Oral Cancer Knowledge, Attitudes and Practices: A Survey of Undergraduate Medical Students in Himachal Pradesh, India

Knowledge, attitudes, and practices of oral cancer prevention among students, interns, and faculty members at the college of dentistry of Jazan University

Background

Oral cancer awareness among current and future dental practitioners plays a substantial role in the early detection and prevention of oral cancer. Therefore, this study aimed to assess the knowledge, attitudes, and practices (KAP) of oral cancer prevention (OCP) among oral health practitioners in the College of Dentistry at Jazan University, Saudi Arabia, and to determine factors that facilitate, or limit practices related to oral cancer prevention.

Methods

A self-administered questionnaire survey was done among dental students (n = 274), interns (n = 81), and faculty members (n = 117) in the College of Dentistry at Jazan University between May 2019 to February 2020. The questionnaire was developed in English and modified from a previously validated and published questionnaire into Arabic. It covered every KAP of oral cancer prevention that was useful in accomplishing the study's objectives. Logistic regression analysis was utilized to determine the factors associated with the practice of oral cancer prevention in the past year.

Results

Only 29.7% reported having participated in any OCP activities in the past 12 months while about 42% and 53% of participants referred suspected oral cancer patients to the departments of maxillofacial surgery and oral medicine, respectively. Most of the participants had poor knowledge (71.9%), unfavourable attitudes towards OCP (83.6%) and poor levels of practice (62.9%). The study found that the attitude of the participants was significant in influencing their practices of OCP in the previous 12 months, after adjusting for all other factors.

Conclusion

It was concluded that the level of knowledge, attitudes, and practices of OCP among the sample population was poor. The survey findings suggest that oral health practitioners in Jazan are inexperienced in the methods to adopt for prevention and early detection of oral cancer, despite the high prevalence of oral cancer among province residents. Further research should investigate effective educational strategies and training for improving the participation of students, interns, and faculty members in oral cancer prevention activities.

Comparison of expression of myofibroblasts in normal oral mucosa, oral epithelial dysplasia, and oral squamous cell carcinoma using α-SMA and vimentin: An immunohistochemical study

Background:

Myofibroblasts are thought to play critical roles in inflammation, growth, repair, premalignancy, and malignancy. This study was done to evaluate, compare and co- relate the progressive increase in the immunohistochemical expression of myofibroblasts in normal oral mucosa, epithelial dysplasia, and oral squamous cell carcinoma (OSCC). To compare and co-relate the expression of myofibroblasts in normal oral mucosa, epithelial dysplasia, and oral squamous cell carcinoma. To co-relate the progressive increase in myofibroblasts expression in normal oral mucosa, epithelial dysplasia, and oral squamous cell carcinoma.

Materials and Method:

Forty-nine paraffin-embedded tissue blocks with 7 cases of normal oral mucosa, 21 cases of epithelial dysplasia, and 21 diagnosed cases of OSCCs were studied. The samples were subjected to heat-induced antigen retrieval methods followed by staining using primary mouse monoclonal antibodies against α-smooth muscle actin (SMA) and vimentin. Staining index of all the sections was calculated. Statistical analysis was performed using the Kruskal–Wallis test, Mann–Whitney U test, and Chi-square test. Values of P less than or equal to 0.05 (P ≤ 0.05) were considered statistically significant.

Results:

Statistically significant staining index was obtained by α-SMA and vimentin between normal oral mucosa, epithelial dysplasia, and OSCC.

Conclusion:

Myofibroblast may play a role only during initial tumorigenesis that is the conversion of severe dysplasia into OSCC.

Insights of primary health care providers regarding opportunistic screening of oral cancer/precancers in Patna, Bihar

Background

Clinical opportunistic screening can be valuable for diagnosis of oral cancer/precancer prior to development of symptoms. Thus, the aim of the present study is to assess the knowledge, perceptions, and present practices of primary health care providers regarding oral cancer screening.

Material and Methods

This cross-sectional questionnaire study was carried out on doctors working in primary health centres of Patna district, Bihar. A total of 10 questions in true/false or multiple choice format assessed the knowledge on oral cancer screening. Attitude and practices were evaluated by seven questions each on a 5-point Likert scale. Unpaired t-test and one-way ANOVA followed by post hoc test was applied to determine the significance difference between the mean scores of knowledge and demographic variables. The significance level was set at below 0.05.

Results

The total mean knowledge scores were 6.5 ± 2.17. Response analysis showed that regarding opinion on only 28% health care providers agreed or strongly agreed that they have adequate knowledge regarding detection of oral cancer. It was found that 44.7% never/rarely examined the oral cavity of the patient. Only 14% and 16% doctors aid with the cessation of habits and advised dietary changes in patients with precancerous lesions/conditions, respectively.

Conclusion

Capacity building of primary care physicians is very crucial for a successful screening program. The present study reveals that the training activities of healthcare providers in oral screening need to be reinforced.

A cross-sectional study on oncology nurses' knowledge and practice of oral mucositis among cancer patients in Jordan

OBJECTIVES

This study was conducted to evaluate oncology nurses' knowledge and compliance with oral mucositis (OM) management guidelines.

METHODS

A cross-sectional design with a nonparticipant observation approach was utilized. In phase Ⅰ, a cross-sectional convenience sample (n = 140) of oncology nurses completed the knowledge test. In phase Ⅱ, a random sample (n = 20) of oncology nurses from participants in phase Ⅰ was observed during their practice.

RESULTS

Fifty-seven (40.7%) of the participants had an unsatisfactory level of knowledge. Most of them had knowledge deficits regarding pathology, OM definition, assessment, scoring, treatment, and patient education and advice. A significant difference existed among nurses with diploma, bachelor, and postgraduate degrees as determined by one-way ANOVA (P = 0.001). There were no significant difference between average scores of male and female nurses were higher than those of nurses (P = 0.45). No significant difference was observed among knowledge scores of nurses with different job titles (P = 0.51). The average score of male nurses in terms of skill performance was higher than that of female nurses (29.20 ± 2.10 vs 27.10 ± 1.80) without statistical significance.

CONCLUSION

The knowledge and compliance with OM management guidelines among Jordanian oncology nurses need to be improved. National OM prevention and management guidelines are adopted in Jordan. Continuing education and training are also recommended.

Yoga as an Integrative Approach for Prevention and Treatment of Oral Cancer

Despite tremendous advancements in medicine, the number of oral cancer cases continues to increase, and the need for integrating alternate medicine or adopting an integrative approach has become a compelling cost-effective requirement for the management and treatment of diseases. Conventional treatment of oral cancer involves surgery followed by radiotherapy with or without chemotherapy which causes several complications including poor quality of life and high chances of recurrence of cancer. Oral cancer is often linked with obesity which is major risk factors in other cancers. Apart from obesity, oral cancer is thought to have an inverse relation with neurodegenerative disorders presumably because cell death decreases in the former case and increases in the latter. Ancient mind-body techniques such as yoga have not been adequately tested as a tool to synergize the cellular equilibrium pertaining to the treatment of oral cancer. Nerve growth factor (NGF), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) are among the early experimental cellular biomarkers that may be used to probe the modulation of oral cancer, obesity, and neurodegenerative disorders. Yoga has been reported to influence these molecules in healthy individuals but whether their expression can be altered in patients of oral cancer by yoga intervention is the subject of this research being discussed in this review article. Therefore, the present article not only reviews the current status of research studies in oral cancer, obesity, and neurodegenerative disorders but also how these are linked to each other and why the investigations of the putative NGF pathway, involving TNF-α and IL-6, could provide useful clues to understand the molecular effects brought about by yoga intervention in such patients.