Awareness and knowledge of oral cancer amongst adult dental patients attending regional university clinics in New South Wales, Australia: a questionnaire-based study

Assessing the Capabilities of Generative Pretrained Transformer-4 in Addressing Open-Ended Inquiries of Oral Cancer

INTRODUCTION AND AIMS

In the face of escalating oral cancer rates, the application of large language models like Generative Pretrained Transformer (GPT)-4 presents a novel pathway for enhancing public awareness about prevention and early detection. This research aims to explore the capabilities and possibilities of GPT-4 in addressing open-ended inquiries in the field of oral cancer.

METHODS

Using 60 questions accompanied by reference answers, covering concepts, causes, treatments, nutrition, and other aspects of oral cancer, evaluators from diverse backgrounds were selected to evaluate the capabilities of GPT-4 and a customized version. A P value under .05 was considered significant.

RESULTS

Analysis revealed that GPT-4 and its adaptations notably excelled in answering open-ended questions, with the majority of responses receiving high scores. Although the median score for standard GPT-4 was marginally better, statistical tests showed no significant difference in capabilities between the two models (P > .05). Despite statistical significance indicated diverse backgrounds of evaluators have statistically difference (P < .05), a post hoc test and comprehensive analysis demonstrated that both editions of GPT-4 demonstrated equivalent capabilities in answering questions concerning oral cancer.

CONCLUSIONS

GPT-4 has demonstrated its capability to furnish responses to open-ended inquiries concerning oral cancer. Utilizing this advanced technology to boost public awareness about oral cancer is viable and has much potential. When it's unable to locate pertinent information, it will resort to their inherent knowledge base or recommend consulting professionals after offering some basic information. Therefore, it cannot supplant the expertise and clinical judgment of surgical oncologists and could be used as an adjunctive evaluation tool.

Oral health knowledge is associated with oral health-related quality of life: a survey of first-year undergraduate students enrolled in an American university

BACKGROUND

Oral health knowledge forms part of oral health literacy that enables individuals to inform appropriate oral health decisions and actions. Oral health-related quality of life (OHRQoL) characterizes self-perception of well-being influenced by oral health. This study aimed to examine the relationship between oral health knowledge and OHRQoL.

METHODS

A random sample of 19-to-24-year-old first-year undergraduate students (n = 372) in Minnesota, United States of America was used. Each student was assessed with an online survey using the Comprehensive Measure of Oral Health Knowledge (CMOHK) and the OHRQoL items of the World Health Organization (WHO) Oral Health Questionnaire for Adults. Relationships between OHRQoL parameters and CMOHK together with other covariates were assessed using ordinal regression models. Associations between OHRQoL parameters were examined with the Kendall's tau-b method.

RESULTS

Dry mouth (45%) was the most reported OHRQoL issue. The respondents showing good oral health knowledge were less likely to experience speech or pronunciation difficulty (β=-1.12, p = 0.0006), interrupted sleep (β=-1.43, p = 0.0040), taking days off (β=-1.71, p = 0.0054), difficulty doing usual activities (β=-2.37, p = 0.0002), or reduced participation in social activities due to dental or oral issues (β=-1.65, p = 0.0078).

CONCLUSIONS

This study suggested a protective effect of better oral health knowledge on specific OHRQoL issues. In addition to provision of affordable dental services, university-wide oral health education can be implemented to improve OHRQoL in undergraduate students.

Bayesian Disease Mapping to Identify High-Risk Population for Oral Cancer: A Retrospective Spatiotemporal Analysis

Objectives

Bayesian mapping is an effective spatiotemporal approach to identify high-risk geographic areas for diseases and has not been used to identify oral cancer hotspots in Australia previously. This retrospective disease mapping study was undertaken to identify the oral cancer trends and patterns within the Queensland state in Australia.

Methods

This study included data obtained from Queensland state Cancer Registry from 1982 to 2018. Domains mapped included the oral cancer incidence and mortality in Queensland (QLD). Local government areas (LGAs) and suburbs were utilized as geographical units for the estimation using Bayesian mapping approach.

Results

Of the 78 LGAs, 21 showed high-oral cancer incidence as measured using higher median smoothed incidence risk (SIR), above the state average. Specifically, nine LGAs within predominantly rural areas had SIR above 100% of the state average. Of these, only one LGA (Mount Isa City) had a median smoothed SIR and 95% CI of 2.61 (2.14-3.15) which was constantly above 100% of the state average. Furthermore, mortality risk estimated using smoothed mortality risk (SMR), were significantly higher than the state average in 31 LGAs. Seventeen LGAs had a median SMR above 100% of the state average while three LGAs had the highest overall, 3- and 5-year mortality risks. Considering the 95% credible interval which is indicative of the uncertainty around the estimates, three LGAs had the highest overall mortality risks-Yarrabah Aboriginal Shire (3.80 (2.16-6.39)), Cook Shire (3.37 (2.21-5.06)), and Mount Isa City (3.04 (2.40-3.80)).

Conclusion

Bayesian disease mapping approach identified multiple incidence and mortality hotspots within regional areas of the Queensland. Findings from our study can aid in designing targeted public health screening and interventions for primary prevention of oral cancer in regional and remote communities.

Oral cancer knowledge in adults evaluated through a phone survey in the context of the SARS-CoV2 health emergency in Colombia

BACKGROUND

in Colombia, oral cancer is the eighth most common type of cancer, with an estimated survival rate of 52%. Lack of knowledge about oral cancer and its risk factors is associated with late detection.

MATERIAL AND METHODS

a descriptive cross-sectional study was carried out on 268 patients attending the School of Dentistry of the University of Antioquia clinics, to whom a validated 47-question questionnaire was applied by phone during the COVID-19 pandemic (2020 and 2021). Data were analyzed using the SPSS software.

RESULTS

the mean age was 58.9. 58.6% of the participants had heard of oral cancer, 42% acquire knowledge from the media, and 96.7% considered screening necessary. Most of the patients expressed not feeling worried (54.5%), fearful (59.7%), or anxious (56.3%) in the case of being submitted to an examination for early detection of oral cancer. A correlation between low socioeconomic status and educational level with less knowledge of oral cancer was found. The dimensions of experience and attitude towards screening were not associated with sociodemographic variables.

CONCLUSIONS

There is little knowledge about oral cancer, especially in low socioeconomic and educational status, although this does not occur in the dimensions of attitude and experience toward screening. In contrast, patients participating in this study presented high knowledge about oral cancer risk. This population recognizes the situations most related to the development of cancer. This level of knowledge was similar for the demographic conditions except for people with no education, who presented less knowledge of the risks. The need for educational campaigns on oral cancer knowledge is reaffirmed, especially in socially disadvantaged groups, considering that there would be no barriers related to screening.

Oral Cancer Awareness of Tertiary Education Students and General Public in Singapore

OBJECTIVES

Oral cancer confers high morbidity and mortality rates. Late diagnosis of oral cancer is linked to a lack of awareness of its existence and known risk factors. The purpose of this survey was to examine the knowledge and awareness of oral cancer amongst different groups in Singapore.

METHODS

A self-administered questionnaire (including questions on awareness, risk factor knowledge, and health beliefs about oral cancer) was distributed to undergraduate students from the medical and dental schools and other faculties at the National University of Singapore, as well as the general public.

RESULTS

A total of 470 responses were analysed. Both medical and dental students were almost universally aware of the disease and correctly identified recognised risk factors for oral cancers. Dental students had a significantly higher level of knowledge of chewing betel quid as a risk factor than medical students (98% vs 74%; P < .0001), although 1 in 10 dental students did not identify alcohol as a risk factor. In contrast, undergraduate students from other faculties were the least aware of oral cancer (62%). Within the general public, knowledge of the risk factors of oral cancer aside from smoking was low, with only 41% aware of viruses as a possible aetiology. However, the younger population group, aged 18 to 34 years old, in general had better knowledge of the risk factors of oral cancer compared with older participants.

CONCLUSIONS

There is a general lack of awareness about oral cancer and its associated risk factors amongst certain cohorts of the Singapore population. There exists room for further targeted education.

Knowledge of Oral Cancer Amongst Dental Patients Attending Public Clinics in South East Queensland, Australia

Patient knowledge of risk factors, signs and symptoms associated with oral cancers is crucial for increasing the likelihood of patient presentation for opportunistic screening and reducing delay in patient appraisal for early detection. This study aimed to assess the knowledge of oral cancer and to ascertain socio-demographic factors that influence knowledge amongst adult dental patients attending public clinics in Brisbane, Australia. A convenience sample of 213 adult dental patients who attended the Herston and Stafford public health clinics in Brisbane, Australia, between July and August 2019 participated in the self-administered questionnaire. Multivariate analyses were performed to identify predictors for oral cancer knowledge. Patients were well informed of smoking as a risk factor (n = 135; 84.4%), whereas only 53.8% (n = 82) of participants agreed that heavy alcohol consumption was a risk factor. A larger proportion of participants identified difficulty of moving the tongue (n = 79; 49.4%) and pain on swallowing (n = 72; 45.0%) compared to the proportion who identified fixed red patches (n = 61; 38.1%) and fixed white patches (n = 57; 35.6%) as a sign or symptom. Education level and gender were significant knowledge predictors for alcohol (p = 0.01), old age (p = 0.008) and family history (p = 0.004) as a risk factors for oral cancer. Those with a family history of cancer were more likely to identify a red patch (p = 0.02), bleeding gums (p = 0.001) and altered sensation (p = 0.023) as a sign or symptom of oral cancer. Overall, patient knowledge was greater for risk factors than for signs and symptoms for oral cancer. Symptoms associated with later stages of cancer were recognised by a greater proportion of patients compared to early stages of oral cancer. These results indicate the need for targeted public health initiatives to improve patient knowledge.

Factors influencing oral cancer screening preferences in patients attending Tertiary Care University Oral Health Clinic

BACKGROUND

Understanding factors that influence patients' preferences towards oral cancer (OC) screening is imperative to provide high-quality evidence-based OC screening interventions that can be targeted for population-level uptake. This study determined adult patients' knowledge and awareness of OC, and how health behaviours influenced their preferences towards OC screening.

METHODS

This cross-sectional study used a 42-point questionnaire, between February and May 2020 using a combination of in-person and telephone interviews. Chi-square test and multiple logistic regression analysis were applied to confounding factors that returned statistical significance against OC knowledge and awareness. Significance of P < 0.05 was accepted.

RESULTS

Sixty-eight (38.6%) participants out of a total 176 had good knowledge of OC and 89 (50.6%) had good awareness. A total of 31.8% reported preference for OC screening by a general dental practitioner (GDP) over a general medical practitioner (GMP). Majority (72.7%) reported acceptance of OC screening at their next GDP visit. Ages 56-70 (OR = 0.357, 95% CI) and previous smokers (OR = 0.336, 95% CI) significantly influenced screening preferences. Knowledge of risk factors did not significantly influence OC screening preferences (χ²  = 3.178, P = 0.075).

CONCLUSIONS

Significant gaps in OC knowledge, screening and role of GDPs exist with smoking history and age influencing OC screening preferences.

Oral cancer awareness in patients attending university dental clinics: A scoping review of Australian studies

This scoping review was carried out to evaluate the important role Australian university-based dental teaching clinics and dental students might have in promoting oral cancer awareness in their patients. Four Online database (PubMed, OVID, Scopus and Emcare) were searched for studies that assessed oral cancer awareness amongst patients attending Australian university-associated (teaching) clinics. A total of five articles were retrieved for full-text analysis. All studies showed significant variation in patient awareness and understanding regarding the principal risk factors associated with oral cancer development. Smoking was predominantly identified as a significant risk factor, but alcohol consumption was less frequently recognized as relevant. Non-healing ulceration was most commonly identified as a symptom of concern, whilst red and/or white mucosal patches were infrequently recognized as potentially malignant conditions. Our review confirms that a significant lack of patient awareness regarding oral cancer risk and the signs /symptoms of early malignancy or potentially malignant disease exist in patients attending dental teaching clinics. Important opportunities exist to involve dental students proactively in raising oral cancer awareness, delivering smoking cessation interventions and safe alcohol consumption advice to their patients. Incorporation of established health educational models might deliver effective support for such student-delivered patient education.

Social and behavioural determinants of areca nut consumption in adolescents

OBJECTIVE

This study aimed to investigate the prevalence of areca nut consumption and to identify social and behavioural determinants among a Taiwanese adolescent population.

SUBJECTS AND METHODS

A random sample of 5,343 high school students aged between 15-18 years in Kaohsiung, Taiwan, participated in the study. Participants underwent a clinical dental examination and completed a self-administered questionnaire. Data analyses were performed using multivariate logistic regression to establish a relationship between areca nut consumption as well as social and behavioural characteristics.

RESULTS

The prevalence of areca nut consumption was 3.0%. The chewing habit was more prevalent among older adolescents (p < .001, OR = 1.50, 95% CI: 1.26, 1.78), males (p < .001, OR = 17.91, 95% CI: 8.57, 37.40), pupils living with non-birth parent(s) (p = .003, OR = 2.13, 95% CI: 1.29, 3.50), children of family heads with primary (p = .001, OR = 2.90, 95% CI: 1.50, 5.59) or secondary level of education (p < .001, OR = 2.78, 95% CI: 1.74, 4.46), frequent risk takers (p < .001, OR = 1.35, 95% CI: 1.27, 1.43) and students of low physical fitness (p < .001, OR = 3.65, 95% CI: 1.81, 7.35).

CONCLUSIONS

Areca nut consumption has become an ongoing pertinent issue in adolescent health. Future investigations into neurocognitive influences of risk-taking behaviour on areca nut consumption and social dependence of the habit are indicated.