Abstract
BackgroundOral cancers account for 3% of annual U.S. cancer diagnosis, 2 in 5 of which are diagnosed late when prognosis is poor. The purpose of this study was to report the population-level prevalence of oral cancer examination among adult smokers and alcohol drinkers and assess if these modifiable lifestyle factors are associated with receiving an oral cancer examination.MethodsAdult participants ≥30 years (n = 9374) of the 2013–2016 cycles of the National Health and Nutrition Examination Survey were included. Oral cancer examination (yes/no), smoking (never, former, current) and alcohol use (abstainers, former, current) were self-reported. Survey-logistic regression estimated odds ratios (OR) and 95% confidence intervals (CIs) of ever and past year oral cancer examination adjusted for age, gender, race/ethnicity, education, income, and time since last dental visit.ResultsOne third (33%) reported ever been examined for oral cancer, 66% of whom reported an examination in the past year. Adjusted OR (95% CI) of past year examination comparing current and former smokers to non-smokers were 0.51 (0.29, 0.88) and 0.74 (0.53, 1.04) respectively. Similarly, current and former alcohol drinkers relative to abstainers were less likely to report a past year oral cancer examination, OR (95% CI) = 0.84 (0.53, 1.30) and 0.50 (0.30, 0.83) respectively.ConclusionThis study showed that smokers and alcohol users were less likely than abstainers to self-report a past year oral cancer examination. Access to affordable and targeted oral cancer examination within the dental care setting might ensure that these high-risk individuals get timely examinations and earlier diagnosis that might improve prognosis and survival.
Highlights
Oral cancers account for 3% of annual U.S cancer diagnosis, 2 in 5 of which are diagnosed late when prognosis is poor
In a pooled analysis of 15 case control studies, smoking was associated with a 2-fold higher odds of oral cavity cancers among never drinkers of alcohol and excessive alcohol consumption was associated with increased odds of oral cancers among never smokers [4]
About a third (33%) self-reported ever receiving an oral cancer examination of whom 66% received this examination in the past year and 19%, 1–3 years prior
Summary
Oral cancers account for 3% of annual U.S cancer diagnosis, 2 in 5 of which are diagnosed late when prognosis is poor. The purpose of this study was to report the population-level prevalence of oral cancer examination among adult smokers and alcohol drinkers and assess if these modifiable lifestyle factors are associated with receiving an oral cancer examination. Oropharyngeal cancers, a subset of head and neck cancer has the human papillomavirus (HPV) as an important risk factor [3] while modifiable lifestyle behaviors including smoking and alcohol consumption are implicated in the etiology of oral cavity cancers. In a pooled analysis of 15 case control studies, smoking was associated with a 2-fold higher odds of oral cavity cancers among never drinkers of alcohol and excessive alcohol consumption was associated with increased odds of oral cancers among never smokers [4]. Dual use of tobacco products and alcohol act synergistically and together accounts for 3 in 4 oral cavity cancer cases [5]
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