Dentists' perspectives on oral cancer: a survey in Northern Germany and a comparison with international data

Knowledge, opinions, and practices related to oral cancer prevention and oral mucosal examination among dentists in Moldova, Belarus and Armenia: a multi-country cross-sectional study

INTRODUCTION

Moldova, Belarus, and Armenia are post-Soviet countries with a high rate of heavy smokers and a relatively high age-standardized incidence of oral cancer. However, to our knowledge, there is lack of available information on dentists' knowledge on prevention of oral cancer in the countries in question. Accordingly, this study aimed to assess the knowledge, opinions, and practices related to oral cancer prevention and oral mucosal examination among dentists in Moldova, Belarus, and Armenia.

METHODS

This was a multi-country, cross-sectional study based on a self-administered questionnaire. A structured questionnaire was distributed to 3534 dentists (797 in Chisinau, Moldova, 1349 in Minsk, Belarus, and 1388 in Yerevan, Armenia). Dentists' knowledge about risk factors for oral cancer development and its clinical picture, current practices and opinions with regard to oral mucosal screening and oral cancer prevention, and their consistency to perform oral mucosal examination were assessed. A knowledge score ranging from 0 to 14 points was generated based on each dentist's answer to the questionnaire.

RESULTS

A total of 1316 dentists responded, achieving an overall response rate of 37.2% (34.5% in Moldova; 52.3% in Belarus; 24.2% in Armenia). Most dentists in the three countries correctly identified tobacco (83.8-98.2%) and prior oral cancer lesions (84.0-96.3%) as risk factors for oral cancer. Most dentists correctly identified leukoplakia as a lesion with malignant potential (68.7% in Moldova; 88.5% in Belarus; 69.9% in Armenia), while erythroplakia was identified by much fewer in all three countries. Less than 52% of dentists identified the tongue, rim of tongue, and floor of mouth as the most common sites for oral cancer. The mean knowledge score for all countries combined was 7.5 ± 2.7. The most commonly reported barriers to perform oral mucosal examination were lack of training, knowledge, and experience.

CONCLUSIONS

This study highlights the need for improved oral cancer-related education and training on oral mucosal examination for dentists in Moldova, Belarus, and Armenia. Such skills are essential to enhance oral cancer prevention and to improve the prognostic outcome by early detection.

Current Knowledge, Attitudes, and Practice among Health Care Providers in OSCC Awareness: Systematic Review and Meta-Analysis

OSCC remain a global health problem. Lack of awareness leads to inadequate watchfulness regarding early signs/symptoms despite the ease of visual oral inspection. What clinicians know and feel, and how they behave on OSCC is crucial to understand the feasibility and effectiveness of screening programs. The aim of this systematic review was to assess knowledge, attitudes, and practice (KAP) regarding OSCC among health care providers (HCPs). Therefore, a systematic review was conducted with SPIDER and PICO as major tools. A meta-analysis was structured through common items in two comparison groups of medical and dental practitioners. Descriptive statistics and a Mantel–Haenszel test were used to validate data. Sixty-six studies were selected for systematic review, eight of which are useful for meta-analysis. A statistically significant difference was recorded between dentists and medical practitioners for questions regarding: Alcohol (p < 0.001); Elderly (p < 0.012); Sun exposure (p < 0.0001); Erythroplakia (p < 0.019); Red patch (p < 0.010); White patch (p < 0.020); Tobacco consultation (p < 0.0001); Intraoral examination (p < 0.0001) and Up-to-date knowledge (p < 0.002). Overall, the incidence of OSCC screening is low. Most HCPs feel the need to increase KAP. Data confirmed gaps in KAP, highlighting the need for a more efficient pre- and post-graduation training, necessary to increase competence worldwide.

Evaluación del conocimiento del cáncer oral y manejo odontológico del paciente oncológico en Cali, Colombia

Objetivo: evaluar el conocimiento del cáncer oral y su manejo odontológico, en estudiantes de pregrado de último año de medicina y odontología y odontólogos egresados de diferentes universidades en Cali, Colombia. Métodos: se realizó un estudio descriptivo, cuantitativo de corte transversal. El instrumento de recolección de datos fue una encuesta de 19 preguntas. La muestra incluyó 360 participantes y se realizó un análisis multivariado con pruebas no paramétricas con un grado de confiabilidad del 95%. Resultados: las categorías evaluadas fueron: I) conocimiento del cáncer oral y II) manejo del paciente oncológico. Según la rúbrica empleada, el nivel alcanzado fue “regular” en ambas categorías, con un promedio de 8,7/19 para estudiantes de odontología, 11,29/19 para estudiantes de medicina y 11,33/19 para odontólogos egresados. La media general fue 10,37 respuestas acertadas (a=0,05). Hubo diferencias estadísticamente significativas al evaluar las tres facultades de odontología en ambas categorías y la rúbrica refleja un desempeño “regular” aún para la universidad con el mejor promedio. Conclusión: el nivel de conocimiento sobre cáncer oral y su manejo odontológico en Cali, Colombia, según la rúbrica planteada es insuficiente en la población evaluada y se sugiere un replanteamiento de estrategias de abordaje de estos temas desde la academia.

Oral Cancer Knowledge, Attitudes, and Practices among Dentists in Khartoum State, Sudan

The dental professions hold an important responsibility in the control of oral cancer and the early diagnosis highly depends on their knowledge. The present study was developed to assess the knowledge, attitude, and practice of dentists in Khartoum State regarding oral cancer prevention and early detection. An administered questionnaire was structured and sent to all licensed 130 dentists working in public dental clinics in Khartoum State. Responses to the questionnaire were analyzed using descriptive and analytical statistics. Although the majority of the dentists were knowledgeable about the major risk factors of oral cancer, more than half of the dentists reported they do not carry out any special examination to detect oral cancer in age 40 and above in asymptomatic patients. Dentists indicated their lack of training as the main barrier for conducting a comprehensive oral cancer examination. Interestingly, the vast majority of the dentists express their interest to have further oral cancer educational and training sessions. The findings of the present study suggested strongly that educational and training interventions are necessary to enhance preventive measures which may lead to reduce mortality and morbidity from oral cancer.

Knowledge of Oral Precancerous Lesions Considering Years Since Graduation Among Dentists in the Capital City of Iran: a Pathway to Early Oral Cancer Diagnosis and Referral?

Background:

Late diagnosis and improper treatment lead to many avoidable deaths in patients suffering from oral cancer. This study evaluated the knowledge and perceptions of general dentists regarding oral precancerous lesions and oral cancer risk factors with reference to early diagnosis and referral.

Materials and Methods:

In this descriptive study, 200 private general dental practitioners were randomly selected in Tehran, Iran. Demographic information and years since graduation were recorded; knowledge levels were evaluated with a standardized questionnaire consisting of 15 closed-response item questions about precancerous lesions and oral cavity cancer. Each correct answer got one point.

Results:

Out of 200 selected dentists, 153 returned completed questionnaires. The average age of participants was 36 and the average achieved score was 7.96 out of 15 (Min 3, Max 13). Most (64.7%) of participants were in the group that graduated within the previous 10 years, 23.5% between 10 and 20 years since graduation, and 11.8% more than 20 years previously. There was a statistically significant difference between the most recently graduated group (< 10 years) and the other two groups. The dentists’ awareness was also significantly dependent on age. There was no statistically significant difference in awareness between male and female dentists.

Conclusion:

As professional oral health care providers, dentists should be aware of all aspects regarding precancerous lesions in order to optimize early diagnosis and referral of oral cancer patients. Training courses and continuing education seem to be an essential strategy to increase and maintain knowledge of this group.

Discussing HPV with oropharyngeal cancer patients: A cross-sectional survey of attitudes in health professionals

BACKGROUND

Human papillomavirus (HPV) is now known to cause a significant proportion of head and neck cancers (HNC). Qualitative research has shown that some health professionals find it difficult to discuss HPV with patients due to its sexually transmitted nature, and have concerns about their own knowledge of the virus. We used a survey to quantify attitudes towards discussing HPV among HNC health professionals.

METHODS

We carried out a cross-sectional survey of HNC health professionals (n=260) in the UK and Ireland, assessing participants' knowledge of HPV, their experiences of and attitudes towards discussing HPV with patients, and their willingness to discuss HPV with their patients in the future.

RESULTS

Overall, health professionals had good knowledge of HPV (mean score: 9.97 out of 12). Oncologists had significantly greater knowledge than specialist nurses, speech and language therapists and 'other' health professionals. Most were willing to discuss HPV with patients (mean=4.3 out of 5). Willingness to discuss HPV in the future was associated with higher HPV knowledge (r=0.35, p<0.001), fewer negative and more positive attitudes towards discussing HPV (r=-0.23 and r=0.20 respectively, both p<0.001), fewer personal barriers (r=-0.49, p<0.001) and greater confidence (r=0.58, p<0.001).

CONCLUSION

Knowledge, experiences and attitudes to discussing HPV varied across HNC health professionals. Addressing gaps in health professionals' HPV knowledge and improving their confidence in discussing HPV with patients may increase their willingness to have such conversations. This may help minimise the negative psychosocial consequences of an HPV diagnosis in this patient group.

Factors Influencing Early Detection of Oral Cancer by Primary Health-Care Professionals

The purposes of this study are to determine early detection practices performed by primary healthcare professionals, to compare medical and dental sub-groups, and to identify factors that influence the ability of medical and dental practitioners to recognize precancerous changes and clinical signs of oral cancer. A 28-item survey instrument was used to interview a total of 330 Jordanian primary health-care professionals (165 dental and 165 medical). An oral cancer knowledge scale (0 to 31) was generated from correct responses on oral cancer general knowledge. An early detection practice scale (0 to 24) was generated from the reported usage and frequency of procedures in oral cancer examination. Also, a diagnostic ability scale (0 to 100) was generated from correct selections of suspicious oral lesions. Only 17.8 % of the participants reported that they routinely performed oral cancer screening in practices. Their oral cancer knowledge scores ranged from 3 to 31 with a mean of 15.6. The early detection practice scores ranged from 2 to 21 with a mean of 11.6. A significant positive correlation was found between knowledge scores and early detection practice scores (r = 0.22; p < 0.001). The diagnostic ability scores ranged from 11.5 to 96 with a mean of 43.6. The diagnostic ability score was significantly correlated with knowledge scores (r = 0.39; p < 0.001), but not with early detection practice scores (r = 0.01; p = 0.92). Few significant differences were found between medical and dental primary care professionals. Continuous education courses on early diagnosis of oral cancer and oral mucosal lesions are needed for primary health-care professionals.

Human Papillomavirus and Head and Neck Cancer: Psychosocial Impact in Patients and Knowledge of the Link - A Systematic Review

Head and neck cancer (HNC) currently affects approximately 11 200 people in the UK, with an increasing proportion known to be caused by the human papillomavirus (HPV). We undertook a systematic review of studies measuring the psychosocial impact of HPV-related HNC and also studies measuring knowledge about the link between HPV and HNC among different populations. Searches were conducted on MEDLINE, Embase, PsycINFO, CINAHL Plus and Web of Science, with reference and forward citation searches also carried out on included studies. Studies were selected if they (i) were original peer-reviewed research (qualitative or quantitative), (ii) mentioned HPV and HNC, (iii) measured an aspect of the psychosocial impact of the diagnosis of HPV-related HNC as the dependent variable and/or (iv) measured knowledge of the association between HPV and HNC. In total, 51 papers met the inclusion criteria; 10 measuring psychosocial aspects and 41 measuring knowledge of the link between HPV and HNC. Quality of life in those with HPV-positive HNC was found to be higher, lower or equivalent to those with HPV-negative HNC. Longitudinal studies found quality of life in patients was at its lowest 2–3 months after diagnosis and some studies found quality of life almost returned to baseline levels after 12 months. Knowledge of the link between HPV and HNC was measured among different populations, with the lowest knowledge in the general population and highest in medical and dental professionals. Due to the limited studies carried out with patients measuring the psychosocial impact of a diagnosis of HPV-positive HNC, future work is needed with the partners of HPV-positive HNC patients and health professionals caring for these patients. The limited knowledge of the association between HPV and HNC among the general population also indicates the need for research to explore the information that these populations are receiving.

Oral cancer: knowledge, practices and opinions of dentists in yemen

BACKGROUND

Oral cancer presents with high mortality rates, and the likelihood of survival is remarkably superior when detected early. Dental professionals have an important role and responsibility in prevention and early detection of oral cancer.

PURPOSE

The aim of this study was to assess the knowledge, practices and opinions regarding oral cancer among dentists in Yemen.

MATERIALS AND METHODS

A cross-sectional survey was conducted using a self-administered questionnaire involving private and public dental practitioners, working in different governorates in Yemen.

RESULTS

Of the 800 dentists surveyed, a total of 221 questionnaires were completed and returned (response rate 27.6%). A vast majority of dentists (96.38%) identified tobacco as the major risk factor for oral cancer, and 82.8% knew that squamous cell carcinoma is the most common form. While 47.1% of the dentists agreed that they were adequately trained in oral cancer screening, the majority (86%) believed that they need further training in oral cancer screening.

CONCLUSIONS

These results suggest that additional training and continuing educational programs on prevention and early detection of oral cancer for dentists are to be highly recommended.

Available web-based teaching resources for health care professionals on screening for oral cancer

Objectives: To identify websites with adequate information on oral cancer screening for healthcare professionals (HCPs) and to assess both their quality and contents. Study Design: Websites were identified using Google and HON medical professional search engines using the terms “screening for oral cancer”. The first 100 sites retrieved by each engine were analysed using the DISCERN questionnaire (reliability), the V instrument (contents on oral cancer) and further by the Flesch-Kinkaid Reading Grade Level and the Flesch Reading Ease (readability). Results: The overall rating showed minimal shortcomings in the quality of the information in the websites. The coverage and correctness of information on “visual examination” was rated as fair/good, whereas updating of contents resulted very variable (eg: 81% for visual examination and 18.2% for molecular biomarkers). These results permitted to rank the websites housing relevant information for oral cancer. Top ranking websites were affiliated to the Oral Cancer Foundation (USA), WHO Collaborating Centre for oral cancer (UK) whose webpage is entitled “Oral Cancer Education and Research”, and the Clinical Guidelines maintained by the British Columbia Cancer Agency (Canada) and the British Dental Association (UK) respectively. Conclusions: There are web-based, HCP-addressed, resources on screening for oral cancer housing heterogeneous information both in quality and contents. The use of specific evaluation tools permits the selection of reliable websites on this topic with a potential to improve the existing educational gaps among HCPs.

Key words:Oral cancer, early diagnosis, screening, secondary prevention, internet, teaching resources, continuous education.

Dentists' perception of the role they play in early detection of oral cancer

BACKGROUND

Dentists are typically the first professionals who are approached to treat ailments within the oral cavity. Therefore they should be well-equipped in detecting suspicious lesions during routine clinical practice. This study determined the levels of knowledge on early signs and risk factors associated with oral cancer and identified which factors influenced dentist participation in prevention and early detection of oral cancer.

MATERIALS AND METHODS

A survey on dentists' knowledge and their practices in prevention and early detection of oral cancer was conducted using a 26-item self-administered questionnaire.

RESULTS AND CONCLUSIONS

A response rate of 41.7% was achieved. The level of knowledge on early signs and risk habits associated with oral cancer was high and the majority reported to have conducted opportunistic screening and advised patients on risk habit cessation. Factors that influenced the dentist in practising prevention and early detection of oral cancer were continuous education on oral cancer, age, nature of practice and recent graduation. Notably, dentists were receptive to further training in the area of oral cancer detection and cessation of risk habits. Taken together, the study demonstrated that the dental clinic is a good avenue to conduct programs on opportunistic screening, and continuous education in these areas is necessary to adequately equip dentists in running these programs. Further, this study also highlighted knowledge deficits and practice shortcomings which will help in planning and developing programs that further encourage better participation of dentists in prevention and early detection of oral cancer.

Impact of academic and continuing education on oral cancer knowledge, attitude and practice among dentists in north-western Italy

The present study aims to assess the knowledge, attitude and practice of dentists practicing in the Turin Province (north-western Italy) regarding oral cancer prevention and early detection, to weigh the impact of academic and continuing education and to compare actual and perceived knowledge/practice. A survey was prospectively carried out using an anonymous 23-item questionnaire. Bivariate analyses, multivariate logistic regression analyses and Spearman's correlation analyses examined the overall effect of demographic/background characteristics of responders, with particular emphasis on academic and continuing education. The responder group was formed by 450 dentists representative of the Turin Province Council of Dentists. Both academic and continuing education have a significant impact on knowledge, with a significant association between the time elapsed from continuing education and the degree of knowledge. Knowledge acquired during graduation is seen to significantly weaken in the absence of continuing education. The present study highlights the need of both thorough academic curricula and compulsory current continuing education.

Knowledge of diagnostic and risk factors in oral cancer: results from a large-scale survey among non-dental healthcare providers in Northern Germany

INTRODUCTION

A survey was conducted to assess the level of knowledge on oral cancer among different medical fields, in particular about diagnostic items and risk factors.

MATERIAL AND METHODS

A self-administered questionnaire was mailed to physicians from various fields, such as otorhinolaryngology, general practice, internal medicine, and dermatology.

RESULTS

388 of the 2,952 questionnaires were returned (13.1%), subdivided into otorhinolaryngology (n = 33), internal medicine (n = 135), dermatology (n = 28), and general practice (n = 192). The average knowledge of risk factors was similar in the specialisations, ranging from 68% for internal medicine to 76% for otorhinolaryngology and 77% for dermatology. The three main risk factors: tobacco (93%-100%), alcohol (79%-100%), and prior oral cancer lesions (91%-100%) were the most commonly known. Regarding the diagnostic items, the average percentage of correct answers ranged from 69% for internal and general medicine to 77% for dermatologists. Continuous courses of education and the year of graduation were the only two variables that significantly related to a better level of knowledge of risk factors and diagnostic items.

CONCLUSIONS

The average knowledge among the different medical fields was satisfying. These results demonstrated a robust base for all healthcare providers to continue working together to improve the early detection of oral cancer.

Expertise regarding dental management of oral cancer patients receiving radiation therapy among Western Australian dentists

OBJECTIVES

Dental care forms an important part of the multidisciplinary management of oral cancer patients. The aim of this study was to examine actual and self-perceived knowledge and clinical expertise regarding dental management of oral cancer patients receiving radiation therapy among Western Australian general dentists.

MATERIALS AND METHODS

An invitation to participate in a web-based questionnaire was emailed to 1095 dentists registered with the Australian Dental Association (ADA), WA branch. To assess dentists' knowledge and expertise, actual and perceived knowledge was investigated. Information regarding type of practice, practice location, year of graduation and number of oral cancer patients treated in the preceding 12 months was also obtained.

RESULTS

One hundred and ninety one dentists responded to the survey. General dentists who took part in the study appeared to possess some knowledge regarding dental management of oral cancer patients treated with radiation therapy. The majority of responders however identified deficiencies in their knowledge and willingness to participate in continuing education programs.

CONCLUSION

In view of the rising incidence of oral cancer in Western Australia, efforts should be made to provide more clinically relevant training to dentists in this area.

Oral cancer prevention and early detection: knowledge and practice among Saudi Arabian healthcare practitioners

PURPOSE

Despite the crucial role that healthcare practitioners (HCPs) have in preventing and detecting oral cancer (OC), studies suggest that dentists and physicians do not adequately detect early stage OC which is attributed to their attitude and knowledge. This Saudi Arabian study aims to assess HCP's knowledge and practice vis-à-vis OC's risk factors and patient evaluation.

DESIGN/METHODOLOGY/APPROACH

A questionnaire was distributed to HCPs in six different Saudi Arabian settings. A total of 16 items representing a mixture of OC's risk and non-risk factors were measured.

FINDINGS

The study found that only 20.9 percent of HCPs could distinguish 11 items or more correctly. Additionally, when HCPs obtained the patient's medical history, no more than 32.3 percent routinely assessed ten important OC issues. Almost 36 percent of HCPs thought that attending to too many patients prevented them from taking proper medical histories, and 37.6 percent admitted that more training in preventing and detecting OC is needed.

RESEARCH LIMITATIONS/IMPLICATIONS

Since there is no effective automated system to reach Saudi Arabian practitioners, the number of practitioners involved in this study is limited.

PRACTICAL IMPLICATIONS

The knowledge and practice of HCPs with relation to OC do not appear to be sufficient and HCPs should have better and more training in OC prevention and early detection.

ORIGINALITY/VALUE

It appears that Saudi Arabian HCPs do not adequately participate in OC's prevention and early detection. It is suggested that continuous education strategies in Saudi Arabia should be reassessed and emphasis given to OC diagnosis.

Oral cancer awareness among dentists in Kuwait

OBJECTIVES

The aim of this study was to assess oral cancer awareness among dentists in Kuwait.

SUBJECTS AND METHODS

A cross-sectional survey was conducted among 200 dentists working at the Ministry of Health Dental Centers and Kuwait University Dental Center using a structured questionnaire. Dentists' knowledge about risk factors of oral cancer and about diagnostic concepts, current practices and opinions, preferred point of referral as well as interest in continuing education were assessed and the responses were analyzed.

RESULTS

Of the 200 dentists surveyed, 153 responded (76.5% response rate). The mean knowledge score of the respondents was 20.6 ± 4.0 out of a total score of 30. Thirty-five (22.9%) dentists had consistently high knowledge scores for both risk factors and diagnostic concepts. Of the 153 dentists, 132 (86.3%) were interested in obtaining further information about oral cancer.

CONCLUSION

This study highlighted the need for improved knowledge and education of dental practitioners on oral cancer.

Comparing dentists' and the public's awareness about oral cancer in a community-based study in Northern Germany

INTRODUCTION

The purpose of the study was to compare the knowledge about oral cancer of dentists and the public using a standardised, internationally accepted questionnaire in Schleswig-Holstein, Germany.

MATERIAL AND METHODS

In November 2007, a standardised questionnaire about knowledge on oral cancer was mailed to all dentists within the state (n=2233). Simultaneously, a polling firm conducted a representative survey with a shortened version of the questionnaire, via computer-aided telephone interview, among the public (n=1000).

RESULTS

The results are based on 306 usable dental questionnaires (n=14%) and 1000 interviews of the population. Most of the diagnostic factors were correctly identified by the dentists, whereas less than 30% of the public knew these factors. Only 47% of the dentists and 27% of the public were aware that the patient is asymptomatic in the early stage of oral cancer. The knowledge about risk factors was inconsistent and showed deficits by the dentists as well as by the public.

CONCLUSIONS

The survey revealed a few gaps in dentists' knowledge compared to large deficits in the public's knowledge about oral cancer. Based on these results, a continuing educational programme for the dentists as well as an educational campaign for the public should be pursued.