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Idrees M, Halimi R, Gadiraju S, Frydrych AM, Kujan O. Clinical competency of dental health professionals and students in diagnosing oral mucosal lesions. Oral Dis 2024; 30:3108-3116. [PMID: 37727932 DOI: 10.1111/odi.14743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/19/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE Proper identification of oral potentially malignant disorders (OPMDs) provides an opportunity for oral cancer prevention. This study aims to assess the competency of dental health professionals in identifying OPMDs and, in turn, reducing the incidence of oral malignancy by early detection. METHODS A 26-case online questionnaire of oral mucosal lesions was distributed to cohorts of 363 dental health professionals and dental students in Australia. The participants were asked to provide their provisional diagnosis for each case based on the available information. RESULTS The overall accuracy in identifying oral mucosal lesions was 65.9%. There were no significant differences in the overall diagnostic accuracies between dental specialists, general dental practitioners and final-year dental students (p > 0.05). The lowest diagnostic accuracies were associated with normal mucosal variations and OPMDs. The predoctoral dental curriculum showed statistically significant values in terms of improving skills in diagnosing oral mucosal lesions. CONCLUSIONS Lack of adequate knowledge in identifying OPMDs was evident among the participants, highlighting a non-promising figure in reducing the incidence of oral cancers in Australia. Comprehensive modifications of the current continuing professional development system are required to ensure adequate knowledge among dental health providers in Australia.
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Affiliation(s)
- Majdy Idrees
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Rodwan Halimi
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Shashank Gadiraju
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Agnieszka M Frydrych
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
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Ramírez-Amador V, Anaya-Saavedra G, Petti S, Lara-Flores N, Aranda-Romo S, Cruz-Monroy E, Muela-Campos D, Nava-Villalba M, Ocampo-Acosta F, Pulido-Díaz K, Rumayor-Piña A. Oral cancer and precancer in Oral Pathology and Medicine curricula of Mexican dental schools. Oral Dis 2024; 30:2150-2157. [PMID: 37265065 DOI: 10.1111/odi.14639] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/13/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To identify the teaching-learning process characteristics of Oral Pathology and Medicine (OP&M) related to oral potentially malignant disorders (OPMDs) and oral cancer (OC), in the dental schools' curricula in Mexico, to analyze the approach given to this topic worldwide, and to provide the possible solution strategies. MATERIALS AND METHODS Questionnaires were sent to OP&M deans and professors from public Mexican Universities to explore the curriculum and academic profile of the dental schools. The recommendations gathered from a workshop with expert professors on the challenges in OPMD/OC teaching were reported. RESULTS Twenty-two dental schools participated (22 deans, 30 professors). The most widely used strategies were clinical-case resolving (86%) and presentations (73%). Although 77.3% of the programs included maxillofacial lesions, only 40.9% contemplated OPMD/OC. Only 45% of the programs developed community activities for early OC detection. The workshop recommendations were (i) multidisciplinary approach to OPMD/OC teaching, involving OP&M professors in other dental and nondental courses; (ii) implementation of the most effective teaching techniques (currently, problem-based learning and clinical-case presentation) in OP&M curricula; (iii) education of OP&M professors on teaching-learning processes. CONCLUSIONS These recommendations from the Mexican context, integrated with similar experiences from other countries could contribute to develop a unique, internationally acknowledged OP&M curriculum.
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Affiliation(s)
- Velia Ramírez-Amador
- Oral Pathology and Medicine Master, Metropolitan Autonomous University, México City, Mexico
| | | | - Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Norma Lara-Flores
- Health Care Department, Metropolitan Autonomous University, México City, Mexico
| | | | - Eduardo Cruz-Monroy
- Oral and Maxillofacial Pathology Specialty Program, Mexican National Autonomous University, Mexico City, Mexico
| | | | - Mario Nava-Villalba
- Pathology Research and Diagnostic Center, Department of Microbiology and Pathology, Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico
| | - Fabián Ocampo-Acosta
- Oral and Maxillofacial Pathology, Medicine Department, Autonomous University of Baja California, Tijuana, Baja California, Mexico
| | - Katya Pulido-Díaz
- Faculty of Health Sciences, Autonomous University of Baja California, Tijuana, Baja California, Mexico
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Fernández-Martínez NF, Petrova D, Špacírová Z, Barrios-Rodríguez R, Pérez-Sayáns M, Martín-delosReyes LM, Pérez-Gómez B, Rodríguez-Barranco M, Sánchez MJ. The duration of intervals on the oral cancer care pathway and implications for survival: a systematic review and meta-analysis. Front Public Health 2023; 11:1183244. [PMID: 37614446 PMCID: PMC10442570 DOI: 10.3389/fpubh.2023.1183244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/19/2023] [Indexed: 08/25/2023] Open
Abstract
Introduction Previous studies measuring intervals on the oral cancer care pathway have been heterogenous, showing mixed results with regard to patient outcomes. The aims of this research were (1) to calculate pooled meta-analytic estimates for the duration of the patient, diagnostic and treatment intervals in oral cancer, considering the income level of the country, and (2) to review the evidence on the relationship of these three intervals with tumor stage at diagnosis and survival. Materials and methods We conducted a systematic review with meta-analysis following PRISMA 2020 guidelines (pre-registered protocol CRD42020200752). Following the Aarhus statement, studies were eligible if they reported data on the length of the patient (first symptom to first presentation to a healthcare professional), diagnostic (first presentation to diagnosis), or treatment (diagnosis to start of treatment) intervals in adult patients diagnosed with primary oral cancer. The risk of bias was assessed with the Aarhus checklist. Results Twenty-eight studies reporting on 30,845 patients met the inclusion criteria. The pooled median duration of the patient interval was 47 days (95% CI = 31-73), k = 18, of the diagnosis interval 35 days (95% CI = 21-38), k = 11, and of the treatment interval 30 days (95% CI = 23-53), k = 19. In lower-income countries, the patient and treatment intervals were significantly longer, and longer patient intervals were related to later stage at diagnosis. In studies with a lower risk of bias from high-income countries, longer treatment intervals were associated with lower survival rates. Conclusion Interval duration on the oral cancer care pathway is influenced by the socio-economic context and may have implications for patient outcomes.
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Affiliation(s)
- Nicolás Francisco Fernández-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Zuzana Špacírová
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rocío Barrios-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- ORALRES Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Luis Miguel Martín-delosReyes
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Pérez-Gómez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology for Chronic Diseases, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - María José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Sayal L, Hamadah O, Almasri A, Idrees M, Thomson P, Kujan O. Saliva-based cell-free DNA and cell-free mitochondrial DNA in head and neck cancers have promising screening and early detection role. J Oral Pathol Med 2023; 52:29-36. [PMID: 36459078 PMCID: PMC10108294 DOI: 10.1111/jop.13392] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Cell-free DNA (cfDNA) and cell-free mitochondrial DNA (cf-mtDNA) have been postulated as potential diagnostic and prognostic biomarkers for different human malignancies. Early detection of head and neck malignancies is fundamental for optimal patient management. This study, therefore, aimed to assess the utility of saliva-based liquid biopsy as a noninvasive source of cfDNA and cf-mtDNA for detecting head and neck cancer (HNSCC). METHODS One hundred thirty-three patients diagnosed with either oral leukoplakia (OLK) or HNSCC were compared with 137 healthy volunteers. An unstimulated whole saliva sample was collected from each participant. The absolute copy numbers of salivary cf-mtDNA and cfDNA were quantified using Multiplex Quantitative PCR. Two diagnostic indices based on the investigated molecules were assessed for their ability to differentiate between different diagnostic categories. RESULTS The median scores of cfDNA and cf-mtDNA were statistically significantly higher among HNSCC patients (p < 0.05), revealing area under the curve values of 0.758 and 0.826, respectively. The associated accuracy for this test in discriminating HNSCC from other diagnostic categories was 77.37% for the cfDNA-based index and 80.5% for the cf-mtDNA-based index. The median score of cfDNA was statistically significantly higher for patients with severe epithelial dysplasia (OED) compared to those with epithelial keratosis with no OED and mild OED. However, there was no significant difference between controls and OLK individuals. CONCLUSION cfDNA and cf-mtDNA showed potential for use as precision medicine tools to detect HNSCC. Further multi-centre prospective studies are warranted to assess the prognostic utility of these molecules.
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Affiliation(s)
- Lana Sayal
- Department of Oral Medicine, The Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Omar Hamadah
- Department of Oral Medicine and Pathology, The Faculty of Dental Medicine, Al-Sham Private University, Damascus, Syria
| | - Aroub Almasri
- Biomedical Department, National Commission of Biotechnology, Damascus, Syria
| | - Majdy Idrees
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
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do Rêgo TJR, Lemos JVM, Matos APL, Caetano CFF, Dantas TS, Sousa FB, de Barros EM, Silva PGDB. Development and professional validation of an App to support Oral Cancer Screening. Braz Dent J 2022; 33:44-55. [PMID: 36477964 PMCID: PMC9733366 DOI: 10.1590/0103-6440202204895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/12/2022] [Indexed: 12/12/2022] Open
Abstract
The objective of this study was to develop and validate an App for identifying risk factors for oral cancer. To this end, we developed an App (OCS: Oral Cancer Screening) with predictors of Oral Cancer (OC) and algorithm assembly to estimate the risk of its development. METHODOLOGY Simulated clinical cases were designed so that 40 professionals with expertise in oral diagnostics could validate the algorithm and test its usability (SUS: System Usability Score) and acceptability (TAM: Technology Acceptance Model). Cronbach's alpha coefficient, Friedman/Dunn tests, and Spearman correlation evaluated the SUS and TAM scales. ROC curve was plotted to estimate the cutoff point of the algorithm in suggesting a high risk for OCS of the simulated cases. Chi-square and Fisher's exact tests were additionally used (p<0.05, SPSS v20.0). RESULTS Professionals with expertise in oral diagnosis had usability of 84.63±10.66 and acceptability of 84.75±10.62, which correlated positively (p<0.001, r=0.647). Acting in clinical areas of dentistry (p=0.034) and history of performing OC risk factor orientation (p=0.048) increased acceptability while acting in higher education increased usability (p=0.011). The cutoff point suggested by the App after validation of the simulated clinical cases showed high sensitivity of 84.8% and lower specificity of 58.4%. CONCLUSION The OCS was effective and with adequate sensitivity, usability, and acceptability and may contribute to the detection of early oral lesions.
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Affiliation(s)
- Talita Jordânia Rocha do Rêgo
- Centro Universitário Christus, Departamento de Odontologia, Fortaleza, Ceará, Brazil.,Universidade Federal do Ceará. Fortaleza, Ceará, Brazil
| | - José Vitor Mota Lemos
- Centro Universitário Christus, Departamento de Odontologia, Fortaleza, Ceará, Brazil.,Universidade Federal do Ceará. Fortaleza, Ceará, Brazil
| | - Amanda Pinheiro Leitão Matos
- Centro Universitário Christus, Departamento de Odontologia, Fortaleza, Ceará, Brazil.,Universidade Federal do Ceará. Fortaleza, Ceará, Brazil
| | | | - Thinali Sousa Dantas
- Centro Universitário Christus, Departamento de Odontologia, Fortaleza, Ceará, Brazil
| | - Fabrício Bitu Sousa
- Centro Universitário Christus, Departamento de Odontologia, Fortaleza, Ceará, Brazil
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Lu F, Lysack JT. Lessons Learned From Commonly Missed Head and Neck Cancers on Cross-Sectional Imaging. Can Assoc Radiol J 2022; 73:595-597. [PMID: 35164522 DOI: 10.1177/08465371221079107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Fangshi Lu
- Department of Radiology, 2129University of Calgary, Calgary, AB, Canada
| | - John T Lysack
- Departments of Radiology, Clinical Neurosciences, and Surgery, University of Calgary, Calgary, AB, Canada
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7
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Badri P, Baracos V, Ganatra S, Lai H, Samim F, Amin M. Retrospective study of factors associated with late detection of oral cancer in alberta: A qualitative study. PLoS One 2022; 17:e0266558. [PMID: 35472099 PMCID: PMC9041853 DOI: 10.1371/journal.pone.0266558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/22/2022] [Indexed: 11/19/2022] Open
Abstract
Oral cancer continues to be diagnosed in advanced stages, giving patients lower chances of survival. The objective of this study was to explore reasons for delayed diagnosis of oral cancer in Alberta. A retrospective qualitative design was implemented through seven steps suggested for conducting a narrative clinical document. Data was retrieved from the Alberta Cancer Registry database between 2005 and 2017. A sample of initial consultation notes (ICN) of oral and oropharyngeal cancer patients were identified through a purposeful sampling method and added to the study until saturation was achieved. A deductive analysis approach inspired by the model pathways to treatment health care provider (HCP) was employed. From the 34 ICN included in our analysis, five main categories were identified: appraisal interval, help-seeking interval, diagnosis interval, pre-treatment interval, and other contributing factors such as health-related behaviours, system delay, and tumor characteristics. These factors negatively contributed to early detection of oral and oropharyngeal cancers and affect treatment wait time with patients, providers, and the healthcare system. Patient's lack of awareness, provider's oversight and prolonged access to care were the main reasons of delay in cancer diagnosis and management in our study. A sustainable plan for public awareness interventions and implementation of a solid curriculum for medical and dental students is needed to enhance their related knowledge, competence in clinical judgement, and treatment managements.
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Affiliation(s)
- Parvaneh Badri
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Vickie Baracos
- Department of Oncology, Cross Cancer Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Seema Ganatra
- Division of Oral Medicine, Pathology and Radiology, School of Dentistry University of Alberta, Edmonton, Alberta, Canada
| | - Hollis Lai
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Firoozeh Samim
- Oral Medicine/Oral pathologist Division, McGill University Faculty of Dentistry, Montreal, Quebec, Canada
| | - Maryam Amin
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Badri P, Lai H, Ganatra S, Baracos V, Amin M. Factors Associated with Oral Cancerous and Precancerous Lesions in an Underserved Community: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1297. [PMID: 35162318 PMCID: PMC8835623 DOI: 10.3390/ijerph19031297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022]
Abstract
Street-involved people with limited access to regular healthcare have an increased risk of developing oral cancer and a lower survival rate. The objective of this study was to measure the prevalence of oral cancerous/precancerous lesions and determine their associated risk factors in a high-risk, underserved population. In this cross-sectional study, English-speaking adults aged 18 years and older living in a marginalized community in Edmonton were recruited from four non-profit charitable organizations. Data were collected through visual oral examinations and a questionnaire. Descriptive statistics, chi-squared tests, and logistic regressions were applied. In total, 322 participants with a mean (SD) age of 49.3 (13.5) years completed the study. Among them, 71.1% were male, 48.1% were aboriginal, and 88.2% were single. The prevalence of oral cancerous lesions was 2.4%, which was higher than the recorded prevalence in Canada (0.014-1.42: 10,000) and in Alberta (0.011-1.13: 10,000). The clinical examinations indicated that 176 (54.7%) participants had clinical inflammatory changes in their oral mucosa. There was a significant association between clinical inflammatory oral lesions and oral cancerous/precancerous lesions (p < 0.001). Simple logistic regression showed that the risk of the presence of oral cancerous/precancerous lesions was two times higher in participants living in a shelter or on the street than in those living alone (OR = 2.06; 95% CI: 1.15-3.82; p-value: 0.021). In the multiple logistic regression analysis, the risk of oral cancerous/precancerous lesions was 1.68 times higher in participants living in a shelter or on the street vs. living alone after accounting for multiple predictors (OR = 1.67; 95% CI: 1.19-2.37; p-value: 0.022). The results demonstrated a high prevalence of cancerous/precancerous lesions among the study participants, which was significantly associated with clinical inflammatory oral lesions. The evidence supports the need for developing oral cancer screening and oral health promotion strategies in underserved communities.
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Affiliation(s)
- Parvaneh Badri
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada; (P.B.); (H.L.); (S.G.)
| | - Hollis Lai
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada; (P.B.); (H.L.); (S.G.)
| | - Seema Ganatra
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada; (P.B.); (H.L.); (S.G.)
| | - Vickie Baracos
- Department of Oncology, Cross Cancer Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1Z2, Canada;
| | - Maryam Amin
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada; (P.B.); (H.L.); (S.G.)
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9
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McGowan B, Grace H, Beste D, Frey S, Bridges J, Sun J, Nair RG. Factors influencing oral cancer screening preferences in patients attending Tertiary Care University Oral Health Clinic. Aust Dent J 2021; 67:55-68. [PMID: 34706067 DOI: 10.1111/adj.12881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/06/2021] [Accepted: 10/17/2021] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- B McGowan
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - H Grace
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - D Beste
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - S Frey
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - J Bridges
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - J Sun
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute of Queensland, Gold Coast, Queensland, Australia
| | - R G Nair
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute of Queensland, Gold Coast, Queensland, Australia.,Haematology and Oncology, Gold Coast University Hospital, Queensland Health, Gold Coast, Queensland, Australia
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10
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Saraswat N, Pillay R, Prabhu N, Everett B, George A. Perceptions and Practices of General Practitioners towards Oral Cancer and Emerging Risk Factors among Indian Immigrants in Australia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11111. [PMID: 34769631 PMCID: PMC8582889 DOI: 10.3390/ijerph182111111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND In Australia, Indian immigrants are one of the fastest-growing communities. Since oral cancer is widespread in India, the indulgence of Indians in customs of areca (betel) nut use in Australia may be linked to the recent rise in oral cancer cases. Since GPs (general practitioners) are primary healthcare providers, it is pivotal to ensure the oral cancer awareness of GPs. This study aimed to explore oral cancer risk-related knowledge, beliefs, and clinical practices of GPs in Australia. METHODS Fourteen semi-structured interviews were conducted with GPs practicing across New South Wales and Victoria. Purposive and snowball sampling were used for recruitment. Data were analysed through a directed content analysis approach. RESULTS All GPs were knowledgeable of major oral cancer causative factors including tobacco and alcohol, but some had limited understanding about the risks associated with areca nut preparations. Positive attitudes were evident, with all participants acknowledging the importance of oral cancer risk assessment. Most GPs recalled not performing oral cancer routine check-ups. CONCLUSION GPs presented good oral cancer knowledge except for emerging risk factors such as areca nut use. Varied beliefs and inconsistent clinical practices relating to oral cancer screening is concerning. Accessible oral cancer training around emerging risk factors may benefit GPs.
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Affiliation(s)
- Nidhi Saraswat
- Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, School of Nursing and Midwifery, South Western Sydney Local Health District, Western Sydney University, Liverpool, NSW 1871, Australia; (B.E.); (A.G.)
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
| | - Rona Pillay
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
| | - Neeta Prabhu
- Paediatric Dentistry, Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Camperdown, NSW 2006, Australia;
- Paediatric Dentistry, Westmead Centre for Oral Health, Sydney, NSW 2145, Australia
| | - Bronwyn Everett
- Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, School of Nursing and Midwifery, South Western Sydney Local Health District, Western Sydney University, Liverpool, NSW 1871, Australia; (B.E.); (A.G.)
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Ingham Institute for Applied Medical Research, School of Nursing and Midwifery, South Western Sydney Local Health District, Western Sydney University, Liverpool, NSW 1871, Australia; (B.E.); (A.G.)
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW 2116, Australia;
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Camperdown, NSW 2006, Australia
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11
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Ilhan B, Lin K, Guneri P, Wilder-Smith P. Improving Oral Cancer Outcomes with Imaging and Artificial Intelligence. J Dent Res 2020; 99:241-248. [PMID: 32077795 DOI: 10.1177/0022034520902128] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Early diagnosis is the most important determinant of oral and oropharyngeal squamous cell carcinoma (OPSCC) outcomes, yet most of these cancers are detected late, when outcomes are poor. Typically, nonspecialists such as dentists screen for oral cancer risk, and then they refer high-risk patients to specialists for biopsy-based diagnosis. Because the clinical appearance of oral mucosal lesions is not an adequate indicator of their diagnosis, status, or risk level, this initial triage process is inaccurate, with poor sensitivity and specificity. The objective of this study is to provide an overview of emerging optical imaging modalities and novel artificial intelligence-based approaches, as well as to evaluate their individual and combined utility and implications for improving oral cancer detection and outcomes. The principles of image-based approaches to detecting oral cancer are placed within the context of clinical needs and parameters. A brief overview of artificial intelligence approaches and algorithms is presented, and studies that use these 2 approaches singly and together are cited and evaluated. In recent years, a range of novel imaging modalities has been investigated for their applicability to improving oral cancer outcomes, yet none of them have found widespread adoption or significantly affected clinical practice or outcomes. Artificial intelligence approaches are beginning to have considerable impact in improving diagnostic accuracy in some fields of medicine, but to date, only limited studies apply to oral cancer. These studies demonstrate that artificial intelligence approaches combined with imaging can have considerable impact on oral cancer outcomes, with applications ranging from low-cost screening with smartphone-based probes to algorithm-guided detection of oral lesion heterogeneity and margins using optical coherence tomography. Combined imaging and artificial intelligence approaches can improve oral cancer outcomes through improved detection and diagnosis.
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Affiliation(s)
- B Ilhan
- Department of Oral & Maxillofacial Radiology, Ege University Faculty of Dentistry, Bornova-Izmir, Turkey
| | - K Lin
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - P Guneri
- Department of Oral & Maxillofacial Radiology, Ege University Faculty of Dentistry, Bornova-Izmir, Turkey
| | - P Wilder-Smith
- Beckman Laser Institute, University of California, Irvine, CA, USA
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Liu TPJ, Fisher BM, Chua B, Clark JR, Low THH, Batstone MD. Survival outcomes following modern multidisciplinary management of oral squamous cell carcinoma in Australia. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:92-98. [PMID: 33187950 DOI: 10.1016/j.oooo.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/23/2020] [Accepted: 09/30/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Oral squamous cell carcinoma (SCC) has been traditionally described as a highly lethal disease. This study aims to provide updated multi-institutional data on the survival of patients with oral SCC in Australia. STUDY DESIGN Retrospective survival analysis was performed between 2008 and 2016. All new patients with oral SCC treated with curative intent were recruited from 2 high-volume Australian head and neck oncology centers. Outcomes were measured in overall survival (OS), disease-specific survival (DSS), disease-free survival, and salvage rates for recurrences. RESULTS Survival analysis included 771 patients with oral SCC. Five-year OS and DSS were 66.1% and 79.7%, respectively. Stage I and II oral SCC had significantly better survival than higher stages. Five-year OS and DSS for patients with stage I SCC were 79.7% and 93.4%, respectively, and for patients with stage IVB they were 37.9% and 54.3%, respectively. Two hundred forty-nine patients had disease recurrence (32.3%), with 66 patients (26.5% remaining disease free post salvage treatment. CONCLUSION Survival outcomes for oral SCC among Australian patients have improved, possibly due to advances in multidisciplinary care. Early detection of oral SCC leads to highly favorable prognosis; there is therefore an opportunity for routine oral cancer screening to be performed by community health practitioners with the aim of improving survival from oral SCC.
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Affiliation(s)
- Timothy P J Liu
- Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland, Australia.
| | - Bradley M Fisher
- Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Benjamin Chua
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Jonathan R Clark
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney; Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District
| | - Tsu-Hui Hubert Low
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney; Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District
| | - Martin D Batstone
- Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
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13
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Thomas A, Manchella S, Koo K, Tiong A, Nastri A, Wiesenfeld D. The impact of delayed diagnosis on the outcomes of oral cancer patients: a retrospective cohort study. Int J Oral Maxillofac Surg 2020; 50:585-590. [PMID: 32917484 DOI: 10.1016/j.ijom.2020.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/21/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022]
Abstract
The contemporary literature is discordant regarding the role of delayed diagnosis in the prognosis of patients with oral cancer. This study examined data on a previously reported cohort of 101 patients with oral squamous cell carcinoma diagnosed at a single institution between 2008 and 2010. The time interval between symptom onset and initial histological diagnosis (diagnostic delay) was recorded for each patient, as were demographic data and cancer features such as T stage, nodal status, and smoking status. The mean follow-up period was 4 years 10 months. The mean diagnostic delay was 4 months, mean overall survival was 5years 6 months, and mean disease-specific survival was 4 years 9 months. No significant correlation was found between diagnostic delay and overall survival, disease-specific survival, or recurrence rates. Patients with node-positive disease were more likely to be diagnosed earlier, whereas women and non-smokers were more likely to have a delayed diagnosis. Inherent tumour biology is likely an important prognostic factor separate to diagnostic delay. Public education efforts should focus on symptom recognition and encourage early presentation for investigation of oral lesions, particularly for females and non-smokers, so that more aggressive tumours can be treated sooner to give the best chance at survival.
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Affiliation(s)
- A Thomas
- Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
| | - S Manchella
- Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - K Koo
- Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - A Tiong
- Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - A Nastri
- Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - D Wiesenfeld
- Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, the University of Melbourne, Parkville, Victoria, Australia
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