Promoting oral cancer awareness and early detection using a mass media approach

Effects of educational interventions based on the theory of planned behavior on oral cancer-related knowledge and tobacco smoking in adults: a cluster randomized controlled trial

BACKGROUND

The theory of planned behavior (TPB) is an effective model for facilitating behavioral change. The aim of the present study was to evaluate the impact of TPB-based educational interventions on oral cancer-related knowledge and tobacco smoking behavior in an Iranian adult population in 2022.

METHODS

In this randomized controlled trial, a total of 400 healthy individuals were enrolled. The study was implemented in 20 urban health centers in the south of Tehran, Iran. The health centers were randomly allocated into two intervention groups. In group PowerPoint (PP), the participants received education through a 20-minute PowerPoint presentation complemented by a pamphlet. Group WhatsApp (WA) was educated via WhatsApp messages and images. Data was collected using a structured questionnaire at baseline, and at one- and three-month follow-ups. The outcomes were evaluated in terms of knowledge, tobacco smoking behavior, and the related model constructs i.e. intention, attitude, subjective norm, and perceived behavioral control. Generalized estimating equations (GEE) regression models were applied to assess the effect of interventions on repeated measurements of the outcomes. All analyses were conducted using STATA Software Version 17.

RESULTS

Out of all the participants, 249 (62%) were women. The mean and standard deviation (SD) of age were 39.67 and 13.80 years. Overall, group PP had a significantly higher score of knowledge compared to group WA (β = 0.43, p = 0.005). No significant differences were found between the groups with regard to tobacco smoking and the related TPB constructs, except for attitude with a higher score in group PP compared to group WA (β = 0.50, p = 0.004). At the three-month follow-up, both interventions had significant effects on increasing knowledge (β = 4.41), decreasing tobacco smoking (OR = 0.54), and increasing intention (β = 1.11), attitude (β = 1.22), subjective norm (β = 1.37), and perceived behavioral control (β = 1.08) (P < 0.001).

CONCLUSIONS

Both interventions were effective in improving knowledge, tobacco smoking, and the TPB constructs after three months. Therefore, the application of both methods could be considered in the design and implementation of oral cancer prevention programs.

TRIAL REGISTRATION

The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Effectiveness of Interventions to Improve Oral Cancer Knowledge: a Systematic Review

Oral cancer is prone to late-stage diagnosis, and subsequent low five-year survival rates. A small number of interventions or campaigns designed to enhance knowledge of risk factors and symptoms associated with oral cancer have been attempted in the UK, US, and some other countries. The purpose of this systematic review is to assess the effectiveness of interventions designed to improve oral cancer knowledge. We searched five databases to identify randomized controlled trials (RCTs) and non-randomized/quasi-experimental (NR/QE) studies targeting the general population or high-risk groups (tobacco users or alcohol consumers), aged ≥15 years, and reporting the outcomes of individual and/or community level interventions. Two co-authors independently identified relevant studies, extracted data, and assessed the risk of bias. Adhering to PRISMA guidelines, 27 (eight RCTs and 19 NR/QE studies) of the 551 studies identified from the five databases met the inclusion criteria. All RCTs and nine NR/QE studies used either printed materials, health education sessions, multimedia aids, or some combinations of these tools. The other ten NR/QE studies were community-based and used mass media campaigns to increase oral cancer awareness. Overall, the majority of studies significantly improved oral cancer knowledge; however, heterogeneity in study design and variation in measurement tools made it difficult to compare outcomes. Findings suggest that individual and/or community level interventions are generally effective in increasing knowledge of oral cancer risk factors, signs and symptoms, and/or its early diagnosis and prevention strategies among the general population or high-risk groups. However, the long-term benefits of these interventions are understudied.

Barriers to early detection and management of oral cancer in the Asia Pacific region

Objective

Oral cancer is amenable to early detection but remains a prominent cause of mortality in the Asia Pacific region. This study aimed to identify barriers to early detection and management of oral cancer in the Asia Pacific region.

Methods

A mixed-methods approach was employed triangulating findings from a survey and focus groups. The survey was conducted among seven representative members of the Asia Pacific Oral Cancer Network (APOCNET) across six countries. Focus groups were conducted to gain deeper insights into the findings of the survey.

Results

The identified barriers were a lack of national cancer control strategies and cancer registries and the limited availability of trained health care professionals. Overcoming these challenges in the Asia Pacific region where resources are scarce will require collaborative partnerships in data collection and novel approaches for continuous professional training including eLearning. Further, to overcome the lack of trained health care professionals, innovative approaches to the management of oral potentially malignant lesions and oral cancer including telemedicine were suggested.

Conclusion

The findings of this study should be taken into account when charting national cancer control plans for oral cancer and will form the basis for future collaborative studies in evaluating effective measures to improve oral cancer detection and management in low- and middle-income countries.

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.

Determinants of Compliance to Population-Based Oral Cancer Screening Program among low Socioeconomic Women in Mumbai, India

Background

The use of tobacco, especially smokeless variety, is common and culturally accepted among Indian women. Hence, oral cavity cancers rank as the fourth most common cancers among Indian women.

Objectives

The objectives of this study were to study factors determining compliance of women for oral cancer screening in a population-based program in Mumbai and to create awareness among women regarding ill effects of tobacco and importance of oral cancer screening.

Materials and Methods

This is a community-based organized service program for awareness and screening of oral cavity cancers among women residing in low socioeconomic areas of Mumbai, India. Screening was conducted by oral visual inspection by trained primary health workers (PHWs). Univariate and multivariate logistic regression analyses were conducted to identify predictors of participation in oral cancer screening.

Results

138,383 population was surveyed, out of which 13,492 eligible women were enlisted for oral cancer screening. Among these, 12,495 were contacted and 11,895 (95.12%) women participated in a cancer awareness program and 11,768 (94.18%) participated in oral cancer screening. According to results of multivariate logistic regression analysis, women belonging to Hindu religion 94.57%, with mother tongue Marathi 94.76%, and with family history of cancer 95.84% complied significantly higher to oral cancer screening as compared to other women.

Conclusion

This program has assisted in identifying predictors of compliance to oral cavity screening. Furthermore, it demonstrates that good compliance can be achieved through multiple household visits, personal invitation during camps, organizing well-planned Health Education Program, and the use of simple, low-cost visual inspection test performed by trained PHWs.

Awareness about oral cancer among nonhealth professional students - A cross-sectional study in Bengaluru city

Background and Aim

Oral cancer is one of the most life-threatening conditions, early diagnosis of which greatly increases the probability of cure and survival rates. Knowledge regarding risk factors and early signs among the nonhealth professionals which help in early detection prevention and of the disease. Therefore, the aim of this study is to assess the awareness about tobacco use among nonhealth professional students in Bangalore city.

Methodology

A cross-sectional descriptive questionnaire study was conducted to assess the knowledge and awareness about oral cancer among 800 nonhealth professional students in Bengaluru city. A self-administered questionnaire containing 26 questions pertaining to awareness, signs, symptoms and risk factors of tobacco use was administered to the students.

Results

The results revealed that the majority of the students (55.5%) were aware about oral cancer but have less knowledge in terms of its signs and symptoms of oral cancer. The main source for information pertaining to oral cancer was obtained from mass media, i.e., TV, radio and social media (21.5%).

Conclusion

The study reveals that there is a need for education and raise awareness about oral cancer among nonhealth professional students.

The Inequitable Global Burden of Lip and Oral Cancers: Widening Disparities Across Countries

PURPOSE

In light of continued innovation in cancer immunotherapy regimens and surgical management, no studies currently exist assessing the effect of these advances on global disparities in lip and oral cavity cancer disease burden. The purpose of this study is to characterize longitudinal trends in disease burden caused by lip and oral cavity cancers globally.

MATERIALS AND METHODS

This retrospective, longitudinal cohort study extracted data on lip and oral cavity cancer disease burden from The Global Health Data Exchange for 1990-2017. The primary predictor variable was country human development index (HDI). The primary outcome variable was disease burden, measured by age-standardized disability-adjusted life years (DALYs) per 100,000 population, listed for each individual country. Additional variables assessed include country-level data on alcohol consumption and tobacco smoking. Concentration indices were also calculated. Mann-Whitney U and Kruskal-Wallis one-way analysis of variance tests with Bonferroni correction were utilized with a significance threshold of 0.008.

RESULTS

A total of 185 countries met inclusion criteria. Global age-standardized DALYs increased from 44.5 ± 35.7 to 51.1 ± 41.1 from 1990 to 2017. High HDI and medium HDI countries showed a +37.6% and +22.4% median increase in DALYs, respectively, which is significantly greater than very-high HDI (+3.8%) and low HDI countries (-0.5%) (P < .001). The concentration index for lip and oral cavity cancer became increasingly negative from -0.064 to -0.077 from 1990 to 2015. In 2017, disease burden was concentrated in South Asia and Eastern Europe.

CONCLUSIONS

High and medium HDI countries experienced a disproportionate growth in lip and oral cavity cancer disease burden. These findings may have resulted from increased life expectancy among these countries. Global and public health policy initiatives should focus on understanding the mechanisms driving these disparities with the goal of reducing disease burden globally.

The systematic cultural adaptation of a UK public health cancer awareness raising programme for Malaysia: the Be Cancer Alert Campaign

Increasingly, policy and research attention is being directed toward improving global health in low- and middle-income countries. This study investigated the cultural adaptation of a UK-designed and developed evidence-based mass media campaign with the aim of improving colorectal cancer and breast cancer awareness in Malaysia. Guided by the heuristic framework of cultural adaptation, a multidisciplinary team adapted the UK Be Cancer Aware programme for implementation in the Malaysian context. The approach included five steps: (a) information gathering and needs assessment; (b) preliminary design; (c) preliminary testing; (d) refinement; and (e) final trial. Key findings from the information gathering stage related to the need to take into account differences in ethnicity, religion, and beliefs about cancer. Discussions with experts indicated that particular words were not acceptable in Malay culture and that specific aspects were “taboo” (e.g., showing pictures of breasts in relation to breast cancer on TV). Stage 3 of the analysis revealed that the presentation of cancer survivors rather than health professionals on programme materials was preferred by Malaysians and that there was a poor level of awareness about colorectal cancer. The results were used systematically to adapt two culturally suitable cancer awareness mass media campaigns for implementation in Malaysia. The developed materials were in line with government priorities and took into account the local health care system structure. The establishment of a partnership with key stakeholders (e.g., the Ministry of Health and the lead patient advocacy organization) and the application of a systematic approach to address cultural factors and resource constraints contribute to the successful implementation of public health programmes in global health settings.

Cancer awareness and attitude towards cancer screening in India: A narrative review

Cancer awareness is the key to early detection and better health-seeking behaviour. Cancer is quite common in both developing as well as developed countries, but awareness is yet poor among the general population. Poor awareness may lead to poor uptake of screening modalities and delay in diagnosis. One factor that has been consistently shown to be associated with late diagnosis and treatment is a delay in seeking help for cancer-like symptoms. This paper reviews the literature on cancer awareness among the general population and attitude towards screening modalities. The poor awareness level among the Indian population shows the need for health education and sensitisation regarding cancer and its different aspects. This will be helpful in the successful implementation of health programmes related to cancer.

Effectiveness of Mass and Small Media Campaigns to Improve Cancer Awareness and Screening Rates in Asia: A Systematic Review

PURPOSE

The main objective of this systematic review was to identify whether mass and small media interventions improve knowledge and attitudes about cancer, cancer screening rates, and early detection of cancer in Asia.

METHODS

The review was conducted according to a predefined protocol. Medline, EMBASE, CINAHL, Web of Science, Cochrane Library, and Google Scholar were searched in September 2017, and data extraction and rating of methodologic study quality (according to Joanna Briggs Institute rating procedures) were performed independently by reviewers.

RESULTS

Twenty-two studies (reported across 24 papers) met the inclusion criteria. Most studies (n = 21) were conducted in high or upper-middle income countries; targeted breast (n = 11), cervical (n = 7), colorectal (n = 3), or oral (n = 2) cancer; and used small media either alone (n = 15) or in combination with mass media and other components (n = 5). Studies regarding cancer screening uptake were of medium to high quality and mainly reported positive outcomes for cervical cancer and mixed results for breast and colorectal cancer. The methodologic strength of research that investigated change in cancer-related knowledge and the cost effectiveness of interventions, respectively, were weak and inconclusive.

CONCLUSION

Evidence indicated that small media campaigns seemed to be effective in terms of increasing screening uptake in Asia, in particular cervical cancer screening. Because of the limited number of studies in Asia, it was not possible to be certain about the effectiveness of mass media in improving screening uptake and the effectiveness of campaigns in improving cancer-related knowledge.

Interventions Addressing Barriers to Delayed Cancer Diagnosis in Low- and Middle-Income Countries: A Systematic Review

BACKGROUND

Delays to cancer diagnosis exist, resulting in worse survival outcomes for many cancers. Interventions targeting delays and barriers to cancer diagnosis and treatment have been investigated, but mostly in high-income countries. We conducted a systematic literature review to identify and characterize the interventions studied across cancers, within low- and middle-income countries (LMICs).

METHODS

This systematic review forms part two of a wider study examining solutions to delays and barriers in cancer early diagnosis in LMICs. A comprehensive literature search was conducted on November 27, 2017, encompassing published studies from the preceding 15 years. We extracted study design, population, and intervention, and reported outcome measures from each study. Results were presented by target of interventions (general vs. health care professionals). A narrative synthesis was used to summarize intervention efficacy.

RESULTS

Of 10,193 abstracts returned, 25 were included, consisting of studies across World Health Organization geographical regions, examining breast, cervix, childhood, prostate, head and neck, and gastric cancers. Altogether, 11 intervention studies targeted the general population, 12 targeted health care professionals, and 2 targeted both. The majority (17/25) of studies reported interventions focusing on patient and diagnosis-related barriers early in the cancer care pathway. Most studies reported knowledge score as primary outcome measure (17/25); few (6/25) reported on clinically relevant measures such as reducing disease stage at presentation or diagnostic time interval. Effectiveness of interventions was demonstrated for some cancers only.

CONCLUSION

More interventions reporting clinically relevant measures and using standardized methods and outcomes are required to improve our ability to effectively improve cancer early diagnosis in LMICs.

IMPLICATIONS FOR PRACTICE

Prior to this study, the extent of intervention literature in cancer early diagnosis in low- and middle-income countries had not been characterized. This study aimed to outline and characterize interventions across all cancer types and across all countries. This systematic review demonstrated that interventions have been investigated targeting both the general population and health care professionals. Furthermore, this review demonstrates that the majority of studies report knowledge as an outcome measure, rather than clinically significant measures that improve cancer-related outcomes, such as delay intervals or downstaging of disease. Future interventions should address clinically relevant measures to better assess efficacy of interventions.

An Overview on Betel Quid and Areca Nut Practice and Control in Selected Asian and South East Asian Countries

Background: Areca nut (AN) and betel quid (BQ) chewing are ancient practices followed by an extensive proportion of the world's population. These practices are endemic in larger parts of South and Southeast Asia and selected Western Pacific countries. The prevalence of these habits varies across regions, age, gender, cultural practice, and socioeconomic status groups. Considerable variations exist between countries with respect to prevention/intervention programs, and policy guidelines of BQ usage. Objectives: (1) To provide an overview of the BQ chewing prevalence, practices, preventive interventions and policies in selected Asian and Western Pacific countries. (2) To explore the different terminologies associated with BQ use. Method: A narrative review of the current literature related to BQ, AN, and oral cancer was conducted by searching PUBMED, CINAHL, and GOOGLE databases. Results: The literature review revealed that the prevalence of BQ was found to be highest in Papua New Guinea, followed by Bangladesh, India, Pakistan, Myanmar and Sri Lanka. While, Cambodia, Malaysia, Indonesia and Taiwan had comparatively lower prevalence. Smokeless tobacco, BQ with tobacco, BQ without tobacco, AN were some of the terminologies used for BQ in various studies. Conclusions: The prevalence, and the interventional policies related to BQ and AN chewing habits varies widely among the selected countries. With the increasing awareness and association of BQ with oral cancer, there is a need to have better awareness, prevention and interventional strategies in place. We also found considerable variation in the use of terminologies associated with BQ.

Public awareness of oral cancer among adults in Jakarta, Indonesia

AIM

The aim of the present study was to investigate the awareness of oral cancer among adults in Jakarta, Indonesia, and explore the factors influencing it.

METHODS

A previously-tested questionnaire on 1000 adults in Jakarta was used in the present study. The data included sociodemographic factors and answers to assess the awareness of oral cancer, early signs and symptoms, risks factors, lifestyles, and history of dental visits.

RESULTS

Only 53.2% of participants were aware of oral cancer. The level of awareness significantly differed by level of education, occupation, and experience of dental visits. Only 30% of patients had been asked about their tobacco and alcohol habits, and had been informed about the hazards of these by their dentists. All of the smokers knew that tobacco increased the risk for oral cancer. However, only a few participants considered alcohol, betel quid chewing, UV light exposure, poor diet, and genetics to play role in the development of oral cancer. Health warnings were the main source of information about oral cancer; the role of health professionals is still quite low and needs to be emphasized.

CONCLUSION

Oral cancer awareness is still low among adults in Jakarta; this finding was consistent with other studies conducted in Asia. Educational material suited to particular communities is warranted.

The 'Be Cancer Alert Campaign': protocol to evaluate a mass media campaign to raise awareness about breast and colorectal cancer in Malaysia

Background

Breast and colorectal cancer are the two most common cancers in Malaysia. Low awareness coupled with stigma and erroneous beliefs delay help-seeking behaviours, lead to late presentation and contribute to poor detection rates. Promoting cancer awareness through mass media may be effective in improving cancer-related knowledge and uptake in screening tests. However, research is sparse regarding the cultural translation and implementation of mass media campaigns in Malaysia (and Asia) in terms of raising awareness about colorectal and breast cancer.

Methods

A collaborative partnership comprising researchers from Malaysia and the UK as well as policy makers, public health experts and non-government organisations from Malaysia was formed to design, deliver and evaluate the Be Cancer Alert Campaign. Each awareness-raising campaign will run for five weeks (Colorectal Cancer in April 2018, followed by Breast Cancer in October 2018). Evaluation of the campaigns will take place in Gombak district (Colorectal Cancer) and Petaling district (Breast Cancer) respectively, in the form of a pre-post randomly selected household survey and collection of service utilisation data. Occupants who are aged 40-years and above and are able to answer questions independently will be selected from each household. A sample of 730 with 80% power will detect a change of 6.09% in knowledge that unexplained lump or swelling is a symptom of breast cancer or changes in bowel habits is a symptom of colorectal cancer.

Discussion

Malaysia and most South-East Asian countries have a low middle-income economy, with limited resources for cancer control. Late-staged cancers impose a significant economic burden on patients, households, communities, employers, health systems and governments. Our proposed strategy for the implementation of the culturally sensitive mass media cancer awareness-raising campaign will serve as a blueprint for cancer prevention and control policy in South-East Asian countries where the burden of cancer is increasing and there are high cancer death rates.

Effectiveness of a Mass Media Campaign on Oral Carcinogens and Their Effects on the Oral Cavity

Objective:

To develop a mass media campaign on oral carcinogens and their effects on the oral cavity in order to increase awareness among the general population.

Methods:

Documentary and public service announcements highlighting the effects of tobacco and its products were designed and developed based on principles of behavior change. A questionnaire, designed to determine the knowledge, attitude and practice of people regarding oral carcinogens, was used to conduct a baseline survey at various sites in eastern Nepal. Local television channels and radio stations broadcasted the documentary and public service announcements. An evaluation survey was then performed to assess the effectiveness of the campaign.

Results:

Baseline and evaluation surveys covered 1,972 and 2,140 individuals, respectively. A third of the baseline population consumed quid, 22% chewing tobacco, 16% gutka (commercial preparation of arecanut, tobacco, lime and chemicals) and 25% cigarettes. Tobacco consumption differed significantly between 3 ecologic regions with greater use in the Terai region. The knowledge prevalence regarding the oral carcinogens quid (70%), chewing tobacco (82%), gutka (58%) and cigarettes (93%) significantly increased in the evaluation population. Females were more aware about the various tobacco products and their effects on health. More people knew about the harmful effects of tobacco on their health and oral cavity, and had their mouth examined and the frequency of consumption of these products reduced significantly after the campaign. Attitudes towards production, sale and advertisements of tobacco also improved significantly.

Conclusions:

The mass media campaign was an effective tool for increasing awareness among the population.

Untapped aspects of mass media campaigns for changing health behaviour towards non-communicable diseases in Bangladesh

In recent years, non-communicable diseases (NCDs) have become epidemic in Bangladesh. Behaviour changing interventions are key to prevention and management of NCDs. A great majority of people in Bangladesh have low health literacy, are less receptive to health information, and are unlikely to embrace positive health behaviours. Mass media campaigns can play a pivotal role in changing health behaviours of the population. This review pinpoints the role of mass media campaigns for NCDs and the challenges along it, whilst stressing on NCD preventive programmes (with the examples from different countries) to change health behaviours in Bangladesh. Future research should underpin the use of innovative technologies and mobile phones, which might be a prospective option for NCD prevention and management in Bangladesh.

Oral Cancer: Awareness and Knowledge Among Dental Patients in Riyadh

More than 50 % of oral cancer cases are diagnosed at advanced stages. Public knowledge about oral cancer can help in prevention and early detection of the disease. The aim of the present study was to assess the levels of awareness and knowledge about signs and risk factors of oral cancer among dental patients in Saudi Arabia. A self-administered questionnaire was used to collect information from 1410 randomly selected patients attending dental departments within public hospitals in Riyadh, Saudi Arabia. The collected data were analyzed using SPSS software. The significance level was set at P < 0.05. The study revealed that only 62.4 % were aware of oral cancer. Some 68.2 and 56.5 %, respectively, were able to correctly identify tobacco and alcohol as risk factors. More than two thirds of subjects had no knowledge about any signs of oral cancer. Participants with lower than university education were significantly less aware, and had much less knowledge, of the signs and risk factors of oral cancer. The knowledge regarding oral cancer among Saudi dental patients is alarmingly low. Interventions to improve public knowledge about oral cancer and attitudes towards early diagnosis and treatment are urgently indicated.

Oral Cancer Awareness Among Dental Patients in Omdurman, Sudan: a cross-sectional Study

Background

Oral cancer is a preventable disease. Its occurrence is mostly due to lifestyle. In Sudan, the use of smokeless tobacco (Toombak) has long been linked to oral cancer. Knowledge of the signs and symptoms of oral cancer may well aid in early diagnosis and treatment. This is bound to result in increasing survival rates, as well as reducing the oral cancer burden on the society. This study aimed to assess oral cancer awareness regarding knowledge of signs, symptoms, risk factors and sources of the information. Furthermore, it attempts to evaluate attitudes towards oral cancer screening and any previous experience of screening, amongst dental patients attending University of Science and Technology (UST) Dental Teaching Hospital. Omdurman, Sudan.

Methods

A hospital based cross-sectional study, interviewer-administered questionnaire was conducted amongst 500 adult patients attending the UST Dental Hospital during 2015.

Results

A total of 57.7% (286) of the individuals demonstrated good knowledge of signs and symptoms, whereas 49% (139) expressed good knowledge of risk factors of oral cancer. For the majority of the individuals 66.1% (290), the most common source of information about oral cancer was from the media, while 33.9% individuals (149), obtained knowledge from direct contact of health workers. The overwhelming majority, 93.2% (466) never screened for oral cancer despite their positive attitude towards it 66.4% (332). Knowledge of risk factors associated significantly with those reported positive attitude towards oral cancer screening and those reported direct contact with health workers as a source of information, (p ≤ 0.001). Moreover, females and those living in urban districts scores higher than their counterpart in knowledge of risk factor of oral cancer. In addition, those employed 58.6% (280) and 62.8% (164) with correct believes about oral cancer showed significant association with positive knowledge of signs and symptoms (p ≤ 0.05).

Conclusions

Awareness levels, knowledge of risk factors and identifying early signs and symptoms of oral cancer necessitate the need for more structured preventive programs using media. Dentists and health workers should do more because they have a pivotal role in early diagnosis by performing oral cancer screening, raising levels of knowledge and in rectifying misconceptions about oral cancer. This would entail a reduction in high rates of morbidity and mortality associated with oral cancer.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-017-0351-z) contains supplementary material, which is available to authorized users.

Evaluation of Head and Neck Cancer Awareness and Screening Status in Jeddah, Saudi Arabia

BACKGROUND

Head and neck cancer (HNC) is one of the deadliest cancers worldwide. Early detection is a key determinant of HNC prognosis. Hence, raising awareness of this disease may improve survival rates. The present study evaluated the level of awareness and screening status for HNC in the general population of Jeddah, Saudi Arabia.

MATERIALS AND METHODS

An e-questionnaire was distributed during our HNC awareness campaign at the Red Sea Mall in Jeddah. The questions assessed HNC knowledge and screening status among participants.

RESULTS

Of the 112 respondents, 68% indicated that they had no knowledge of HNC. Social media was the major source of information (39%) for respondents. The majority (40%) believed that it was the joint responsibility of dentists, dental hygienists, and general physicians to screen for HNC; 82% had never been screened.

CONCLUSIONS

Knowledge and awareness of HNC must be increased in the general population and among dental health professionals.

Evaluation of the Impact of a Mass Media Campaign on Periodontal Knowledge among Iranian Adults: A Three-Month Follow-Up

Objectives

This study aimed to evaluate the impact of a national media campaign to promote oral health and periodontal knowledge among adults after a three-month follow-up.

Methods

We conducted a population-based study of adults aged 18 to 50 years using a stratified multi-stage sampling method in Tehran, Iran in 2011. The campaign included an animation clip about periodontal health and disease telecast on national TV for ten consecutive days. We used an instrument to assess the effect of the campaign at baseline, immediately after the campaign and after a three-month follow-up. A total of 543 participants responded at baseline and immediately after the intervention, and 294 were interviewed at the three-month follow-up assessment (response rate: 54.1%). We assessed each participant’s periodontal knowledge score, calculated as a sum of correct answers, and the change in their score following the campaign. We then used a five-item questionnaire to evaluate the participants’ opinion of the success of the campaign. We used descriptive statistics and generalised estimating equations (GEE) analysis to conduct the statistical analysis.

Results

The mean score for knowledge improvement from baseline to immediate post-intervention evaluation was higher among those who saw the campaign (0.61) than among those who did not (0.29); the corresponding figures from immediate evaluation to three-month follow-up were -0.17 and 0.15, respectively. Adjusting for baseline values, the GEE analysis demonstrated that improvement in the mean score of post-campaign knowledge associated significantly with age, education and seeing the campaign. Significant interaction between the time since seeing the campaign and whether the participant saw it (p < 0.001) revealed that the mean difference in the knowledge score between the groups who did and did not see the campaign was 0.4 at the immediate evaluation and -0.04 at the three-month follow-up. The participants received the campaign well in terms of being appealing (91.4%), worth bearing in mind (83.4%) and containing valuable information (80.3%).

Conclusions

Our findings indicate that a population-based media campaign promoting oral health and periodontal knowledge among adults had a positive short-term impact, although the effect seemed to plateau after three months.

Oral cancer awareness of the general public in Saudi Arabia

BACKGROUND

The aim of this study was to assess the level of awareness and knowledge about signs and risk factors of oral cancer in the general population in Saudi Arabia.

MATERIALS AND METHODS

A self-administered questionnaire was used to collect information from Saudi adults aged 15 years and older. A total of 679 persons participated in the survey. Descriptive statistics were calculated and chi-square tests, t-tests, and one-way analysis of variance (ANOVA) were used to examine differences between groups. The significance level was set at p<0.05.

RESULTS

Only 53.6% of the participants had heard of oral cancer. Smoking and alcohol consumption were identified as the major risk factors by 81.7% and 56.3% of the participants, respectively. Only 22.2% and 18.2%, respectively, were able to correctly identify red and white lesions as early signs of oral cancer. Participants with less than high school education were significantly less aware, and had much less knowledge, of the signs and risk factors of oral cancer (p<0.05).

CONCLUSIONS

This survey demonstrates a general lack of awareness among the public about oral cancer and a lack of knowledge about its signs and risk factors. There is a clear need to inform and educate the public in matters relating to the known risk factors associated with oral cancer. A media campaign informing the public about oral cancer is clearly required.

Public awareness and knowledge of oral cancer in Yemen

BACKGROUND

Oral cancer is in increasing in incidence in Yemen and indeed worldwide. Knowledge regarding risk factors and early signs in the general population can help in prevention and early detection of the disease.

PURPOSE

The aim of this study was to assess the level of awareness and knowledge of oral cancer in the general population in Yemen.

MATERIALS AND METHODS

A cross-sectional survey using a self-administered questionnaire was conducted on Yemeni adults aged ≥15 years old. A total of 543 persons participated, the collected data being analyzed using SPSS software. The significance level was set at p<0.05.

RESULTS

Two thirds (71.5%) of the participants had heard about oral cancer. Smoking and smokeless tobacco usage were identified as the major risk factors by 71.5% and 73.7% of the participants, respectively. Only 24.1% and 21.4%, respectively, were able to correctly identify red and white lesions as early signs of oral cancer. Knowledge of oral cancer was significantly associated with age (p<0.01), gender (p<0.05) and education level (p<0.001).

CONCLUSIONS

The findings suggest that the knowledge regarding oral cancer in this population is low. Therefore, educational programs are highly needed to improve such knowledge.

Oral Cancer Knowledge and Practice among Dental Patients and their Attitude Towards Tobacco Cessation in Iran

BACKGROUND

One of the main causes of delay in diagnosis of oral cancer is lack of awareness about aetiology and symptoms among the general population. The aim of this study was to assess the knowledge and practice of patients regarding oral cancer and their attitude towards tobacco cessation.

MATERIALS AND METHODS

This study was carried out in Isfahan-Iran in 2014. A 29-item self-administrated questionnaire was designed and piloted and distributed to patients attending dental clinics. Questions were focused on awareness about oral cancer risk factors, signs and symptoms, places in the mouth which are more susceptible and attitude toward tobacco cessation. Chi-square, T-test, ANOVA and logistic regression tests were used for statistical analysis.

RESULTS

A total of 546 valid completed questionnaires were obtained. The mean knowledge score of patients was 4.1(±2.7) out of 13. Some 80% of patients did not know about early manifestations of oral cancer. Only 18% knew the most likely sites of oral cancer. Only 43.1% and 65.2% of patients reported alcohol and tobacco consumption as the main risk factors but they had a fair knowledge about other risk factors. There was no significant difference in Knowledge level between patients regarding their sex, educational levels and age. Most patents (90%) expected their dentists to warn them about the harmful effects of smoking and showed willingness to quit if recommended.

CONCLUSIONS

Knowledge about oral cancer was found to be quite low. It seems necessary to increase the level of public awareness using educational programs with cooperation of dentists in tobacco cessation programs.

Determinants of health information-seeking behavior: implications for post-treatment cancer patients

Health information-seeking behavior (HISB) is active need-fulfillment behavior whereby health information is obtained from diverse sources, such as the media, and has emerged as an important issue within the transforming medical environment and the rise of medical consumers. However, little is known about the factors that affect HISB and its associations, and the health outcome of HISB. The aim of this study was to examine individual and social contextual factors associated with HISB and to systematically review their effects on health status among post- treatment cancer patients. Individual determinants of HISB included demographic factors, psychosocial factors, perceived efficacy and norms, and health beliefs. Contextual determinants of HISB encompassed community characteristics, neighborhood social capital, and media advocacy. Improving through factors on these two levels, HISB raised individuals' self-care management skills and medical treatment compliance, and enhanced shared decision-making and medical treatment satisfaction. Moreover, because HISB can differ according to individuals' social contextual conditions, it can give rise to communication inequalities. Because these can ultimately lead to health disparities between groups, social interest in HISB and balanced HISB promotion strategies are necessary.

Oral Lesions Diagnosed during Oral Cancer Prevention Campaign in Fernandópolis, Brazil, 2015

Background

To describe oral lesions diagnosed during oral cancer prevention campaign performed in Fernandópolis, Brazil, in 2015.

Materials and methods

Patients who attended for the Basic Health Units of the city of Fernandópolis on the day of the campaign were examined by dental surgeons who searched for oral lesions clinically suggestive for oral squamous cell carcinoma (SCC) or potentially malignant lesions. Final diagnosis was obtained by a re-evaluation of patients with suspicious lesions performed by an expert in oral diseases.

Results

Seven hundred and sixty-two patients were examined during the campaign; although 96 (12.59%) presented with oral suspicious lesions and forwarded for re-evaluation, only 72 (9.44%) attended for re-evaluation and got the final diagnosis. Among re-evaluated patients, only 1 (1.38%) was diagnosed with oral SCC, whereas 56 (77.77%) were diagnosed with oral benign lesions, and 19 (26.38%) were diagnosed with oral normality variations.

Conclusion

Oral cancer low diagnosis rate detected during this campaign might be attributed to lacks on oral cancer prevention campaign methodologies, which clearly needs to be improved aiming to reach patients in real risk for oral cancer development. Furthermore, oral benign lesions diagnosis among patients forwarded with suspicious lesions rates suggests a lack on dental surgeons’ knowledge regarding oral cancer.

How to cite this article

Tomo S, Cruz MCC, Fernandes KGC, Kina M, Boer NP, Simonato LE. Oral Lesions Diagnosed during Oral Cancer Prevention Campaign in Fernandópolis, Brazil, 2015. World J Dent 2015;6(3):138-142.

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.