A study of the barriers and triggers for early detection of oral potentially malignant lesions

Abstract

In the case of oral cancer, early recognition and subsequent treatment of oral potentially malignant lesions are key to improving 5-year survival rates, as these have not improved over the past few decades. This stagnation of survival rates can be mainly attributed to delay in detection and diagnosis. It is proposed that the beliefs and behaviours of both patients and clinicians can delay the detection of oral cancer. Research has identified barriers to the early detection of oral cancer from both patient and clinician perspectives. Identification of these barriers has allowed an understanding of what factors may contribute to delay in detection of oral cancer, however there is limited original research in the literature in relation to their prevalence. It is important to ascertain how much of an impact each barrier has on delaying detection so that interventions may be targeted to reducing their burden. Furthermore, some clinician groups who contribute to patient oral care have not been included in previous studies. This thesis is divided into four experimental chapters. The first experimental chapter aims to quantify delay time for suspicious oral mucosal lesions, to identify factors associated with delay between appointments and to ascertain patient beliefs and attitudes towards oral mucosal screening. The second experimental chapter aims to describe oral mucosal screening and referral attitudes of Australian dentists. The third experimental chapter aims to identify barriers and triggers to oral mucosal screening and referral by Australian dental prosthetists, while the fourth experimental chapter aims to describe oral mucosal screening and referral attitudes of Australian oral health therapists and dental hygienists.