Prevalence of oral cancer self-examination among elderly people treated under Brazil's Unified Health System: household health survey

Effectiveness of two educational interventions based on the theory of planned behavior on oral cancer self-examination in adults: a randomized controlled trial

BACKGROUND

The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022.

METHODS

This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17.

RESULTS

Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (β = 1.47), attitude (β = 0.66), subjective norm (β = 2.82), and perceived behavioral control (β = 1.19) in both groups (p < 0.001).

CONCLUSIONS

The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer.

TRIAL REGISTRATION

The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Mouth Self-Examination for Prevention and Control of Oral Cavity Cancer

Oral cavity cancer is one of the most common preventable cancers in the world. The burden of the disease is high in South Asia. Therefore, public health strategies such as creating awareness and disease screening should be advocated for its prevention and early detection. Mouth self-examination serves both the purposes. It is easy to perform, non-invasive, and low-cost methods. It not only helps in the early detection of suspicious oral lesions but also helps people to quit their high-risk behaviors such as consumption of tobacco and alcohol.

Prevalence of oral ulcers and its association with addictions in rural population of western Uttar Pradesh and eastern Rajasthan

BACKGROUND

Head and neck cancer in Indian perspective predominantly relates to tobacco use. The present study explores the prevalence of oral ulcers and its association with addictions among the population of Uttar Pradesh and Rajasthan, India.

METHODOLOGY

The screening method in early detection of head and neck cancer is broadly symptom based. 1399 subjects from Uttar Pradesh and Rajasthan were screened by trained personnel between April and June 2015.

RESULTS

Study findings showed, mouth ulcers and trismus were common symptoms and tobacco chewing and smoking were common addictions. There were statistically significant associations among the symptoms and addictions as well as predominance in rural populations. The majority of smokers (27.1%) belonged to age ≥55 years whereas the tobacco chewers (29.2%) and alcohol abusers (45.8%) in the age group 25-34 years. Also the risk of developing mouth ulcers and trismus in this area are approximately 35 (MRR: 35.7, 95% CI: 15.5-81.9) and nearly eight (MRR: 7.7, 95% CI: 2.2-26.6) times higher respectively in males. However, joint use of smoked and smokeless tobacco increases nearly three times more risk of either mouth ulcers or trismus.

CONCLUSION

Male individuals are more exposed to certain addictions such as tobacco (smoked and smokeless) and alcohol. The prevalence of oral ulcers is primarily associated with the addictions. Therefore, these persons are more at risk of further developing head neck cancer. A large level community screening and awareness are required especially among the rural population of India.