Dental service use and the implications for oral cancer screening in a sample of Bangladeshi adult medical care users living in Tower Hamlets, UK

Pearson, Nicola; Croucher, Ray; Marcenes, Wagner; O’Farrell, Mary

doi:10.1038/sj.bdj.4800156

Cited by 18 publications

(19 citation statements)

References 19 publications

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“…This is in line with previous UK oral cancer screening initiatives (Downer et al , 2006) and is almost identical to that observed in a large screening trial in Kerala, India (Sankaranarayanan et al , 2005). Those referred were more likely to be paan with tobacco chewers, confirming previous findings (Pearson et al , 1999; Jayalekshmi et al , 2009), and to have limited years of completed education.…”

Section: Discussionsupporting

confidence: 87%

“…A recent Cochrane review concluded that there was not enough evidence to determine whether oral screening by visual examination, or any other modality, in the general population could reduce mortality from oral cancer (Kujan et al , 2006), but an increasing number of studies suggest that oral screening could feasibly be carried out cost effectively as part of routine dental inspection in NHS general dental practice (Field et al , 1995; Lim et al , 2003; Speight et al , 2006). This may be of limited relevance to the Bangladeshi population of Tower Hamlets who are known to have poor attendance rates at General Dental Practitioners (Pearson et al , 1999). …”

Section: Oral Screening and Potentially Malignant Disordersmentioning

confidence: 99%

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Oral cancer screening in the Bangladeshi community of Tower Hamlets: a social model

et al. 2009

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Background:UK oral cancer incidence has risen by 22% in the last 10 years. Oral cancer is often detected at a late stage when treatment is debilitating and the chances of survival are poor. Certain black and minority ethnic groups are at elevated risk of oral cancer due to the prevalence of risk factor behaviours. We describe the background to, the development of and outcomes of an oral cancer screening activity appropriate to the needs of members of a disadvantaged community at high risk of oral cancer, carried out between 2006 and 2008 in Tower Hamlets, East London.Methods:In all, 1320 people participated during 34 days of screening, divided into two phases (Phase I (2006/2007): n=485, Phase II (2008): n=835). Modifications to the delivery process were implemented for Phase II in an attempt to recruit more high-risk individuals and to improve screening specificity.Results:In total, 75 people were urgently referred for further investigation (Phase I: n=20, Phase II: n= 55). Nine were diagnosed with dysplastic lesions (Phase I: n=3, Phase II: n=6) and a further eight showed potentially malignant disorders without dysplasia (Phase I: n=1, Phase II: n=7). Screening participants with low levels of completed education (OR: 6.94, 95% CI: 1.66, 28.98) and who chewed paan with tobacco (OR: 8.01, 95% CI: 3.54, 18.08) were more likely to be referred for further investigation.Conclusion:The project offers insights for the further development of oral cancer screening interventions for disadvantaged communities.

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Section: Discussionsupporting

confidence: 87%

Section: Oral Screening and Potentially Malignant Disordersmentioning

confidence: 99%

Oral cancer screening in the Bangladeshi community of Tower Hamlets: a social model

et al. 2009

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“…These methods were recently used to identify a tobacco-use prevalence in a national sample of UK resident Bangladeshi women of 38% (Erens, Primatesta, & Prior, 2001). Comparisons of these findings with other investigations of paan chewing with tobacco, which were based upon selfreport, would not be fruitful, although one recent selfreport study in Tower Hamlets identified a similar prevalence (Pearson, Croucher, Marcenes, & O'Farrell, 1999). The mean salivary cotinine concentration for chewing paan quid with tobacco reported here is similar to reports from other studies of smokeless tobacco users (Benowitz, Porchet, Sheiner, & Jacob, 1988;Boyle et al, 1995).…”

Section: Discussionsupporting

confidence: 85%

Tobacco dependence in a UK Bangladeshi female population: a cross-sectional study

Croucher

Islam

Jarvis

et al. 2002

Nicotine & Tobacco Research

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The objective of this study was to establish the prevalence of paan chewing with tobacco by UK-resident Bangladeshi women and the extent to which they manifest nicotine dependence. The cross-sectional study was conducted at two local authority housing estates in Tower Hamlets, London. Participants were 242 Bangladeshi women, selected at random from the current electoral register, who supplied a saliva sample for cotinine and an expired air sample for carbon monoxide analysis. They also participated in a structured interview assessing knowledge, attitudes and behavior with respect to tobacco use. Main outcome measures were data on tobacco use and nicotine dependence, assessed by questionnaire and intake measures. The population prevalence of chewing paan quid with tobacco was 48.5% (95% confidence interval, CI 42.01-54.98%), while 4% (95% CI 2.05-7.41%) smoked cigarettes. Higher mean salivary cotinine scores were associated with greater consumption frequency and use of leaf tobacco in the quid. Above-average nicotine dependence was associated with chewing paan quid with tobacco within 1 h of waking (OR = 4.02, p = 0.03, 95% CI 1.08-14.94) and the use of leaf rather than processed tobacco (OR = 3.91, p = 0.025, 95% CI 1.19-12.81). Smoking prevalence is low, but the prevalence of paan quid with tobacco chewing is high in this sample of Bangladeshi women. Cotinine concentration appears to be a reliable indicator of levels of nicotine dependence among paan quid with tobacco chewers. Questionnaire-derived items can be used to identify those with above-average levels of nicotine dependence.

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“…In addition, whilst many studies report frequent khat chewing as a common risk factor for unfavorable oral and general health outcomes [4,5], the novelty of this study is that severity of dependency on khat chewing is the common factor in symptomatic dental and medical attendance. This finding adds khat chewing dependency as a specific factor influencing dental and medical attendance amongst khat chewers alongside other factors reported for BMEG and drug users [9,24,25]. …”

Section: Discussionmentioning

confidence: 66%

“…Health status and dental and medical attendance amongst this group is similar to other BMEG as well as drug users [9,24,25]. Older respondents reporting health conditions were more likely to have ‘symptomatic‘ medical attendance [26].…”

Section: Discussionmentioning

confidence: 75%

Factors associated with dental and medical care attendance in UK resident Yemeni khat chewers: a cross sectional study

Kassim

Croucher

2012

BMC Public Health

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BackgroundThe chewing of khat leaf with tobacco smoking amongst Yemenis, Somalis and Ethiopians is reported to impact oral and general health. The health status and particularly dental and medical care attendance of UK-khat chewers has not received attention. This study aimed to explore health status and dental and medical attendance and its associated factors in UK permanently resident Yemeni khat chewers.MethodsA cross- sectional study with a purposively selected sample of 204 khat chewers was conducted. Data were collected through face to face interviews. Data analysis included descriptive, Chi-square tests and binary logistic regressions.ResultsThe mean age for this study sample was 44.84 (SD = ±19.70) years and 35% were employed. Forty five percent reported symptomatic medical attendance for self reported health conditions in the last two weeks whilst 44% had symptomatic dental attendance. Higher khat chewing dependency levels associated positively with both symptomatic dental and medical attendance (p = 0.004, OR = 1.14, 95%CI = 1.04-1.25; p = 0.003; OR = 1.16, 95%CI = 1.05-1.29, respectively). Higher social participation levels associated negatively with symptomatic dental attendance (p = 0.034, OR = 0.98, 95%CI = 0.96-0.99) whilst increase in age and self-reported health conditions associated positively with symptomatic medical attendance (p = 0.030, OR = 1.03, 95%CI = 1.01-1.06; p = 0.001, OR = 4.51, 95%CI = 2.02-10.08, respectively).ConclusionsIn this study of khat chewers, a significant proportion reported symptomatic dental and medical attendance. Demographic, psychosocial and self reported general health conditions were associated significantly with dental and medical attendance. Strategies to improve the dental and medical care attendance amongst this group should focus on these and other unexplored underlying factors.

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Dental service use and the implications for oral cancer screening in a sample of Bangladeshi adult medical care users living in Tower Hamlets, UK

Cited by 18 publications

References 19 publications

Oral cancer screening in the Bangladeshi community of Tower Hamlets: a social model

Oral cancer screening in the Bangladeshi community of Tower Hamlets: a social model

Tobacco dependence in a UK Bangladeshi female population: a cross-sectional study

Factors associated with dental and medical care attendance in UK resident Yemeni khat chewers: a cross sectional study

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