acevedo-Mascarúa
- División de posgrado, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca, Av. Universidad S/N, Ex-Hacienda 5 Señores, 68120, Oaxaca de Juárez, Mexico
| | | | - Martha Adelina Torres-Muñoz
- Facultad de Ciencias de la Conducta Universidad Autónoma del Estado de México, Filiberto Gómez s/n, Barrio de Tlacopa, 50010, Toluca de Lerdo, Mexico
| | - María de Los Angeles Moyaho-Bernal
- Facultad de Estomatología, Benemérita Universidad Autónoma de Puebla, calle 31 Poniente #1304, Col. Los Volcanes, C. P. 72410, Puebla, Mexico
| | - Rafael Torres-Rosas
- Laboratorio de Inmunología asociado al Centro de Estudios en Ciencias de la Salud y la Enfermedad, División de Posgrado, Facultad de Odontología, Universidad Autónoma "Benito Juárez" de Oaxaca, Av. Universidad S/N, Ex-Hacienda 5 Señores, 68120, Oaxaca de Juárez, Mexico.
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12
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Fucoidan-Mediated Inhibition of Fibrotic Properties in Oral Submucous Fibrosis via the MEG3/miR-181a/Egr1 Axis. Pharmaceuticals (Basel) 2022; 15:ph15070833. [PMID: 35890132 PMCID: PMC9317791 DOI: 10.3390/ph15070833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 01/27/2023] Open
Abstract
Oral submucous fibrosis (OSF) is a chronic fibrotic remodeling disease that can progress to oral cancer. However, efficient clinical diagnosis and treatment methods for OSF are still lacking. This study investigated the anti-fibrotic effect of fucoidan on oral fibrosis. To evaluate the fibrotic ability (myofibroblast activities), we performed wound-healing, Transwell migration, and collagen contraction assays by using patient-derived normal and fibrotic buccal submucous fibroblasts (BMFs and fBMFs, respectively). RNA-sequencing and dual-luciferase reporter and RNA immunoprecipitation chip assays were performed to identify the clinical significance and molecular mechanism of non-coding RNAs. Fucoidan suppressed the myofibroblast activities and inhibited the MEG3 in fBMFs. MEG3 was overexpressed in the OSF tissue and was positively associated with myofibroblast markers. Knockdown of MEG3 markedly inhibited myofibroblast activities, which were restored by inhibiting miR-181a and overexpressing Egr1. The results from luciferase reporter and RIP assays confirmed that MEG3 functioned as a competing endogenous RNA (ceRNA) and could directly target miR-181a, thereby preventing the miR-181a-mediated translational repression of Egr1. This study demonstrated that MEG3 exerts a profibrotic effect on OSF by targeting miR-181a/Egr1. Therefore, the administration of fucoidan may serve as a potential therapeutic strategy for OSF by targeting the overexpression of MEG3.
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Padin-Iruegas E, Chamorro-Petronacci CM, Sines-Cajade I, Lorenzo-Pouso AI, Blanco-Carrión A, Pérez-Jardón A, Gándara-Vila P, Pérez-Sayans M. DNA Methylation by Bisulfite Next-Generation Sequencing for MLH1 and MGMT in Oral Squamous Cell Carcinomas and Potentially Malignant Disorders: An Integrative Analysis towards Field Cancerization. Medicina (B Aires) 2022; 58:medicina58070878. [PMID: 35888599 PMCID: PMC9322644 DOI: 10.3390/medicina58070878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 01/07/2023] Open
Abstract
Background and Objectives: MGMT methylation is a well-described biomarker in several solid tumors and MLH1 seems to occur in the initial stages of oral carcinogenesis. The aims of this study were to evaluate MHL1 and MGMT methylation levels in oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs), and to integrate this information with The Cancer Genome Atlas (TCGA) database. Materials and Methods: To determine the percentage of gene methylation in MLH1 and MGMT, pyrosequencing analysis was conducted. Samples were divided as follows: (1) patients diagnosed with OSCC (N = 16); (2) patients with OPDM who developed OSCC in the same location (N = 47); and (3) patients with OPDM who developed OSCC in a different location (N = 22). As a validation cohort in this study, data from The Cancer Genomic Atlas (TCGA) database, particularly regarding Head and Neck Squamous Cell Carcinoma, was used. Results: Overall MLH1 methylation levels of 8.6 ± 11.5% and 8.1 ± 9.2% for MGMT were obtained. With regard to MHL1, the OSCC presented the highest degree of methylation with 9.3 ± 7.3% (95%CI 5.1–13.6), and with regards to MGMT, the simultaneous malignancy group presented the highest degree of methylation with 10 ± 13.5% (95%CI 6–10), although no significant differences were found between the groups (p = 0.934 and p = 0.515, respectively). The estimated survival was higher for MGMT methylated cases (19.1 months, 95%CI 19.1–19.1) than for unmethylated cases (9.4 months, 95%CI 6–12.8), but not statistically significant. Conclusions: Our results did not show a correlation between MGMT and MLH1 methylation and any clinicopathological feature or survival in our institutional cohort. MLH1 methylation was present mainly in OSCC, whilst MGMT in OPMD represented a modest contribution to field cancerization, with an overall consistency with the TCGA database.
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Affiliation(s)
- Elena Padin-Iruegas
- Human Anatomy and Embryology Area, Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, University of Vigo, 36001 Pontevedra, Spain;
- Health Research Institute of Santiago de Compostela (IDIS), Department of Oral Medicine, University of Santiago de Compostela (ORALRES Group), 15782 Santiago de Compostela, Spain; (C.M.C.-P.); (A.B.-C.); (A.P.-J.); (P.G.-V.); (M.P.-S.)
| | - Cintia M. Chamorro-Petronacci
- Health Research Institute of Santiago de Compostela (IDIS), Department of Oral Medicine, University of Santiago de Compostela (ORALRES Group), 15782 Santiago de Compostela, Spain; (C.M.C.-P.); (A.B.-C.); (A.P.-J.); (P.G.-V.); (M.P.-S.)
- Department of Oral Medicine, University of Santiago de Compostela (MedOralRes Group), 15782 Santiago de Compostela, Spain;
| | - Iria Sines-Cajade
- Department of Oral Medicine, University of Santiago de Compostela (MedOralRes Group), 15782 Santiago de Compostela, Spain;
| | - Alejandro I. Lorenzo-Pouso
- Department of Oral Medicine, University of Santiago de Compostela (MedOralRes Group), 15782 Santiago de Compostela, Spain;
- Correspondence: ; Tel.: +34-636-67-67-84
| | - Andrés Blanco-Carrión
- Health Research Institute of Santiago de Compostela (IDIS), Department of Oral Medicine, University of Santiago de Compostela (ORALRES Group), 15782 Santiago de Compostela, Spain; (C.M.C.-P.); (A.B.-C.); (A.P.-J.); (P.G.-V.); (M.P.-S.)
- Department of Oral Medicine, University of Santiago de Compostela (MedOralRes Group), 15782 Santiago de Compostela, Spain;
| | - Alba Pérez-Jardón
- Health Research Institute of Santiago de Compostela (IDIS), Department of Oral Medicine, University of Santiago de Compostela (ORALRES Group), 15782 Santiago de Compostela, Spain; (C.M.C.-P.); (A.B.-C.); (A.P.-J.); (P.G.-V.); (M.P.-S.)
- Department of Oral Medicine, University of Santiago de Compostela (MedOralRes Group), 15782 Santiago de Compostela, Spain;
| | - Pilar Gándara-Vila
- Health Research Institute of Santiago de Compostela (IDIS), Department of Oral Medicine, University of Santiago de Compostela (ORALRES Group), 15782 Santiago de Compostela, Spain; (C.M.C.-P.); (A.B.-C.); (A.P.-J.); (P.G.-V.); (M.P.-S.)
- Department of Oral Medicine, University of Santiago de Compostela (MedOralRes Group), 15782 Santiago de Compostela, Spain;
| | - Mario Pérez-Sayans
- Health Research Institute of Santiago de Compostela (IDIS), Department of Oral Medicine, University of Santiago de Compostela (ORALRES Group), 15782 Santiago de Compostela, Spain; (C.M.C.-P.); (A.B.-C.); (A.P.-J.); (P.G.-V.); (M.P.-S.)
- Department of Oral Medicine, University of Santiago de Compostela (MedOralRes Group), 15782 Santiago de Compostela, Spain;
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Chiliti BA, Campos WGD, Gallo CDB, Lemos CA. Oral cancer analysis in a Brazilian city: interval between diagnosis and treatment. Braz Oral Res 2022; 36:e073. [PMID: 36507760 DOI: 10.1590/1807-3107bor-2022.vol36.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 09/09/2021] [Indexed: 12/15/2022] Open
Abstract
In Brazil, there are 15,500 incident cases of oral cancer (OC) yearly, and early diagnosis is the main factor for a better prognosis. The objective of this study was to analyze the interval between the first symptoms, diagnosis, and treatment commencement in patients with malignant neoplasms in the oral cavity, lips, and oropharynx diagnosed between 2012-2018. Epidemiological data, duration, history of lesion, biopsy, and diagnosis were obtained from the medical records of these patients, who were then contacted via phone and interviewed about their oncological treatment. The results were analyzed and expressed as mean, median, and SD. Of 184 patients, most were men, white, 50-69 years old, smokers, and alcoholics. The longest interval was between the first symptoms and first evaluation (a mean of 275 days). The interval between the first appointment and the result of the biopsy was shorter (13 days). Among the 85 patients interviewed, the interval between the diagnosis, the first appointment at the oncological clinic and treatment commencement was 55 days (mean) for patients using private-sector health care, and 96 days (mean) for patients using public health care. The interval was twice as long in the public health system compared with the private sector, which highlights the inequality of access to health care in Brazil. Delay in seeking health care after the appearance of the first symptoms remains a major problem.
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Affiliation(s)
- Beatriz Afonso Chiliti
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | | | - Camila de Barros Gallo
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Celso Augusto Lemos
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
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15
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Morelatto RA, Moretti C, Bolesina NJ, Zapata MJ, Liandro MF, Warnakulasuriya S, de Blanc SL. Reexamination of delays in diagnosis of oral cancer following an intervention program in Cordoba, Argentina. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:301-307. [PMID: 34996734 DOI: 10.1016/j.oooo.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/30/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We compare the results of delay in oral cancer diagnosis before and after a campaign directed toward dentists and raising awareness of the population to achieve early diagnosis of oral cancer in Córdoba, Argentina. The campaign included training dentists in diagnostic skills and a public awareness program through media and networks. STUDY DESIGN Clinical records (period 1: before intervention program, n = 70; period 2: after intervention program, n = 60) of patients presenting with oral squamous cell carcinoma treated in 2 referral centers were analyzed. Records included first symptoms, first consultation with a health professional, and the time when treatment was formulated. RESULTS Oral cancer diagnosis at early stages increased from 27% (period 1) to 40% (period 2). Biopsy at first consultation was indicated in 6% of patients in period 1 and in 23.3% in period 2 (odds ratio = 4.68; 95% confidence interval, 1.87-11.73; P < .05). Professional delay at early stage decreased from 72% in period 1 to 36.8% in period 2. During period 1, for initial stage cancer, the average patient and professional delays were 2.7 and 2.9 months, respectively (P = .06); in period 2, patient delay was 2.67 months and professional delay was 1.34 months (P = .005). CONCLUSION The intervention program helped to improve early-stage diagnosis from 27% to 40% by reducing professional delays.
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Affiliation(s)
- Rosana Andrea Morelatto
- Associate Professor, Department of Oral Pathology, Faculty of Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Caterina Moretti
- Department of Oral Pathology, Faculty of Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Nicolás Jorge Bolesina
- Assistant Professor, Department of Oral Pathology, Faculty of Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Marcelo Javier Zapata
- Assistant Professor, Department of Oral Pathology, Faculty of Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Fernanda Liandro
- Assistant Professor, Department of Oral Pathology, Faculty of Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences King's College London, UK; WHO Collaborating Centre for Oral Cancer, London, UK
| | - Silvia López de Blanc
- Head Professor, Department of Oral Pathology, Faculty of Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
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16
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Saraswat N, Pillay R, Prabhu N, Everett B, George A. Perceptions and Practices of General Practitioners towards Oral Cancer and Emerging Risk Factors among Indian Immigrants in Australia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11111. [PMID: 34769631 PMCID: PMC8582889 DOI: 10.3390/ijerph182111111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND In Australia, Indian immigrants are one of the fastest-growing communities. Since oral cancer is widespread in India, the indulgence of Indians in customs of areca (betel) nut use in Australia may be linked to the recent rise in oral cancer cases. Since GPs (general practitioners) are primary healthcare providers, it is pivotal to ensure the oral cancer awareness of GPs. This study aimed to explore oral cancer risk-related knowledge, beliefs, and clinical practices of GPs in Australia. METHODS Fourteen semi-structured interviews were conducted with GPs practicing across New South Wales and Victoria. Purposive and snowball sampling were used for recruitment. Data were analysed through a directed content analysis approach. RESULTS All GPs were knowledgeable of major oral cancer causative factors including tobacco and alcohol, but some had limited understanding about the risks associated with areca nut preparations. Positive attitudes were evident, with all participants acknowledging the importance of oral cancer risk assessment. Most GPs recalled not performing oral cancer routine check-ups. CONCLUSION GPs presented good oral cancer knowledge except for emerging risk factors such as areca nut use. Varied beliefs and inconsistent clinical practices relating to oral cancer screening is concerning. Accessible oral cancer training around emerging risk factors may benefit GPs.
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Affiliation(s)
- Nidhi Saraswat
- Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, School of Nursing and Midwifery, South Western Sydney Local Health District, Western Sydney University, Liverpool, NSW 1871, Australia; (B.E.); (A.G.)
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
| | - Rona Pillay
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
| | - Neeta Prabhu
- Paediatric Dentistry, Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Camperdown, NSW 2006, Australia;
- Paediatric Dentistry, Westmead Centre for Oral Health, Sydney, NSW 2145, Australia
| | - Bronwyn Everett
- Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, School of Nursing and Midwifery, South Western Sydney Local Health District, Western Sydney University, Liverpool, NSW 1871, Australia; (B.E.); (A.G.)
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, School of Nursing and Midwifery, South Western Sydney Local Health District, Western Sydney University, Liverpool, NSW 1871, Australia; (B.E.); (A.G.)
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Camperdown, NSW 2006, Australia
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17
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Pakravan F, Abbasi F, Garshasbi MA, Isfahani MN. Relationship between oral cancer stage and elapsed time from the onset of signs and symptoms to diagnosis and treatment. Cancer Treat Res Commun 2021; 28:100428. [PMID: 34225105 DOI: 10.1016/j.ctarc.2021.100428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oral cancer includes a variety of diagnoses of malignancies that manifest in the oral tissues. Prognosis and treatment depend on the site of involvement, the time of diagnosis, and the stage of the tumor. Early diagnosis of oral mucosal lesions facilitates the early detection of cancer, which is a key step for treatment. The purpose of this study was to investigate the relationship between delayed referral of patients with oral cancer and disease progression at the time of diagnosis. MATERIALS AND METHODS In this cross-sectional study, data were collected from 108 patients with a definitive diagnosis of oral cancer by a standardized questionnaire. Data were analyzed by descriptive statistics, including mean, standard deviation, frequency, frequency percentage, and inferential statistics, including logistic regression analysis. P<0.05 was considered to be statistically significant. RESULTS The mean time of referral to a therapist was 17.73 ± 22.80 weeks, with 53 (49.1%) patients having a delay of more than 10 weeks. Age, education level, smoking, disease stage, N class, M class, and type of cancer were not significantly associated with the incidence of delay (P>0.05). Patients whose first signs were significant bleeding and/or unrecovered ulceration showed a significant reduction in the delay time (OR = 0.024 and P = 0.038). CONCLUSION There was no significant relationship between the disease progression in oral cancer and the time elapsed from the onset of symptoms to diagnosis and treatment. Hence, it seems necessary to take appropriate measures to enhance public awareness of oral cancer and its symptoms.
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Affiliation(s)
- Fahimeh Pakravan
- Department of Oral Medicine, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Abbasi
- Department of Oral Medicine, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Amin Garshasbi
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Nasr Isfahani
- Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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18
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Girisa S, Kumar A, Rana V, Parama D, Daimary UD, Warnakulasuriya S, Kumar AP, Kunnumakkara AB. From Simple Mouth Cavities to Complex Oral Mucosal Disorders-Curcuminoids as a Promising Therapeutic Approach. ACS Pharmacol Transl Sci 2021; 4:647-665. [PMID: 33860191 PMCID: PMC8033761 DOI: 10.1021/acsptsci.1c00017] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Indexed: 02/08/2023]
Abstract
Oral diseases are among the most common encountered health issues worldwide, which are usually associated with anomalies of the oral cavity, jaws, and salivary glands. Despite the availability of numerous treatment modalities for oral disorders, a limited clinical response has been observed because of the inefficacy of the drugs and countless adverse side effects. Therefore, the development of safe, efficacious, and wide-spectrum therapeutics is imperative in the battle against oral diseases. Curcumin, extracted from the golden spice turmeric, is a well-known natural polyphenol that has been extensively studied for its broad pleiotropic attributes and its ability to modulate multiple biological processes. It is well-documented to target pro-inflammatory mediators like NF-κB, ROS, COX-2, IL-1, IL-2, TGF-β, growth factors, apoptotic proteins, receptors, and various kinases. These properties make curcumin a promising nutraceutical in the treatment of many oral diseases like oral submucous fibrosis, oral mucositis, oral leukoplakia, oral erythroplakia, oral candidiasis, aphthous stomatitis, oral lichen planus, dental caries, periodontitis, and gingivitis. Numerous in vitro and in vivo studies have shown that curcumin alleviates the symptoms of most of the oral complications, including the inhibition of the progression of oral cancer. In this regard, many clinical trials have been completed, and many are ongoing to investigate the "curcumin effect" in oral maladies. Therefore, the current review delineates the mechanistic framework of curcumin's propensity in curbing oral diseases and present outcomes of the clinical trials of curcumin-based therapeutics that can provide a breakthrough in the clinical management of these diseases.
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Affiliation(s)
- Sosmitha Girisa
- Cancer
Biology Laboratory and DBT-AIST International Center for Translational
and Environmental Research (DAICENTER), Department of Biosciences
and Bioengineering, Indian Institute of
Technology (IIT) Guwahati, Guwahati, Assam 781039, India
| | - Aviral Kumar
- Cancer
Biology Laboratory and DBT-AIST International Center for Translational
and Environmental Research (DAICENTER), Department of Biosciences
and Bioengineering, Indian Institute of
Technology (IIT) Guwahati, Guwahati, Assam 781039, India
| | - Varsha Rana
- Cancer
Biology Laboratory and DBT-AIST International Center for Translational
and Environmental Research (DAICENTER), Department of Biosciences
and Bioengineering, Indian Institute of
Technology (IIT) Guwahati, Guwahati, Assam 781039, India
| | - Dey Parama
- Cancer
Biology Laboratory and DBT-AIST International Center for Translational
and Environmental Research (DAICENTER), Department of Biosciences
and Bioengineering, Indian Institute of
Technology (IIT) Guwahati, Guwahati, Assam 781039, India
| | - Uzini Devi Daimary
- Cancer
Biology Laboratory and DBT-AIST International Center for Translational
and Environmental Research (DAICENTER), Department of Biosciences
and Bioengineering, Indian Institute of
Technology (IIT) Guwahati, Guwahati, Assam 781039, India
| | - Saman Warnakulasuriya
- Department
of Oral Medicine, King’s College
London and WHO Collaborating Centre for Oral Cancer and Precancer, London WC2R 2LS, United Kingdom
| | - Alan Prem Kumar
- Medical
Science Cluster, Cancer Translational Research Programme, Yong Loo
Lin School of Medicine, National University
of Singapore, Singapore 117600, Singapore
- Cancer
Science Institute of Singapore, National
University of Singapore, Singapore 117600, Singapore
- National
University Cancer Institute, National University
Health Systems, Singapore 117600, Singapore
| | - Ajaikumar B. Kunnumakkara
- Cancer
Biology Laboratory and DBT-AIST International Center for Translational
and Environmental Research (DAICENTER), Department of Biosciences
and Bioengineering, Indian Institute of
Technology (IIT) Guwahati, Guwahati, Assam 781039, India
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19
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Time-to-Treatment in Oral Cancer: Causes and Implications for Survival. Cancers (Basel) 2021; 13:cancers13061321. [PMID: 33809427 PMCID: PMC8000007 DOI: 10.3390/cancers13061321] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 12/24/2022] Open
Abstract
The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer.
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20
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Ilhan B, Guneri P, Wilder-Smith P. The contribution of artificial intelligence to reducing the diagnostic delay in oral cancer. Oral Oncol 2021; 116:105254. [PMID: 33711582 DOI: 10.1016/j.oraloncology.2021.105254] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/11/2021] [Accepted: 02/24/2021] [Indexed: 02/07/2023]
Abstract
Oral cancer (OC) is the sixth most commonly reported malignant disease globally, with high rates of disease-related morbidity and mortality due to advanced loco-regional stage at diagnosis. Early detection and prompt treatment offer the best outcomes to patients, yet the majority of OC lesions are detected at late stages with 45% survival rate for 2 years. The primary cause of poor OC outcomes is unavailable or ineffective screening and surveillance at the local point-of-care level, leading to delays in specialist referral and subsequent treatment. Lack of adequate awareness of OC among the public and professionals, and barriers to accessing health care services in a timely manner also contribute to delayed diagnosis. As image analysis and diagnostic technologies are evolving, various artificial intelligence (AI) approaches, specific algorithms and predictive models are beginning to have a considerable impact in improving diagnostic accuracy for OC. AI based technologies combined with intraoral photographic images or optical imaging methods are under investigation for automated detection and classification of OC. These new methods and technologies have great potential to improve outcomes, especially in low-resource settings. Such approaches can be used to predict oral cancer risk as an adjunct to population screening by providing real-time risk assessment. The objective of this study is to (1) provide an overview of components of delayed OC diagnosis and (2) evaluate novel AI based approaches with respect to their utility and implications for improving oral cancer detection.
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Affiliation(s)
- Betul Ilhan
- Ege University, Faculty of Dentistry, Department of Oral & Maxillofacial Radiology, Bornova, Izmir, Turkey.
| | - Pelin Guneri
- Ege University, Faculty of Dentistry, Department of Oral & Maxillofacial Radiology, Bornova, Izmir, Turkey
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21
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Knopf A, Teutsch S, Bier H. Mono-institutional retrospective cohort analysis of the insurance status dependent access to ENT-professionals and survival in head and neck squamous cell carcinoma. BMC Health Serv Res 2021; 21:45. [PMID: 33419421 PMCID: PMC7796581 DOI: 10.1186/s12913-020-06035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 12/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To access the influence of insurance status on time of diagnosis, quality of treatment and survival in head and neck squamous cell carcinoma (HNSCC). METHODS This mono-institutional retrospective cohort analysis included all HNSCC patients (n = 1,054) treated between 2001 and 2011, and subdivided the cohort according to the insurance status. Differences between the groups were analyzed using the Chi square and the unpaired student's t-test. Survival rates were calculated by Kaplan-Meier and Cox regression for forward selection. RESULTS Nine hundred twenty-five patients showed general, 129 private insurance. The 2 groups were equal regarding age, gender, tumor localization, therapy, and N/M/G/R-status. The T-status differed significantly between the groups showing more advanced tumors in patients with general insurance (p = 0.002). While recurrence-free survival was comparable in both groups, overall survival was significantly better in private patients (p = 0.009). The time frame between first symptom and diagnosis was equal in both groups. CONCLUSIONS The time frame between subjective percipience of first symptom and final therapy did not differ between the groups. In our cohort, access to otorhinolaryngological specialists is favorable in both, patients with general and private insurance. Recurrence-free survival was comparable in both groups, indicating successful HNSCC treatment both groups. However, overall survival was significantly better in patients with private insurance suggesting other socioeconomic factors influencing survival.
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Affiliation(s)
- Andreas Knopf
- Otorhinolaryngology/Head and Neck Surgery, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. .,Otorhinolaryngology/Head and Neck Surgery, Ismaninger Str. 22, 81675, München, Germany.
| | - Simon Teutsch
- Otorhinolaryngology/Head and Neck Surgery, Ismaninger Str. 22, 81675, München, Germany
| | - Henning Bier
- Otorhinolaryngology/Head and Neck Surgery, Ismaninger Str. 22, 81675, München, Germany
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22
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Freire AR, Freire DEWG, de Araújo ECF, de Lucena EHG, Cavalcanti YW. Influence of Public Oral Health Services and Socioeconomic Indicators on the Frequency of Hospitalization and Deaths due to Oral Cancer in Brazil, between 2002-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E238. [PMID: 33396190 PMCID: PMC7795570 DOI: 10.3390/ijerph18010238] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022]
Abstract
Background: Oral cancer is a frequent neoplasm worldwide, and socioeconomic factors and access to health services may be associated with its risk. Aim: To analyze effect of socioeconomic variables and the influence of public oral health services availability on the frequency of new hospitalized cases and mortality of oral cancer in Brazil. Materials and Methods: This observational study analyzed all Brazilian cities with at least one hospitalized case of oral cancer in the National Cancer Institute database (2002-2017). For each city were collected: population size, Municipal Human Development Index (MHDI), Gini Coefficient, oral health coverage in primary care, number of Dental Specialized Centers (DSC) and absolute frequency of deaths after one year of the first treatment. The risk ratio was determined by COX regression, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Poisson regression was used to determine factors associated with higher mortality frequency. Results: Cities above 50,000 inhabitants, with high or very high MHDI, more unequal (Gini > 0.4), with less oral health coverage in primary care (<50%) and without DSC had a greater accumulated risk of having 1 or more cases (p < 0.001). Higher frequency of deaths was also associated with higher population size, higher MHDI, higher Gini and lower oral health coverage in primary care (p < 0.001). Conclusions: The number hospitalization and deaths due to oral cancer in Brazil was influenced by the cities' population size, the population's socioeconomic status and the availability of public dental services.
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Affiliation(s)
| | | | | | | | - Yuri W. Cavalcanti
- Graduate Program in Dentistry, Department of Clinic and Social Dentistry, Federal University of Paraíba, University City, João Pessoa-PB 58046-600, Brazil; (A.R.F.); (D.E.W.G.F.); (E.C.F.d.A.); (E.H.G.d.L.)
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Yang L, Li G, Gao Y, Ou N, Yu T, Ren S. lncRNA NR4A1AS Upregulates miR-221 Through Demethylation to Promote Cell Proliferation in Oral Squamous Cell Carcinoma. Cancer Manag Res 2020; 12:5285-5292. [PMID: 32753947 PMCID: PMC7342500 DOI: 10.2147/cmar.s241769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/12/2020] [Indexed: 12/16/2022] Open
Abstract
Background Cell proliferation of oral squamous cell carcinoma (OSCC) is precisely regulated with a cascade of genes and pathways. Previous studies have identified NR4A1 as an oncogene and plays a crucial role in colorectal cancer development and progression. This study was performed to investigate the potential interaction between lncRNA NR4A1AS and miR-221 and how their interaction is modulated in periodontitis. Patients and Methods Research subjects of this study included 62 OSCC patients. Cell transfection and RT-qPCR were applied to detect the expression levels of NR4A1AS and miR-221. Methylation-specific PCR (MSP) was carried out to determine the demethylation of miR-221 by NR4A1AS. CCK-8 assay was used to detect the proliferation of OSCC cells with the overexpression of NR4A1AS or/and overexpression of miR-221. Results In this study, we observed that NR4A1AS was upregulated in tumor tissue samples of OSCC, and its high expression levels were significantly correlated with poor survival in patients with OSCC. In addition, miR-221 was significantly down-regulated in OSCC tumors. NR4A1AS and miR-221 were significantly and positively correlated in OSCC tumors but not in non-dysplastic tissue. In OSCC cells, overexpression of NR4A1AS led to upregulation of miR-221 and decreased the methylation of miR-221 gene. However, overexpression of miR-221 did not affect the expression of NR4A1AS in OSCC cells. In addition, overexpression of NR4A1AS or miR-221 increased the proliferation rate of OSCC cells. Conclusion This study is the first to report that NR4A1AS is upregulated in OSCC. Moreover, we also propose that miR-221 is modulated by NR4A1AS through demethylation and the upregulation of NR4A1AS or miR-221 promotes the proliferation of OSCC cells, which suggests that anti-NR4A1AS might be a perspective approach for the therapy of OSCC.
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Affiliation(s)
- Liuqing Yang
- Department of Stomatology, Ningbo Dental Hospital, Ningbo City, Zhejiang Province 315000, People's Republic of China.,Ningbo Institute of Oral Health, Ningbo City, Zhejiang Province 315000, People's Republic of China
| | - Guanghui Li
- Department of Stomatology, Fujian Medical University, Fuzhou City, Fujian Province 350122, People's Republic of China
| | - Ya Gao
- Department of Stomatology, Shanghai First People's Hospital, Shanghai 201600, People's Republic of China
| | - Nini Ou
- Department of Stomatology, Ningbo Dental Hospital, Ningbo City, Zhejiang Province 315000, People's Republic of China
| | - Tingting Yu
- Department of Stomatology, Yinzhou Dental Hospital, Ningbo City, Zhejiang Province 315000, People's Republic of China
| | - Shirong Ren
- Department of Stomatology, Ningbo Dental Hospital, Ningbo City, Zhejiang Province 315000, People's Republic of China
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Cunha ARD, Prass TS, Hugo FN. Mortality from oral and oropharyngeal cancer in Brazil, between 2000 and 2013: trends by sociodemographic strata. CIENCIA & SAUDE COLETIVA 2020; 25:3075-3086. [PMID: 32785543 DOI: 10.1590/1413-81232020258.31282018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/22/2018] [Indexed: 12/31/2022] Open
Abstract
Generalized observations of temporal trends in mortality could mask consistent specific patterns. This study aims to analyze the trend of oral and oropharyngeal cancer mortality rates in Brazil, from 2000 to 2013, considering the differences by gender, anatomical site, age group and ethnicity. Data on oral and oropharyngeal cancer mortality were retrieved from the Mortality Information System. The trend of historical series mortality rates by stratum was estimated through a generalized linear regression by the Prais-Winsten method. In total, 61,190 deaths from oral and oropharyngeal cancer were recorded in the 2000-2013 period (mean of coefficients: 3.50 deaths/100 thousand inhabitants/year). The trend of mortality rates was stable for males and increasing for females (1.31%/year). A growing pattern was identified for men aged 20-29 years (2.92%/year) and brown men (20.36%/year). The increasing pattern was also identified for white women (2.70%/year) and brown women (8.24%/year). We can conclude that surveillance of this condition should consider the sociodemographic differences of the population for equitable planning of care strategies because they reflected in different trends of oral and oropharyngeal cancer mortality rates in Brazil.
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Affiliation(s)
- Amanda Ramos da Cunha
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | | | - Fernando Neves Hugo
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
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Varela-Centelles P, Seoane J, Ulloa-Morales Y, Estany-Gestal A, Blanco-Hortas A, García-Pola MJ, Seoane-Romero JM. People would rather see a physician than a dentist when experiencing a long-standing oral ulceration. A population-based study in Spain. Med Oral Patol Oral Cir Bucal 2020; 25:e455-e460. [PMID: 32388529 PMCID: PMC7338074 DOI: 10.4317/medoral.23292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 03/22/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Primary care physicians have been reported to be the first choice for patients with oral ulcerations. This study investigates the health-seeking behaviour of lay public in Galicia (North-western Spain) if experiencing a long-standing oral ulceration. MATERIAL AND METHODS Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016. RESULTS A total of 5,727 pedestrians entered the study (response rate: 53%), mostly in the 45-64 age group (30.2%; n=1,728), 47.7% of them (n=2,729) were males. Most participants (42.1%; n=2,411) reported to visit their dentist once a year and had secondary or compulsory education as their highest educational achievement (28.18%, n=1,614; 28%, n=1,600 respectively). When questioned what they would do if they had a wound/ulceration lasting longer than 3 weeks, most participants answered they would go to see their primary care physician (62.8%; n=3,597) and less than one quarter of the sample (23.8%; n=1,371) would seek consultation with their dentist. CONCLUSIONS General Galician population would seek professional consultation about a long-standing oral ulceration, relying mostly on primary care physicians. Those neglecting these lesions are elderly, less-schooled people and unaware of oral cancer.
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Daltaban Ö, Özçentik A, Akman Karakaş A, Üstün K, Hatipoğlu M, Uzun S. Clinical presentation and diagnostic delay in pemphigus vulgaris: A prospective study from Turkey. J Oral Pathol Med 2020; 49:681-686. [PMID: 32516514 DOI: 10.1111/jop.13052] [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: 04/16/2020] [Revised: 04/21/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND To evaluate the diagnostic patterns and factors that may influence delays in the diagnosis of pemphigus vulgaris (PV) with oral involvement. MATERIALS AND METHODS In this prospective cohort study, 36 newly diagnosed PV patients with oral involvement were clinically examined and interviewed about the natural history of the oral lesions, number of medical consultations (Med consultation), medical treatment history, and diagnostic delay time (DD time). RESULTS Thirty (83%) PV patients presented initially with oral mucosal involvement (OMI) and 6 (17%) presented initially with skin involvement (SI). The mean DD time was 6.19 ± 3.82 months, and the mean number of Med consultation was 5.8 (n = 36). The means of all the parameters were significantly higher for the OMI patients than for the SI patients (P < .05). All of the patients with OMI had been misdiagnosed. The DD time was significantly longer in patients who presented initially with desquamative gingivitis (8.25 ± 3.81) than patients who presented with ulcers and erosions (4.78 ± 1.11) (P < .05). There was a statistically significant positive correlation between DD time and Med consultation (r = 0.91). CONCLUSION Even with the high frequency of oral involvement and easy access to the oral cavity, diagnostic delays are still common for patients with oral PV. This underlines the need for education to improve healthcare providers' awareness and knowledge of the clinical oral presentation of PV.
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Affiliation(s)
- Özlem Daltaban
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Aslı Özçentik
- Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ayşe Akman Karakaş
- Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Kemal Üstün
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Mükerrem Hatipoğlu
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Soner Uzun
- Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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27
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Langton S, Cousin GCS, Plüddemann A, Bankhead CR. Comparison of primary care doctors and dentists in the referral of oral cancer: a systematic review. Br J Oral Maxillofac Surg 2020; 58:898-917. [PMID: 32591210 DOI: 10.1016/j.bjoms.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 06/09/2020] [Indexed: 12/25/2022]
Abstract
Oral cancer is referred to specialists by both general practitioners (GPs) and dentists, with varying proportions reported in different studies. However, some have noted that dentists more commonly refer oral cancer in the absence of patient-perceived symptoms and may refer at an earlier stage. Unfortunately, approximately half the UK adult population do not receive regular dental care. We have conducted a systematic review of studies that compare GPs and dentists in the referral of oral cancer and have focused on three aspects: the proportion of diagnosed oral cancers, stage on presentation, and delay. Searches of the databases Medline, Embase, Scopus, Google Scholar, Web of Science, and CINAHL, together with additional searches of reference lists, authors, and conference proceedings, found 22 studies from 10 countries, which included a total of 4953 oral cancers. The percentage of medical referrals ranged from 13% to 86%; dental referrals ranged from 15% to 80%. Random-effects meta-analysis indicated a combined relative risk of medical referral to dental referral of 1.36 (95% CI: 0.99 to 1.86). For UK-based studies, the relative risk was also 1.36 (95% CI: 1.05 to 1.76). There was considerable heterogeneity for all studies and for a subgroup of UK studies: I296.4% (95% CI 95.4 to 97.1) and 81.0% (95% CI 63.3 to 90.1), respectively. Several studies showed a lower stage for dentally-referred cancers; the combined risk for dentists and GPs referring early (stages 1 and 2) disease was 1.37 (95% CI: 1.17 to 1.60), and one cause may be the much higher number of cases referred by dentists in the absence of symptoms. No studies showed a significant difference in delay. Oral cancer is referred by both GPs and dentists, typically about 50% and 40%, respectively, although there is a wide range, probably depending on local circumstances. Both groups require skills in oral examination, recognition of lesions, and knowledge of the risk factors. Effectively, regular dental attenders are a select group that is regularly screened for oral cancer, and it is likely that screening is not delivered to those with the highest risk. We suggest that further work is required on how to access high-risk individuals both for possible screening and preventive interventions.
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Affiliation(s)
| | | | - A Plüddemann
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
| | - C R Bankhead
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
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28
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Motta ACF, Rodrigues KRDH. Could we benefit from oral self-examination during the COVID-19 pandemic? Oral Oncol 2020; 107:104840. [PMID: 32532670 PMCID: PMC7269937 DOI: 10.1016/j.oraloncology.2020.104840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 11/18/2022]
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29
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Kerr AR, Robinson ME, Meyerowitz C, Morse DE, Aguilar ML, Tomar SL, Guerrero L, Caprio D, Kaste LM, Makhija SK, Mungia R, Rasubala L, Psoter WJ. Cues used by dentists in the early detection of oral cancer and oral potentially malignant lesions: findings from the National Dental Practice-Based Research Network. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:264-272. [PMID: 32561250 DOI: 10.1016/j.oooo.2020.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/15/2020] [Accepted: 05/11/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to assess the influence of clinical cues on risk assessment of cancer-associated mucosal abnormalities. STUDY DESIGN We differentiated lesions with a low risk from those with a high risk for premalignancy or malignancy by using 4 cues: (1) color, (2) location, (3) induration, and (4) pain on exploration. Combinations of color and location were presented through 8 photographs, with induration and pain status variably presented in the standardized history and physical findings. This created 16 clinical scenarios (vignettes) that were permutations of the 4 cues. Three questions assessed the extent to which each cue was used in obtaining a clinical impression as to whether a lesion was benign, premalignant, or malignant. RESULTS Completed vignette questionnaires were obtained from 130 of 228 invited dentists, (two-thirds males; 79% white; mean age 52 years; average weekly hours of practice 33 hours). Only 40% of the responding dentists had statistically significant decision policies to assign a clinical diagnosis of a lesion as benign, premalignant, or malignant. Lesion location and color were the 2 dominant cues. As a cue, induration was used as a cue by more of the respondents in determining a clinical diagnosis of malignancy, and pain was infrequently used as a cue. CONCLUSIONS Many dentists do not to have a decision strategy for the clinical diagnosis and risk stratification of oral potentially malignant lesions.
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Affiliation(s)
- Alexander Ross Kerr
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY, USA.
| | - Michael E Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Douglas E Morse
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Maria L Aguilar
- Department of Restorative Dental Science, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Scott L Tomar
- Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, Gainesville, FL, USA
| | | | - Dianne Caprio
- Faculty Director of General Dentistry, Brunswick County-CSLC, Department of General Dentistry, School of Dental Medicine, East Carolina University, Greenville, NC, USA
| | - Linda M Kaste
- Department of Pediatric Dentistry, University of Illinois College of Dentistry, Chicago, IL, USA
| | - Sonia K Makhija
- Department of Clinical and Community Sciences, Division of Behavioral and Population Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rahma Mungia
- Associate Professor, Department of Periodontics; Director, South Texas Oral Health Network; Assistant Director, Southwest Region National Dental PBRN, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Linda Rasubala
- Assistant Director Howitt Urgent Dental Care, Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Walter J Psoter
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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- National Dental PBRN Collaborative Group includes practitioner, faculty, and staff investigators who contributed to this activity. A list is available at http://nationaldentalpbrn.org/collaborative-group.php
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Nagao T, Warnakulasuriya S. Screening for oral cancer: Future prospects, research and policy development for Asia. Oral Oncol 2020; 105:104632. [PMID: 32315954 DOI: 10.1016/j.oraloncology.2020.104632] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/05/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023]
Abstract
Although the incidence of oral cavity cancer is high among low and middle income countries in Asia where the risk habits (tobacco smoking, tobacco chewing and betel quid use) are common, the benefits for introducing oral cancer screening for the whole population in these countries still remains controversial. It is disappointing, but not surprising that many of studies, without control arms, could not provide a clear answer as to whether screening is effective in reducing mortality or combating rising incidence trends. Only one Indian study that reported a randomized controlled trial (RCT) elucidated that mass screening for high risk groups could significantly reduce the cancer mortality or down-stage cancers detected by screening. Several professional organizations that considered any potential benefits of oral cancer screening remain unconvinced that the current knowledge on its natural history, available tests and interventions to treat potentially malignant disorders satisfy the desirable criteria to recommend organized screening for oral cancer. In this review we discuss advantages and disadvantages for oral cancer screening particularly with reference to high incidence countries in Asia. If screening is undertaken, we propose that it is targeted to high risk groups and to combine screening with education on risky life-styles so that overall incidence can be reduced in the future. Further research on increasing public awarenes and impact of professional education such as e-learning to reduce diagnostic delays, studies on the natural history of oral potentially malignant disorders and cancer, comprehensive tobacco and areca nut cessation programs, developing tools to identify high-risk individuals and high-risk lesions are proposed.
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Affiliation(s)
- Toru Nagao
- Department of Maxillofacial Surgery School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, UK
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Narayanan AM, Yogesh A, Chang MP, Finegersh A, Orosco RK, Moss WJ. A Survey of Areca (Betel) Nut Use and Oral Cancer in the Commonwealth of the Northern Mariana Islands. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:112-116. [PMID: 32328582 PMCID: PMC7175360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Areca nut use is a cause of higher rates of oral cavity cancer in the Commonwealth of the Northern Mariana Islands (CNMI). Little is known about patient insights into the risks of areca nut use worldwide. The purpose of this study is to evaluate perceptions of areca nut use and oral cancer among chewers in the CNMI. This is a survey study undertaken at the CNMI's only regional health center-300 adult participants completed a 21-question survey that assessed demographics, chewing behaviors, perceptions of areca nut use and oral cancer, and the willingness to participate in cessation and screening programs. Data was analyzed using chi-squared tests, at a significance value of P < .05. The participant average age was 38, and 41% were male. Almost all (92%) knew that chewing areca nut causes oral cancer, but only 13% correctly identified the actual areca nut as a carcinogen. About half (59%) believed that oral cancer could be treated. Most people (74%) were willing to participate in screening programs for oral cancer. Those who chewed areca nut daily were more likely to be interested in medicated replacement products relative to those who chewed less frequently (P = .048). In conclusion, there are drastic misperceptions about areca nut and oral cancer in the CNMI. Efforts should be made towards promoting awareness of the carcinogenicity of the actual areca nut, and the treatability of oral cancer. Mandated educational warnings should be required with areca nut sales. Further research evaluating substitution methods and screening programs is indicated.
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Affiliation(s)
- Ajay M. Narayanan
- University of Texas Southwestern Medical Center, Dallas, TX (AMN, AY)
| | - Ahana Yogesh
- University of Texas Southwestern Medical Center, Dallas, TX (AMN, AY)
| | - Mary P. Chang
- Department of Emergency Medicine, University of Texas at Southwestern, Dallas, TX (MPC)
| | - Andrey Finegersh
- University of California, San Diego, Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, San Diego, CA (AF, RKO)
| | - Ryan K. Orosco
- University of California, San Diego, Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, San Diego, CA (AF, RKO)
| | - William J. Moss
- Commonwealth Health Center, Saipan, Northern Mariana Islands (WJM)
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López AF, Sanabria Quiroga ÁE. Características clínicas y administrativas que se relacionan con el retraso en el diagnóstico y tratamiento de los pacientes con cáncer de cabeza y cuello. REVISTA COLOMBIANA DE CIRUGÍA 2020. [DOI: 10.30944/20117582.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. En Colombia, el diagnóstico de los tumores de cabeza y cuello es tardío, lo cual aumenta la mortalidad, las secuelas estéticas y funcionales, y los costos para el sistema de salud. Actualmente, hay poca información sobre los factores que retrasan el diagnóstico y tratamiento de los pacientes con cáncer de cabeza y cuello.
Métodos. Se trata un estudio transversal y analítico. Como referencia, se utilizó el cálculo de muestras para una población finita con un nivel de confianza del 95 % y un margen de error del 5 %, para un total de 159 pacientes con diagnóstico de cáncer de cabeza y cuello atendidos en la Clínica Vida de Medellín, entre los años 2016 y 2017.
Resultados. Se evaluaron 146 pacientes. Los síntomas más frecuentes por los que consultaron fueron masa cervical y disfonía. Solo el 53,4 % de los pacientes buscó atención médica inmediata ante la presencia del síntoma. De aquellos que no la buscaron, la causa más frecuente fue la creencia de que el síntoma desaparecería espontáneamente.
Discusión. Con base en los resultados obtenidos, se puede concluir que el síntoma de presentación juega un papel importante para que el paciente decida buscar o no buscar atención médica inmediata. El síntoma de presentación y el vivir en el área rural, retrasan el tiempo transcurrido entre la aparición del síntoma y la primera valoración por un médico de atención primaria. Los factores que se asociaron al retraso entre el diagnóstico y el inicio del tratamiento, fueron la seguridad social y el haber presentado tos como síntoma inicial.
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Yu AJ, Choi JS, Swanson MS, Kokot NC, Brown TN, Yan G, Sinha UK. Association of Race/Ethnicity, Stage, and Survival in Oral Cavity Squamous Cell Carcinoma: A SEER Study. OTO Open 2019; 3:2473974X19891126. [PMID: 31840132 PMCID: PMC6904786 DOI: 10.1177/2473974x19891126] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/07/2019] [Indexed: 11/27/2022] Open
Abstract
Objective Survival differences in oral cancer between black and white patients have
been reported, but the contributing factors, especially the role of stage,
are incompletely understood. Furthermore, the outcomes for Hispanic and
Asian patients have been scarcely examined. Study Design Retrospective, population-based national study. Setting Surveillance, Epidemiology, and End Results 18 Custom database (January 1,
2010, to December 31, 2014). Subjects and Methods In total, 7630 patients with primary squamous cell carcinoma in the oral
cavity were classified as non-Hispanic white (white), non-Hispanic black
(black), Hispanic, or Asian. Cox regression was used to obtain unadjusted
and adjusted hazard ratios (HRs) of 5-year mortality for race/ethnicity with
sequential adjustments for stage and other covariates. Logistic regression
was used to examine the relationship between race/ethnicity and stage with
adjusted odds ratios (aORs). Results The cohort consisted of 75.0% whites, 7.6% blacks, 9.1% Hispanics, and 8.3%
Asians. Compared to whites, the unadjusted HR for all-cause mortality for
blacks was 1.68 (P < .001), which attenuated to 1.15
(P = .039) after adjusting for stage and became
insignificant after including insurance. The unadjusted HRs for all-cause
mortality were not significant for Hispanics and Asians vs whites. Compared
to whites, blacks and Hispanics were more likely to present at later stages
(aORs of 2.63 and 1.42, P < .001, respectively). Conclusion The greater mortality for blacks vs whites was largely attributable to the
higher prevalence of later stages at presentation and being uninsured among
blacks. There was no statistically significant difference in mortality for
Hispanics vs whites or Asians vs whites.
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Affiliation(s)
- Alison J Yu
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.,Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Janet S Choi
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Mark S Swanson
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Niels C Kokot
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Tamara N Brown
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Guofen Yan
- Division of Biostatistics, Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Uttam K Sinha
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Prajeesh KM, Soni S. A Study of Toluidine Blue Staining in Suspected Oral Malignancies in Patients Presenting to Tertiary Care Hospital in Central India. Indian J Otolaryngol Head Neck Surg 2019; 71:492-497. [DOI: 10.1007/s12070-019-01672-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 05/30/2023] Open
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History and future perspectives for the use of fluorescence visualization to detect oral squamous cell carcinoma and oral potentially malignant disorders. Photodiagnosis Photodyn Ther 2019; 28:308-317. [DOI: 10.1016/j.pdpdt.2019.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 12/20/2022]
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Cunha ARD, Prass TS, Hugo FN. Mortality from oral and oropharyngeal cancer in Brazil: impact of the National Oral Health Policy. CAD SAUDE PUBLICA 2019; 35:e00014319. [PMID: 31800779 DOI: 10.1590/0102-311x00014319] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/03/2019] [Indexed: 11/22/2022] Open
Abstract
The objective was to investigate if there is an association between the mortality rates due to oral and oropharyngeal cancer in Brazil and the expansion of access to public primary and specialized dental care services that resulted from the implementation of the National Oral Health Policy, between 2000 and 2013. The mortality data were obtained from the records of the Mortality Information System and the exposure variables were obtained from databases of the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics. The main exposures investigated were "coverage of primary dental care" and "number of specialized dental care centers". Additional covariates included "Gini index of household income", "average number of years of study", "proportion of unemployed people" and "proportion of smokers". For the statistical analysis, a random coefficient model was used. There was a statistically significant association between the mortality rates by oral and oropharyngeal cancer with coverage by primary dental care and the number of specialized dental care centers with males. This study found that the expansion of the coverage of primary dental care and the number of specialized dental care centers are associated with the reduction of mortality rates due to oral and oropharyngeal cancer in Brazil. There is plausibility for the association found, which needs to be confirmed by implementation studies.
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Papadiochou S, Papadiochos I, Perisanidis C, Papadogeorgakis N. Medical practitioners' educational competence about oral and oropharyngeal carcinoma: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2019; 58:3-24. [PMID: 31785865 DOI: 10.1016/j.bjoms.2019.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/12/2019] [Indexed: 02/02/2023]
Abstract
Medical practitioners' (MP) role is pivotal in primary prevention, early diagnosis, prompt referral and effective management of oral and oropharyngeal carcinomas (OC/OPC), which raises the importance of their effective OC/OPC education at all levels of medical education. The purpose of this systematic review was to summarise the available scientific evidence about their educational competence in dealing with OC/OPC. We made a systematic search of papers in the English language in MEDLINE, Scopus, Cochrane Library CENTRAL and CINAHL databases from their inception until December 2018. Overall, 23 cross-sectional and three interventional studies have been selected for the systematic review and 18 of these were included in the meta-analyses. Excluding tobacco use (synthesised estimate of 95% of respondents identified tobacco as an OC/OPC risk factor, 95% CI of synthesised estimate 92% to 97%) and alcohol consumption (65%, 95%CI 52% to 77%), less than half of MP (approximately) were knowledgeable about important OC/OPC risk factors including human papilloma virus (42%, 95% CI 30% to 54%), poor diet (34%, 95% CI 17% to 54%), and advancing age (45%, 95% CI 21% to 70%). There was a low to moderate level of awareness among MP regarding common precancerous oral lesions involving leukoplakia (56%, 95% CI 32% to 79%), erythroplakia (30%, 95% CI 8% to 58%), and oral lichen planus (13%, 95% CI 0 to 41%). Moderate knowledge was also recorded about frequent sites of OC development involving the tongue (48%, 95% CI 33% to 64%) and floor of the mouth (37%, 95% CI 19% to 57%). Most MP enquired about tobacco use (86%, 95% CI 74% to 96%), and alcohol consumption (73%, 95% CI 47% to 94%) during history taking, and expressed willingness to be given supplementary OC/OPC education (78%, 95% CI 54% to 96%), as well. With regard to the incidence of intraoral screening, 27% of MP (95% CI 12% to 46%) make an intraoral examination as a routine. Interestingly, studies from each continent yielded significantly different outcomes to some research questions in the review. From the MP's perspective, clinical time restrictions and deficiencies in organised training were recognised as the main barriers towards their OC/OPC educational competence. The findings of this systematic review indicated the existence of deficiencies in knowledge and misconceptions, neglected preventive responsibilities, and associated barriers towards OC/OPC. A need for improved OC/OPC training at all levels of medical education is required to increase competence worldwide.
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Affiliation(s)
- S Papadiochou
- Health Center of Spata, Spata Attikis 19004, Greece.
| | - I Papadiochos
- Eacmfs Clinical Fellow, Chirurgie Maxillo-faciale et Stomatologie, CHU Amiens-Picardie, 1 Rue du Professeur Christian Cabrol, 80000 Amiens, France.
| | - C Perisanidis
- Oral & Maxillofacial Surgery Department, Evaggelismos General Hospital of Athens, National and Kapodistrian University of Athens, Greece.
| | - N Papadogeorgakis
- Oral and Maxillofacial Surgery, National and Kapodistrian University of Athens, Greece.
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Al‐Amad SH, Ghebeh M, Saloum P, Maarouf TB, Moustafa YM, Younis Z. Pharmacists' clinical competency towards oral mucosal diseases: Results from a mystery shopper study. Oral Dis 2019; 26:89-95. [DOI: 10.1111/odi.13208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/16/2019] [Accepted: 09/26/2019] [Indexed: 12/11/2022]
Affiliation(s)
| | - Maya Ghebeh
- College of Dental Medicine University of Sharjah Sharjah UAE
| | | | | | | | - Zeyad Younis
- College of Dental Medicine University of Sharjah Sharjah UAE
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Purkayastha M, McMahon AD, Gibson J, Conway DI. Is detecting oral cancer in general dental practices a realistic expectation? A population-based study using population linked data in Scotland. Br Dent J 2019; 225:241-246. [PMID: 30095121 DOI: 10.1038/sj.bdj.2018.544] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2018] [Indexed: 12/27/2022]
Abstract
Aims To examine, for the first time on a population-basis via data linkage, whether early detection by general dental practices (GDP) is a realistic expectation by i) estimating the number of OC cases/year a dentist in Scotland may encounter over time, accounting for the deprivation level of practice location and dental registration/attendance rates, and ii) assessing whether patients attended GDPs two years pre-diagnosis. Materials and methods Scottish Cancer Registry data on all OC cases (2010-2012), published NHS Scotland dental workforce and registration/participation statistics, and individual patient data linked with NHS dental service activity were analysed. Results Dentists were estimated to potentially encounter one case of OC every 10 years, OCC every 16.7 years, and OPC every 25 years. However, 53.7% of OC patients had made no dental contact two years pre-diagnosis. Conclusion Strategies for early detection must consider the rarity of OC incidence and poor dental attendance patterns. These results highlight the importance of improving access and uptake of dental services among those at highest risk to increase the opportunities for early detection.
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Affiliation(s)
- M Purkayastha
- Community Oral Health, University of Glasgow Dental School, Post-graduate Balcony, Level 9, 378 Sauchiehall Street, Glasgow, G2 3JZ
| | - A D McMahon
- Community Oral Health, University of Glasgow Dental School, Post-graduate Balcony, Level 9, 378 Sauchiehall Street, Glasgow, G2 3JZ
| | - J Gibson
- Community Oral Health, University of Glasgow Dental School, Post-graduate Balcony, Level 9, 378 Sauchiehall Street, Glasgow, G2 3JZ
| | - D I Conway
- Community Oral Health, University of Glasgow Dental School, Post-graduate Balcony, Level 9, 378 Sauchiehall Street, Glasgow, G2 3JZ
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Zhang X, Liu D, Dong H, Li Y, Zhang Y, Wang X, Zhang B, Bian L. Factors associated with delay in presentation among patients for oral cancer. J Comp Eff Res 2019; 8:1003-1071. [PMID: 31290337 DOI: 10.2217/cer-2019-0067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This study aimed to determine factors that influence delay in presentation among oral cancer patients. Materials & methods: A cross-sectional study with 128 Oral cancer patients receiving treatment from the Hospital of Stomatology, at Jilin University, in China, was conducted. Results: A total of 78 patients delayed seeking treatment for more than 3 weeks after noticing symptoms of oral anomaly. Patients who were male, farmers (Odds ratio [OR] = 2.617; 95% CI: 1.90–3.64), or currently smoking (OR = 4.651; 95% CI: 1.21–9.46), were more likely to delay. Patients alerted to the problem at a physical exam had much lower risk of delay than patients who discovered the disease independently (OR = 0.029; 95% CI: 0.01–0.30). Higher coping style scores (OR = 0.747; 95% CI: 0.47–1.18) and oral cancer knowledge scores (OR = 0.886; 95% CI: 0.60–2.01) were significantly correlated with shorter delays. Conclusion: Delay in presentation may be achieved through regular oral health screening and improved public education about factors influencing delay.
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Affiliation(s)
- Xinyan Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Dongling Liu
- School of Nursing, Jilin University, Changchun, Jilin, China
- Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Hongmei Dong
- Gastrointestinal Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yuxiang Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Ye Zhang
- Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Xiuli Wang
- Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Bingyan Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Lijuan Bian
- Department of Cataract, Eye Center, The Second Hospital of Jilin University, Changchun, Jilin, China
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Keser G, Pekiner FN. Assessing Oral Cancer Awareness Among Dental Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:512-518. [PMID: 29446005 DOI: 10.1007/s13187-018-1332-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of this study was to assess oral cancer awareness among undergraduate dental students in Marmara University Faculty of Dentistry. A validated questionnaire which tested oral cancer awareness was given to third- and fifth-year students of the dental faculty of Marmara University. A total of 198 students participated in this survey. Knowledge of oral cancer risk factors and diagnosis procedures, dentistry student's attitude towards oral cancers, management practice regarding oral cancer, and oral cancer information sources were assessed using 25 questions. The data were analyzed with IBM SPSS Statistics 22.0 program. Among 198 participant dentistry students, there were 99 (50%) third-grade and 99 (50%) fifth-grade students. The largest number of the third- and last-grade students identified tobacco (98%) and alcohol usage (87.4%), prior oral cancer lesions (94.9%), viral infections (91.9%), UV exposure (94.4%), betel quid chewing (84.8%), older age (62.1%), and low consumption of fruit and vegetables (85.4%). Both groups showed higher scores in indicating squamous cell carcinoma as the most common form of oral cancer (p < 0.05); yet, third-grade students performed significantly higher scores in indicating erythroplakia and leukoplakia for most likely to be precancerous (p = 0.001; p < 0.05). This study highlighted the importance of improved educational methods for dentistry on oral cancer detection and prevention.
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Affiliation(s)
- Gaye Keser
- Faculty of Dentistry, Department of Oral Diagnosis and Maxillofacial Radiology, Marmara University, Başıbüyük Sağlık Yerleşkesi Başıbüyük Yolu 9/3 Maltepe, 34854, Istanbul, Turkey.
| | - Filiz Namdar Pekiner
- Faculty of Dentistry, Department of Oral Diagnosis and Maxillofacial Radiology, Marmara University, Başıbüyük Sağlık Yerleşkesi Başıbüyük Yolu 9/3 Maltepe, 34854, Istanbul, Turkey
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The impact of the UK ‘two-week rule’ on stage-on-diagnosis of oral cancer and the relationship to socio-economic inequalities. J Cancer Policy 2019. [DOI: 10.1016/j.jcpo.2019.100191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Ahmed NHM, Naidoo S. Oral Cancer Knowledge, Attitudes, and Practices among Dentists in Khartoum State, Sudan. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:291-296. [PMID: 29151257 DOI: 10.1007/s13187-017-1300-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The dental professions hold an important responsibility in the control of oral cancer and the early diagnosis highly depends on their knowledge. The present study was developed to assess the knowledge, attitude, and practice of dentists in Khartoum State regarding oral cancer prevention and early detection. An administered questionnaire was structured and sent to all licensed 130 dentists working in public dental clinics in Khartoum State. Responses to the questionnaire were analyzed using descriptive and analytical statistics. Although the majority of the dentists were knowledgeable about the major risk factors of oral cancer, more than half of the dentists reported they do not carry out any special examination to detect oral cancer in age 40 and above in asymptomatic patients. Dentists indicated their lack of training as the main barrier for conducting a comprehensive oral cancer examination. Interestingly, the vast majority of the dentists express their interest to have further oral cancer educational and training sessions. The findings of the present study suggested strongly that educational and training interventions are necessary to enhance preventive measures which may lead to reduce mortality and morbidity from oral cancer.
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Affiliation(s)
- Nada H M Ahmed
- University of the Western Cape, Tygerberg, South Africa.
| | - Sudeshni Naidoo
- Department of Community Oral Health, University of the Western Cape, Tygerberg, South Africa
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Janse van Rensburg B, Freeman CR, Ford PJ, Taing MW. Investigating the management of potentially cancerous nonhealing mouth ulcers in Australian community pharmacies. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:415-423. [PMID: 30246463 DOI: 10.1111/hsc.12661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 05/20/2023]
Abstract
We sought to examine the management and referral of nonhealing mouth ulcer presentations in Australian community pharmacies in the Greater Brisbane region. Trained simulated patients visited 220 randomly selected community pharmacies within the Greater Brisbane region in 2016. Simulated patients enacted two nonhealing (>1 month) mouth ulcer scenarios: A direct product request (DPR) (n = 110) and a symptom-based request (SBR) (n = 110). Results were documented and evaluated against Australian national pharmacy practice standards. Referral rates for pharmacy staff (pharmacist, pharmacy assistant or mixed-pharmacist and assistant) were also assessed. Australian pharmacy practice standards recommend staff ask six key questions during SBR and DPR consultations to enable informed decision-making. Two questions relating to identifying the patient and their symptoms were asked in the majority of interactions (76% and 69% respectively); the remaining four questions relating to symptom duration, treatments tried, other medications, and medical conditions were enquired in only 32%, 53%, 31%, and 27% of interactions, respectively. Simulated patients were referred to the doctor/dentist in only 11.8% of all interactions (both scenarios requiring referral). Overall, staff handling of nonhealing mouth ulcer consultations was suboptimal compared to national professional standards. In particular, duration of the nonhealing mouth ulcer was enquired in less than one-third of consultations potentially resulting in low referral rates by staff. This study identifies the need for increased oral cancer awareness and education for community pharmacy staff and reinforcing the importance of practising according to professional standards to effectively screen for potentially cancerous nonhealing mouth lesions.
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Affiliation(s)
| | | | - Pauline J Ford
- School of Dentistry, The University of Queensland, QLD, Australia
| | - Meng-Wong Taing
- School of Pharmacy, The University of Queensland, QLD, Australia
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Diagnosis and referral delays in primary care for oral squamous cell cancer: a systematic review. Br J Gen Pract 2018; 69:e112-e126. [PMID: 30455220 DOI: 10.3399/bjgp18x700205] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 08/28/2018] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The incidence of oral cancer is increasing. Guidance for oral cancer from the National Institute for Health and Care Excellence (NICE) is unique in recommending cross-primary care referral from GPs to dentists. AIM This review investigates knowledge about delays in the diagnosis of symptomatic oral squamous cell carcinoma (OSCC) in primary care. DESIGN AND SETTING An independent multi-investigator literature search strategy and an analysis of study methodologies using a modified data extraction tool based on Aarhus checklist criteria relevant to primary care. METHOD The authors conducted a focused systematic review involving document retrieval from five databases up to March 2018. Included were studies looking at OSCC diagnosis from when patients first accessed primary care up to referral, including length of delay and stage of disease at time of definitive diagnosis. RESULTS From 538 records, 16 articles were eligible for full-text review. In the UK, more than 55% of patients with OSCC were referred by their GP, and 44% by their dentist. Rates of prescribing between dentists and GPs were similar, and both had similar delays in referral, though one study found greater delays attributed to dentists as they had undertaken dental procedures. On average, patients had two to three consultations before referral. Less than 50% of studies described the primary care aspect of referral in detail. There was no information on inter-GP-dentist referrals. CONCLUSION There is a need for primary care studies on OSCC diagnosis. There was no evidence that GPs performed less well than dentists, which calls into question the NICE cancer option to refer to dentists, particularly in the absence of robust auditable pathways.
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Macpherson LMD. Raising awareness of oral cancer from a public and health professional perspective. Br Dent J 2018; 225:809-814. [DOI: 10.1038/sj.bdj.2018.919] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 11/09/2022]
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Troiano G, Guida A, Aquino G, Botti G, Losito NS, Papagerakis S, Pedicillo MC, Ionna F, Longo F, Cantile M, Pennella A, Lo Russo L, Di Gioia G, Mariggiò MA, Lo Muzio L, Pannone G. Integrative Histologic and Bioinformatics Analysis of BIRC5/Survivin Expression in Oral Squamous Cell Carcinoma. Int J Mol Sci 2018; 19:ijms19092664. [PMID: 30205554 PMCID: PMC6174346 DOI: 10.3390/ijms19092664] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/02/2018] [Indexed: 12/27/2022] Open
Abstract
Survivin is a well-known protein involved in the inhibition of apoptosis in many different cancer types. The aim of this study was to perform an integrated bioinformatic and histologic analysis in order to study the expression and prognostic role of Survivin and its related gene BIRC5 in oral cancer. Publicly available databases were accessed via Gene Expression Omnibus and Oncomine, in addition raw data from The Cancer Genome Atlas (TCGA) were also obtained in order to analyze the rate of gene mutation, expression and methylation in patients with oral squamous cells carcinoma (OSCC). Immunohistochemistry (IHC) was also performed in order to evaluate the nuclear and cytoplasmic expression of Survivin and their correlation with cell proliferation in samples from OSCC patients. Results of this study revealed that Survivin is rarely mutated in OSCC samples and upregulated when compared to non-cancerous tissue. A negative correlation between the methylation of the island cg25986496 and BIRC5 mRNA expression was detected from TCGA data. IHC staining revealed that cytoplasmic (and not nuclear) expression of Survivin is associated with poor overall survival in OSCC patients, while the nuclear expression correlates with higher proliferation rate. In addition, data from TCGA database revealed that BIRC5 gene expression is an independent prognostic factor for OSCC patients.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Agostino Guida
- Maxillofacial and ENT Surgery Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Gabriella Aquino
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Gerardo Botti
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Nunzia Simona Losito
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Silvana Papagerakis
- Department of Surgery, Cancer Research Cluster, Room 4D10.2, Health Sciences Building, Saskatchewan University, Saskatoon, SKS7N5E5, Canada.
| | - Maria Carmela Pedicillo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Franco Ionna
- Maxillofacial and ENT Surgery Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Francesco Longo
- Maxillofacial and ENT Surgery Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Monica Cantile
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Antonio Pennella
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Giovanni Di Gioia
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Maria Addolorata Mariggiò
- Department of Biomedical Sciences and Human Oncology, University of Bari. Piazza Giulio Cesare 11, Bari 70124, Italy.
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Giuseppe Pannone
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
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Hassona Y, Sawair F, Matarweh D, Abdalhamid A, Thweib D, Scully C. Oral Cancer Early Detection: What Do Patients Need To Know? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:865-869. [PMID: 28220285 DOI: 10.1007/s13187-017-1191-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of the present study was to examine the educational needs of patients regarding early detection of oral cancer. A total of 790 patients without cancer were interviewed and shown a set of validated clinical images of various oral lesions including early oral cancer. Participants were asked about their perception of cancer and the action that they would take if they notice a similar lesion. Lower risk lesions (e.g., lumps) were more likely to be perceived as cancer (52.4%), while higher risk lesions (e.g., red patches) were least likely to be perceived as cancer (8.8%). The perceived appearance of the lesions was correlated with patients' perceived need for medical advice. Higher risk lesions were less likely to make patients feel the need to seek professional advice. High-risk patients were less aware about oral cancer appearance and were less likely to take action if they notice an oral lesion. Patients are not aware of the various presentations of early oral cancers, especially higher risk lesions. Patients need to know more about the clinical appearance of early oral cancer. The use of representative clinical images of early oral cancer and educational videos on self-inspection of oral mucosa is important.
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Affiliation(s)
- Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan.
| | - F Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - D Matarweh
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - A Abdalhamid
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - D Thweib
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - C Scully
- University College London, London, UK
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Monteiro LS, Antunes L, Santos LL, Bento MJ, Warnakulasuriya S. Survival probabilities and trends for lip, oral cavity and oropharynx cancers in Northern Portugal in the period 2000-2009. Ecancermedicalscience 2018; 12:855. [PMID: 30093917 PMCID: PMC6070366 DOI: 10.3332/ecancer.2018.855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Indexed: 12/15/2022] Open
Abstract
Background Oral cancer represents a serious public health problem worldwide. Our aim was to analyse the survival probabilities and trends of patients presenting with lip, oral cavity and oropharynx cancers, who were residents in the north of Portugal. Methods Using cancer-registry data, we conducted a population-based study of lip, oral cavity and oropharynx cancers diagnosed in the period 2000-2009, among residents in the north of Portugal. Net survival was estimated using the Pohar-Perme estimator. Excess hazard ratios (for gender, age group, tumour location, stage, residence area and period of diagnosis) were estimated using flexible parametric models. Results A total of 2,947 cases (79.5% males) were included of which 18.5% were located on the lip, 56.2% in the oral cavity and 25.3% in the oropharynx. A large proportion of patients were diagnosed in stages III and IV (18.6% and 48.7%, respectively). The 5-year net survival (5yr-NS) for all three cancer sites together was 46% (95%CI 44-48), being 88% (95%CI 83-94), 41% (95%CI 38-43) and 27% (95%CI 23-30) for lip, oral cavity and oropharynx cancer, respectively. The 5yr-NS stratified by tumour stage was 84% (95%CI 78-90) for stage I, 69% (95%CI 63-76) for stage II, 42% (95%CI 37-47) for stage III and 19% (95%CI 16-21) for stage IV. When comparing the periods 2000-4 and 2005-9, no overall improvements in survival were observed. However, when analysed by stage, a significant reduction in the adjusted excess mortality was observed for stages II (p = 0.021) and III (p < 0.001). Conclusion More than half of the oral cavity and oropharynx cancers were diagnosed in advanced stages of the disease, having a low survival probability. Improvements in survival in the first decade of this century were limited to stages II and III, which were the result of changes in hospital cancer care practices.
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Affiliation(s)
- Luís Silva Monteiro
- Department of Medicine and Oral Surgery, Cancer Research Group, IINFACTS, Instituto Universitário de Ciências da Saúde Norte-CESPU, Paredes 4585-116, Portugal
| | - Luís Antunes
- Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto 4200-072, Portugal
| | - Lúcio Lara Santos
- Experimental Pathology and Therapeutics Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Porto 4200-072, Portugal.,Department of Surgical Oncology, Portuguese Oncology Institute of Porto, Porto 4200-072 Portugal
| | - Maria José Bento
- Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto 4200-072, Portugal
| | - Saman Warnakulasuriya
- King's College London and WHO Collaborating Centre for Oral Cancer, London SE5 9RW, UK
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50
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Noro LRA, Landim JR, Martins MCDA, Lima YCP. The challenge of the approach to oral cancer in primary health care. CIENCIA & SAUDE COLETIVA 2018; 22:1579-1587. [PMID: 28538928 DOI: 10.1590/1413-81232017225.12402015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 10/29/2015] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to understand the performance of dentists in public health about mouth cancer. A cross-sectional study was performed whit 121 dentists from Fortaleza Health Department, interviewed through a semi-structured questionnaire. The study did not identify statistically significant difference regarding the ability to perform biopsy by gender, year of graduation, expertise or time of public service. Only 22 professionals (18.2%) reported being able to perform biopsies and 13 (10.7%) would do so at the Family Health Unit. The reference and counter-reference system, by including another stage in patient care, increase the possibility of absenteeism from patient to health service. Although clearly identify the relevance of oral cancer mortality in the population, the vast majority of dentists is not equipped to perform the biopsy as a routine activity. Whereas the vast majority of biopsies of the oral tissues is performed as an outpatient, low technological complexity to perform the procedure and the effectiveness of biopsy in the early diagnosis of oral cancer, it is essential to hold this procedure in primary care, what can effectively contribute to decreasing mortality from oral cancer.
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Affiliation(s)
- Luiz Roberto Augusto Noro
- Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte. Av. Salgado Filho 1787, Lagoa Nova. 59056-000 Natal RN Brasil.
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