Oral Cancer Examination Research Articles

A Study to Assess the Effectiveness of Planned Teaching Programme regarding Knowledge on oral Cancer and Oral Self Examination among the Auto Drivers at Kanyakumari District

A Study to Assess the Effectiveness of Planned Teaching Programme regarding Knowledge on oral Cancer and Oral Self Examination among the Auto Drivers at Kanyakumari District

Diagnostic approach used by US general dental practitioners following discovery of oral lesions suspicious for malignancy/premalignancy: findings from the National Dental Practice-Based Research Network.

Oral cancer examinations seek to clinically identify early oral cancers and discover premalignancies prior to their progression to invasive cancer. A cross-sectional study was conducted between April and August 2017 to explore and quantify the diagnostic approach used by United States (US) general dental practitioners following discovery of an oral lesion suspicious for malignancy/premalignancy. US licensed general dental practitioners who were clinically active members of the US National Dental Practice-Based Research Network were eligible to participate. Data for analysis were obtained via two questionnaires. The majority of participants were males, practiced full-time, had a suburban primary practice, were born during the 1950s, and graduated dental school in the 1980s or 2000s. After identifying an oral lesion suspicious for premalignancy/malignancy, the next action of most general dental practitioner respondents (65.4%) was to refer the patient for consultation/biopsy. Most general dental practitioners (87.2%) referred to an oral and maxillofacial surgeon; 22% of general dental practitioners reported personally biopsying suspicious lesions. There was a relatively weak association between completing an Advanced Education in General Dentistry or General Practice Residency and subsequently personally performing biopsies on patients with oral lesions suspicious for malignancy/premalignancy (OR 1.33, P = .06). Most written referrals took place electronically and often included information, including lesion location (87.0%), lesion sign/symptoms (85.3%), lesion history (83.9%), radiographs (59.3%), medical history (50.6%), dental history (48.8%), and photographs (42.4%). When a referral biopsy was performed, referring clinicians were most frequently informed of the findings via a written report (96.7%, when positive for malignancy/premalignancy, and 95.4% when negative). A snapshot is presented of current actions taken by US general dental practitioners following the discovery of oral abnormalities suspicious for premalignancy/malignancy.

Knowledge, Attitudes, and Practices Towards Oral Cancer Among Dental Practitioners in the Northeastern Region of India: An Online Cross-Sectional Survey.

This study aimed to review the overall knowledge of oral cancer based on its clinical presentation as well as associated risk factors, attitudes towards oral cancer examination, and practices among dentists in the northeastern region of India. A total of 300 dentists practicing in various parts of the northeastern region participated in this online cross-sectional study. A questionnaire consisting of 26 questions was mailed to the dentists requesting them to fill in the survey form. Based on their responses, knowledge of the risk factors of oral cancer, information on attitudes towards oral cancer examination, and clinical practices were attained. The data was analyzed using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, New York, United States). Descriptive statistics was used for demographic variables. Unpaired t-test and one-way ANOVA were used to compare the mean knowledge scores with demographic variables. The level of significance was set at P<0.05. Overall, the knowledge of the risk factors of oral cancer was low among dentists. The majority were not familiar with the proper physical oral examination steps and considered oral medicine specialists to have a vital role. This study revealed areas in which the knowledge, attitudes, and practices were good to below average and identified areas where improvement is required. Gaps in dentists' knowledge of oral cancer could be identified; dentists displayed substandard knowledge of the clinical presentation as well as risk factors of oral potentially malignant disorders.

The ISAC Paradigm to Tame Oral Cancer in Saudi Arabia: A Quasi-experimental Study

Late detection of oral cancer (OC) cases in Saudi Arabia is concerning. It reduces survival rate and complicates treatment. The ISAC intervention was developed to bridge the gaps observed in dentists’ practice of OC examination and patient education. The ISAC stands for I, informing patients of OC screenings; S, screening for OC; A, advising high-risk patients to quit risk factors; and C, connecting patients to advanced services. This study tested the potential effect of the ISAC in influencing dentists’ cognitive and behavioral skills, to enhance early detection and prevention of OC. A quasi-experimental study was conducted among dental interns (DIs) at dental setting to test the effect on comprehensive oral cancer examination score (COCE), awareness, self-efficacy, descriptive-norms, and self-reported behavior. Data were collected through triangulation of methods pre and post the intervention at two-months. Multiple linear mixed effects regression models were utilized for data analysis. Between October 2020 and April 2021, 47 DIs participated in the study. The final model showed the significant effects of time (ISAC) on COCE (95% CI = 25.12–29.42, P < .001). DIs had a significant improvement in awareness, self-efficacy, descriptive norms, and self-reported behavior. The findings showed promising effects of the intervention toward the early detection and prevention of OC. Dentists, dental organizations, and policymakers in areas with a high risk of OC could benefit from the current intervention which contributes to capacity building and improved community health. A pragmatic study with a robust design is needed to test the effectiveness of the intervention on a wider scale.

Noninvasive oral cancer screening based on local residual adaptation network using optical coherence tomography.

Oral cancer is known as one of the relatively common malignancy types worldwide. Despite the easy access of the oral cavity to examination, the invasive biopsy is still essential for final diagnosis, which requires laborious operation and complicated trained specialists. With the development of deep learning, the artificial intelligence (AI) technique is applied for oral cancer examinations and alleviates the workload of manual screening on biopsy. However, existing computer-aided oral cancer diagnostic methods focus on oral cavity environment photos and histology images, which require complicated operations for doctors and are invasive and painful for patients. As a noninvasive, real-time imaging technique, optical coherence tomography (OCT) can express sufficient identical information for oral cancer screening, but it has not been effectively explored for automatic oral cancer diagnosis. This paper proposes a novel deep learning method named Local Residual Adaptation Network (LRAN) for noninvasive oral cancer screening on OCT images, collected from 25 patients in Beijing Stomatological Hospital. Our proposed LRAN consists of a Residual Feature Representation (RFR) module and a Local Distribution Adaptation (LDA) module. Specifically, RFR firstly adopts stacked residual blocks as the backbone network to learn feature representations for training data, optimized by the Cross-Entropy loss, and then deploy Euclidean distance to measure the distribution distance between training and testing OCT images. Finally, LRAN achieves distribution-gap bridging by the LDA module, which integrates local maximum mean discrepancy constraint to estimate and minimize the distribution discrepancy between training and testing sets within the same category. We also collected an OCT-based oral cancer image dataset to evaluate the effectiveness of the proposed method, and it achieves an accuracy of 91.62%, a sensitivity of 91.66%, and a specificity of 92.58% on this self-collected dataset. Furthermore, we conduct a quantitative and qualitative analysis, and the results demonstrate LRAN model has excellent capability to solve the noninvasive oral cancer screening task.

Oral cancer awareness among patients at 3 university hospitals in Poland and Germany: A survey research.

The epidemic of cancer (including oral cancer) is a growing public health and economic problem in the European societies. A high percentage of patients who come for the appropriate treatment are in the late stages of advancement, often with nodal and/or distant metastases. The literature on the public oral cancer awareness in Poland and Germany is limited. To investigate the levels of public awareness about the early symptoms and risk factors of oral cancer, and to analyze the findings in the context of the socioeconomic profiles of the subjects. The survey consisted of a 20-item questionnaire divided into 4 sections: socioeconomic and demographic factors, the awareness of oral cancer, symptoms of oral cancer, and its risk factors. It was distributed to 465 adult patients in Poland (Wrocław and Łódź) and Germany (Dresden). The response rate was 97.6%. Most of the respondents (65.4%) had heard of oral cancer. The sources of information were mainly the traditional mass media and the Internet, with only 23.8% of the respondents indicating doctors as a source of information about oral cancer. What is worrying, only about 1/5 of the participants in each of the 3 centers had an oral cancer examination last year. The awareness of oral cancer correlated positively with the age of the respondents and negatively with the size of the place of residence. Education level had no significant impact on declared knowledge. The results of this survey do not only show unsatisfactory levels of patients' awareness of the risk factors and symptoms of oral cancer but also emphasize the need to improve the level of healthcare concerning this disease, including screening programs.

Oral cancer and extra-oral examinations

Oral cancer and extra-oral examinations

Observing the Passive Behavior of Dentists towards Oral Cancer Examination and Patient Education: A Case Series

Observing the Passive Behavior of Dentists towards Oral Cancer Examination and Patient Education: A Case Series

Using the Exploratory Sequential Mixed Methods Design to Investigate Dental Patients’ Perceptions and Needs Concerning Oral Cancer Information, Examination, Prevention and Behavior

Objectives: The objective of this study was to investigate dental patients’ behavior, thoughts, opinions and needs for oral cancer information, and dentists’ behavior regarding prevention and examination of oral cancer. Materials and Methods: This study utilized an exploratory sequential mixed methods design. Semi-structured interviews with open-ended questions were conducted for forty dental patients of both sexes. Based on the qualitative analysis, a structured questionnaire was developed and distributed among the participants. Data were analyzed for 315 participants to quantify their thoughts, needs, behavior and behavior expected from dentists regarding oral cancer. Frequency, percentages and cumulative percentages were calculated. Results: This study reveals that patients’ oral cancer knowledge levels were adequate, but most reported that their dentist had never examined them for oral cancer. Additionally, the participants had never performed self-examinations for oral cancer, nor were they aware of the possibility of doing so. Participants showed a preference for being examined and educated by their dentist about oral cancer and believed it would help early detection. Conclusions: The study participants are aware of oral cancer and its risk factors. The practice of oral cancer examinations and patient education of its risk factors by dental practitioners is limited. Patients feel a need for more attention to be paid to oral cancer examinations, preventive measures and targeted information on oral cancer risk factors.

Oral cancer knowledge and screening behavior among smokers and non-smokers in rural communities

BackgroundResearch suggests having an oral and pharyngeal cancer (OPC) examination for early diagnosis can increase survival rate. However, the OPC screening rate is low in certain populations. To improve OPC screening rate, this study identified factors that are associated with having an OPC examination.MethodsParticipants with landlines and aged 25 years and older were recruited from six northern Florida counties. Bivariate and logistic regressions were used to predict the outcome of whether the participants had ever had an OPC examination as well as whether participants had ever heard of an OPC examination.ResultsOf 2260 participants with a mean age of 55.9 ± 15.0 years, the majority of participants never smoked (53.4%), self-identified as Whites (70.6%), and had some college or 2-year degree education (30.3%). Smokers were significantly less likely to have ever heard of an OPC examination than those who never smoked. Significant interaction between smoking status and race, and smoking status and social support interaction were found. Whites who never smoked were more likely to have had an OPC examination than non-Whites who never smoked. Former and current smokers with greater social support were more likely to have had an OPC examination than those with lower social support.ConclusionThe findings from this study inform the need to enhance the awareness of having an OPC examination among smokers and to reduce barriers for racial minority populations to receive an OPC examination. Future research is warranted to develop interventions to target certain populations to improve the rate of OPC examination.

Dental Education for Prevention of Oral Cancer in Turkey: Needs for Changing the Curriculum.

The aim of the present study is to evaluate the knowledge, attitudes, and behaviors of dental students on oral cancer in Istanbul, Turkey. A self-administered questionnaire adapted from Tanriover et al. consisting of 48 questions was distributed to 311 students enrolled in the fourth and fifth grades of a dental faculty in Istanbul, Turkey. Questions were grouped under 5 main headings: socio-demographic features, knowledge on risk factors and diagnostic procedures, history taking regarding to alcohol and smoking status, opinions and behaviors of oral cancer, and distribution of dental students according to diagnostic practice of oral cancer. The frequencies and percentages were calculated with descriptive analysis. The differences in distributions were analyzed using the chi-squared test. The p value was set at 0.05 for statistical significance. The overall response rate was 98% (305/311). The majority of the students identified tobacco and alcohol as risk factors (82% and 75.1%, respectively), while older age and inadequate consumption of fruits and vegetables were less likely to be known (60.2% and 52.8%, respectively). Almost one-fifth of the students stated that they have never performed oral cancer examinations during their first or subsequent dental examinations of their patients. Female students thought that dentists were authorized to make oral cancer examinations with a higher frequency compared to males (65.8% and 34.2%, respectively; p = 0.006). On the other hand, female students reported that they did not receive adequate education regarding cessation of smoking with a higher frequency compared with males (69.2% female and 30.8% male respectively; p = 0.0001). As this present study revealed that future dentists had insufficient knowledge in some of the main concepts on oral cancer risk factors, and they lacked the confidence in performing oral examinations in their patients, it is concluded that there is a need for a more structured teaching program with greater emphasis on the early signs and risk factors of OC. Reorganization of the dental curriculum, and courses which further draw attention on the responsibility of the dental practitioner in the detection of oral cancers will be beneficial for the creation of awareness on this significant topic among future dental workforce. Understanding the knowledge and perception of dental students on oral cancers is not only limited to a specific country but it is a worldwide critical issue in which information should be exchanged.

Dentists Behavioral Factors Influencing Early Detection of Oral Cancer: Direct Clinical Observational Study

This study aimed to investigate the possible factors affecting dentists’ behavior relating to performing oral cancer examinations as part of routine clinical examination. A total of 95 direct clinical observation sessions—utilizing an instrument consisting of 19 evidence-based observational criteria for oral cancer examinations—were observed by four calibrated dentists. Thirty-two final-year students, 32 interns, and 31 faculty members of Jazan Dental School were examined between April 9 and May 4, 2017. A descriptive analysis was conducted to investigate the frequencies/percentages of the performed observing criteria by all examiners. ANOVA and Tukey tests were carried out to investigate the difference between the examiner groups. A total number of 32 patients participated in the study, whereby each patient was examined by three different examiners from each group, as well as by the attending observer/s. Fewer than 50% of the examiners performed the clinical steps necessary for an oral cancer examination—for example, taking into account past medical history, as well as extra and intra-oral examinations. More than 90% of the examiners examined hard tissue, whereas fewer than 30% of them educated their patients about possible risk factors. A significant difference between examiner groups was found in favor of faculty members. A gap between knowledge and actual practice of oral cancer examinations was evident: majority of participants failed to perform the necessary steps for an oral cancer examination. Previous experience and confidence in performing oral cancer examination are possible explanations for the dentist’s behavior toward oral cancer examination.

Chronic Disease Counseling and Screening by Dental Professionals: Results From NHANES, 2011-2016.

IntroductionDental visits may provide an opportunity to counsel and screen for chronic disease prevention. However, few studies have used nationally representative data to assess the potential role of dental professionals in chronic disease prevention. We examined the percentage of US adults who reported chronic disease counseling and screening by dental professionals.MethodsWe analyzed data from the National Health and Nutrition Examination Survey 2011–2016 for 5,541 participants aged 30 or older who reported seeing a dental professional in the past year and estimated the percentage who reported receiving counseling about selected chronic disease prevention during the visit. We used logistic regressions to examine associations between risk factors and counseling.ResultsOverall, 4.0% (standard error [SE], 0.3) of adults were told by a dental professional about the benefits of checking blood glucose, 42.4% (SE, 2.9) giving up tobacco (among tobacco users), 26.6% (SE, 1.2) about checking for oral cancer, and 43.0% (SE, 1.8) had an oral cancer examination. Groups with risk factors were more likely to receive health behavior counseling than those without (eg, those previously told they had diabetes risk factors were more likely to receive blood glucose counseling than those without [8.1% vs 3.3%, P < .05]). The pattern for oral cancer counseling and receiving an oral cancer examination was different: adults without oral cancer risk factors (no tobacco use, normal/underweight, and/or excellent/very good health) were more likely to receive oral cancer counseling or screening. Adjusted analyses did not change these associations.ConclusionMost adults were not counseled about chronic disease prevention during a visit with a dental professional. Current tobacco users and those with overweight or obesity were more likely to report receiving counseling.

PCN193 ORAL CANCER KNOWLEDGE AND SCREENING BEHAVIOR AMONG SMOKERS AND NON-SMOKERS IN RURAL COMMUNITIES

Research suggests having an oral and pharyngeal cancer (OPC) examination for early diagnosis can increase survival rate. However, the OPC screening rate is low in certain groups. The goal of this study is to identify factors that are associated with having an OPC examination. Participants with landlines and aged 25 years and older were recruited from six northern Florida counties. Bivariate and logistic regressions were used to predict the outcome of whether the participants had ever had an OPC examination as well as whether participants had ever heard of an OPC examination. Of 2,260 participants with a mean age of 55.9±15 years, the majority of participants never smoked (53.4%), self-identified as Whites (70.6%), and had some college or 2-year degree education (30.3%). Smokers were significantly less likely to have ever heard of an OPC examination than those who never smoked. Significant smoking status by race interaction and smoking status by social support interaction were found. Whites who never smoked were more likely to have had an OPC examination than non-whites who never smoked. Former and current smokers with greater social support were more likely to have had an OPC examination than those with lower social support. These findings from this study inform the need to enhance the awareness of having an OPC examination among smokers and reduce barriers for racial minority populations to receive an OPC examination. Future research is warranted to develop interventions to target certain populations to improve the rate of OPC examination.

Lifestyle risk factor related disparities in oral cancer examination in the U.S: a population-based cross-sectional study

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.

What Do Dentists and Dental Students Think of Oral Cancer and Its Control and Prevention Strategies? A Qualitative Study in Jazan Dental School

Jazan region of Saudi Arabia has a high prevalence of oral cancer: 35% of cases. However, little is known about the view of dentists and dental students on possible factors that contribute to this high rate with scarce efforts regarding prevention. The study investigated possible factors related to oral cancer as perceived by dentists and dental students, using a qualitative approach. Six focus groups conducted in Jazan Dental School (JDS) and participants included dental students, interns, faculty members, and key decision-makers. All participants acknowledged oral cancer a serious public health issue in Jazan affecting all ages. The majority thought that tobacco is a major risk factor in this region, which can easily be obtained by individuals of any age or gender. Further, formal dental education in the country is not focusing on the local related risk factors. Participants agreed that practicing oral cancer examination and its risk factors education is related to clinicians’ attitude and skills. Several participants declared that no organized effort established toward oral cancer and its risk factors in the region. Cultural acceptance of oral cancer risk factors was mentioned as one of the challenges for patients. The findings indicate that dental education and training at JDS are not focusing on necessary related oral health issues and their risk factors in the community. Also, it casts a new light on the fact that dentists are not educating their patients because they lack the knowledge and the skill of health education and patients’ communication methods.

Oral cancer examinations and lesion discovery as reported by U.S. general dentists: Findings from the National Dental Practice-Based Research Network

General dentists (GDs) have the opportunity to examine their patients for oral premalignancy/malignancy. We estimated the annualized per dentist number of oral lesions suspicious for premalignancy/malignancy discovered by United States (U.S.) general dentists and the annualized per dentist number of histologically-confirmed cancers subsequently diagnosed. Eligible participants were licensed, clinically-active U.S. GDs who were members of the U.S. National Dental Practice-Based Research Network. An a priori sample size of 900 was determined; 2000 GDs were invited to participate; 1,073 completed the study. Self-reported, cross-sectional data were obtained via an online questionnaire during 4/12/2017–8/31/2017 and analyzed. The reported numbers of suspicious oral lesions and histologically-confirmed oral cancer cases diagnosed over the previous six months were quantified. Potential outcome predictors were evaluated as covariates in multivariable analyses. Crude and adjusted statistics were produced by regressing each outcome on each independent variable while assuming a Poisson distribution, log link and utilizing robust standard errors. Eighty-seven percent of dentists reported discovering 1+ lesion suspicious for oral premalignancy/malignancy during the preceding six months. The mean number of suspicious lesions/dentist/year was 9.5; adjusted mean: 9.6. Fifteen percent of participants reported discovering 1+ lesion confirmed as cancer during the same period, 213 confirmed cancer cases/6 months or 426/year. Crude and adjusted mean numbers of histologically-confirmed oral cancers were both 0.4 cancers/dentist/year. Our findings suggest that many U.S. general dentists are actively identifying oral lesions suspicious for premalignancy/malignancy, thereby aiding in the discovery of oral malignancies and representing an important component in the frontline against cancer.

Classification Tree Analysis of Factors Associated with Oral Cancer Exam.

Objective: In this study, we performed a classification tree analysis (CTA) to identify population subgroups that are less likely to have an oral cancer examination (OCE). Methods: We conducted telephone surveys (N = 2401) of adults residing in north Florida to collect data on OCE status and potential OCE predictors including demographics, medical and dental experience, and psychosocial factors. The CTA algorithm exhaustive chi-square automatic interaction detector (E- CHAID) was employed to determine the relationships between OCE status and the predictors. Results: The overall OCE rate was 46.8% in our sample. Participants' rating of the dentist was the first level splitting variable, leading to 15 unique participant subgroups: (1) high dentist rating (N = 1269) led to 5 splits and 11 subgroups; (2) low dentist rating (N = 308) led to zero splits; and (3) no regular dentist (N = 824) led to 2 splits and 3 subgroups. Conclusions: The CTA has identified unique population subgroups that could be targeted in future tailored public health interventions. Among underserved populations, it is important to develop and implement community-based interventions that encourage regular dental visits and provide oral cancer self- examination education..

Commentary: Oral cancer examinations and lesion discovery as reported by U.S. general dentists

Commentary: Oral cancer examinations and lesion discovery as reported by U.S. general dentists

College Students' Knowledge Concerning Oropharyngeal Cancer, Human Papillomavirus, and Intent Toward Being Examined.

The purpose of this study was to assess college students' knowledge of oral/oropharyngeal cancer and the relationship of human papillomavirus (HPV) to oropharyngeal cancer. Data were also collected to determine their perceived susceptibility to oropharyngeal cancer and awareness of emotions toward and intentions to receive an oral cancer examination in order to design tailored messages for promoting oropharyngeal cancer prevention on college campuses. Two hundred ten baccalaureate students in nonhealth majors from a public southeastern university were surveyed. Descriptive statistics were calculated, and multiple regression analysis was conducted to determine the predictors of knowledge of oral/oropharyngeal cancer and the HPV and intentions to be examined. Results indicated most were unaware of oropharyngeal cancer, did not understand the purpose of an oral cancer examination, and could not affirm they had received one or had one explained to them. Results also indicated poor understanding of some of the signs and risk factors of oropharyngeal cancer, especially HPV. In addition, oral/oropharyngeal cancer knowledge and negative emotions were predictors of examination intentions, confirming current behavioral theories that postulate rational decisions require collaboration from both cognitive and affective systems. Recommendations are offered for tailored educational communications and strategies about oropharyngeal cancer on college campuses.