Knowledge, Practice, and Awareness of Oral Cancer and HPV Infection among Dental Students and Residents: A Cross-Sectional Study

Evaluation of Knowledge of Human Papillomavirus Infection and Its Oral Health Implications: A Comparative Study of Polish Medical and Dental Students

Background: Human papillomavirus (HPV) is a virus belonging to the Papillomaviridae family. Infection may be asymptomatic, mildly symptomatic, or clinically evident. It is mostly transmitted through sexual activity. It is estimated that approximately half of sexually active individuals will be infected with HPV, and among women over 50, this percentage increases to 80%. The aim of this study was to assess the level of awareness among medical and dental students regarding the impact of HPV infection on oral health. Materials and methods: This was a prospective study of 562 Polish medical and dental students. The questionnaire was originally designed based on the available literature and consisted of two sections: demographic questions and detailed questions about HPV and its impact on oral health. The data were analyzed using Statistica v. 13.3. All tests were considered statistically significant at p ≤ 0.05. Results: After excluding incomplete questionnaires, 541 remained and were included in the analysis. The medical students achieved a significantly higher average score compared to the dental students (p < 0.001). The students of higher years of studies were more knowledgeable. This tendency was observed both among all respondents together and among the medical and dentistry students separately. Conclusions: The medical students demonstrated a significantly higher level of knowledge on the discussed topic. However, both groups provided correct answers at a relatively unsatisfactory level because the overall value of the results obtained was below 60%. By the end of their education, the students in both fields demonstrated improved knowledge. The dental students gave an average of 74% correct answers, while the medical students achieved 73%. Therefore, the quality of university education regarding the relationship between HPV infection and oral lesions should be improved.

Turkish dental students' knowledge, attitudes, and awareness of oral cancer

PURPOSE

This survey aimed to assess the knowledge, attitudes, and awareness of dental students across multiple dental faculties in Turkey regarding oral cancer.

METHODS

The survey instrument, derived from the questionnaire developed by Horowitz et al., was translated into Turkish and distributed to participants. The survey consisted of 27 questions assessing participants' practices regarding oral cancer examination, their evaluation of patient risk factors, and their perceptions of their educational preparedness. Statistical analyses were conducted using IBM SPSS V23. The Fisher-Freeman-Halton test and Pearson Chi-Square test were employed for categorical data comparisons, while multiple comparisons were analyzed with the Bonferroni-corrected Z test. A significance level of p < 0.05 was applied.

RESULTS

The study enrolled a total of 603 dental students (239 males [39.6%] and 364 females [60.4%]) from 10 different dental faculties. Participants were distributed across three academic years, with 202 (33.5%) in the third grade, 280 (46.4%) in the fourth grade, and 121 (20.1%) in the fifth grade. The findings indicated that students demonstrated a high level of awareness regarding factors such as tobacco (98.7%), alcohol (82.9%), and ultraviolet (UV) exposure (94.5%). However, their knowledge appeared to be lacking in relation to other risk factors, including older age (74.9%) and Human Papillomavirus (HPV) infection (83.7%).

CONCLUSION

Overall, the study suggests that dental students in Turkey exhibit a moderate level of awareness concerning oral cancer. The outcomes of this investigation underscore the pressing need for enhancements in oral cancer education and training for undergraduate dental students. Furthermore, there is a visible need for the implementation of periodic, well-structured continuing professional development activities aimed at enhancing the oral cancer-related competencies of dental professionals in practice.

Knowledge and Awareness of Medical and Dental Students About Oral Cancer Risk Factors: A Systematic Review and Meta-Analysis

OBJECTIVE

This systematic review and meta-analysis aims to assess the knowledge and awareness of oral cancer risk factors among medical and dental students.

METHODS

This study followed the PRISMA guidelines and was registered in INPLASY (ID: 2024110035). Four databases were consulted (PubMed, Science Direct, Scopus, and Web of Science) from February 20th, 2005, to May 10th, 2024. The study selection and data extraction process was performed independently by 2 investigators. The risk of bias was assessed using the JBI tool, which can be found at: https://jbi.global/critical-appraisal-tools. A third investigator was consulted in case of disagreement. Meta-analysis results were systematically illustrated in a forest plot and expressed as odds ratio with 95% confidence interval. The I2 statistic assessed heterogeneity between studies. Funnel plot and Egger regression analysis were used for bias analysis. A P value <.05 was considered significant. All statistical analyses were performed using the STATA V.15 software.

RESULTS

After the selection process, 41 studies met the eligibility criteria, comprising a total of 14,425 participants, 22% medical students and 78% dental students, primarily female (53%). The meta-analysis showed that 98% of students demonstrated relatively good knowledge about oral cancer risk factors. The most recognized risk factor was smoking (99%), followed by advanced age (68%), UV-rays exposure (64%), and alcoholism (57%). Knowledge of several other factors was comparatively lower, with less than 50% of students recognizing them. The studies indicated significant heterogeneity (I2 = 99.8%) and publication bias (P < .001).

CONCLUSIONS

These findings suggest that while medical and dental students have a strong understanding of key risk factors for oral cancer, there are gaps in knowledge regarding other important factors. Addressing these gaps through enhanced education and training is essential to improving early detection and prevention efforts.

Knowledge and Awareness of Dental Students Regarding Human Papillomavirus and Oral Cancer in Saudi Arabia

OBJECTIVE

This study aimed to evaluate the knowledge and awareness of dental students and interns in Saudi Arabia regarding human papillomavirus and oral cancer using a cross-sectional web-based survey.

MATERIALS AND METHODS

A cross-sectional survey was undertaken to assess the knowledge of dental students and dental interns regarding oral cancer and awareness of human papillomavirus (HPV) in public and private dental schools in Saudi Arabia. The survey included 18 questions grouped into three sections. The responses were analyzed for variations between dental students and interns, among males and females, and those attending private or public colleges. The Chai-square test assessed the correlation between participants' demographic data and their knowledge/awareness of oral cancer and HPV.

RESULTS

A total of 451 dental students and dental interns responded. The results show that dental students at private and public dental schools in Saudi Arabia are generally knowledgeable regarding knowledge of oral cancer and awareness of human papillomavirus. The dental interns exhibited significantly superior knowledge compared to the undergraduate dental students (p<0.05), particularly in the areas of identifying the most common location of oral cancer and recognizing the signs and symptoms of oral cancer (76.5% versus 65.1% correct answers). The dental interns showed a significant difference and better awareness (p<0.05) than dental students regarding HPV having a relationship with AIDS and HPV causing common warts.

CONCLUSION

Dental students and interns in this study presented a good but less than optimal knowledge and awareness regarding HPV and its prevention. Improving education courses and training for dental students in Saudi Arabia is crucial for improving their knowledge and awareness regarding oral cancer and HPV infection.

Awareness of the Link Between Human Papilloma Virus Infection and Head and Neck Cancer Among the General Population and Practitioners: A Literature Review

Background: Human papilloma virus (HPV) infection is responsible for 4.5% of cancers worldwide, i.e., for around 630,000 new cases per year. Around 38,000 cases per year of HPV-related cancers arise in the head and neck region, of which 21,000 cases are oropharyngeal squamous cell carcinomas (OPSCCs), with an increasing frequency in high-income countries. In our work, we aimed to collect the available evidence about the awareness of the relation between HPV infection and head and neck cancer among patients and practitioners. Methods: This review was based on all available prospective and retrospective studies, case reports, and review articles published up to May 2024 in PubMed. The search keywords used included "human papilloma virus" plus "head and neck cancer", "awareness", "infection", "vaccination", "awareness in patients and practitioners", "oropharyngeal squamous cell carcinoma", "HPV16-18", "HPV awareness", "cervical cancer". Results: In the U.S.A., with more than 150.00 participants interviewed through different studies, the identification of HPV infection as a risk factor for head and neck cancer (HNC) was made by only 12-39% of the participants. Similar conclusions were drawn from European studies in which only 10-52% of the participants recognized HPV as a risk factor for HNC. HPV-related HNC awareness in health care providers and medical/dental students showed a high variability among studies, being otolaryngology and dental sciences specialists the most conscious in comparison to general practitioners, who demonstrated a low level of awareness. Conclusions: There is a dangerous lack of awareness about HPV infection and its potential role in HNC among both general populations and health care practitioners. A great effort should be made to increase awareness in both practitioners and the general population on this topic, also aiming to increase the HPV vaccination coverage.

Improving HPV-Related Oropharyngeal Cancer Knowledge and HPV Vaccination Rates via Virtual Workshops

OBJECTIVE

To validate the efficacy of a virtual, interdisciplinary workshop in improving HPV knowledge, and vaccination practices among primary care and dental trainees.

METHODS

A virtual platform was utilized to hold HPV educational workshops with primary care and dental trainees. Online surveys were distributed before and after the 1-h interactive workshop, led by otolaryngology residents. Surveys included the workshop's impact on (a) improving knowledge of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) and (b) affecting change in HPV vaccination practices. The vaccination rates of trainees were recorded prior to and after workshop attendance.

RESULTS

After the workshop, participants demonstrated significantly improved scores related to knowledge of HPV in the head and neck (p = 0.003) and showed an increased comfort level with counseling on HPV vaccination (p = 0.002). Respondents were also more aware that the HPV vaccine is approved to prevent OPSCC (61% vs. 95%, p < 0.05). Ninety-seven percent of respondents stated that the workshop changed their HPV vaccination practices, and 95% of those not fully vaccinated stated they would now be more likely to receive the vaccine themselves. There was a significant increase in the average number of HPV vaccines administered at the studied trainee clinic, from 16.83 vaccines/month to 37.6 vaccines/month (percent increase = 123%) in 5 months following the workshop (p = 0.002).

CONCLUSION

The present interactive virtual workshop demonstrates efficacy in improving HPV-related knowledge and vaccination practices among trainees. The virtual nature of the course facilitates knowledge transfer and can be used to foster multi-institutional partnerships regarding medical education and vaccination efforts.

LEVEL OF EVIDENCE

4 Laryngoscope, 134:3096-3101, 2024.

Investigating women's awareness and perceptions on human papillomavirus infection and oropharyngeal cancer in Italy

Introduction

This study explored knowledge, attitudes and behaviors toward human papillomavirus (HPV) infection and oropharyngeal cancer (OPC) among women attending primary care services.

Methods

The cross-sectional study was conducted from September to December 2022 in adult women attending three primary care services in Italy, who were invited to complete a self-administered questionnaire.

Results

Overall, 34.7% of participants know that OPC is HPV-associated; knowledge was higher among women who had personal, familiar or friends' experience of cancer, and who reported to often seek dental care, whereas it was lower in older women. The perception of risk of developing OPC was high for 26.4% of women and was higher in those who had experienced STD, who knew that early sexual debut is a risk factor for OPC, and who considered useful the role of dentists on the provision of information about OPC. Only 22.5% had received HPV vaccination, but 62% intended to receive it in the future. Moreover, 63.2% believe that HPV vaccination is very useful to prevent OPC and only 27% are concerned about health consequences of HPV vaccination.

Conclusion

These findings indicate that women's awareness of the role of HPV infection in the development of OPC is not satisfactory and underline the role that dentists might have in improving their patients' awareness on HPV related OPC.