Missed opportunities for oral cancer screening in Australia

Abstract

Objectives Most patients with oral cancer lack early symptoms, therefore most present with advanced stage of disease. Early detection of oral cancer and oral potentially malignant disorders (OPMDs) in the asymptomatic phase via an opportunistic oral cancer screening examination is important as survival rates are significantly improved if the disease is treated at an earlier stage. The objective is to identify opportunities to achieve early stage diagnosis of oral cancer in Australian patients. Materials and Methods A cohort of 103 patients newly diagnosed with oral cancer were surveyed at a tertiary hospital Head and Neck Clinic. Patient awareness, knowledge, risk factors and diagnostic delay in oral cancer diagnosis were investigated. The asymptomatic period before diagnosis was studied to identify opportunities for improving opportunistic screening rates in Australia. Results Australian patients have poor awareness of oral cancer with 46% having never heard of oral cancer, and poor knowledge of risk factors for oral cancer. Only 7% were diagnosed in the asymptomatic phase and all by dental practitioners. Once symptomatic, median diagnostic delay was 9 weeks. In the asymptomatic phase before diagnosis, patients attended general medical practitioners far more often than general dental practitioners. Both groups rarely discussed risk factors for oral cancer (<10%) or performed opportunistic oral cancer screening examinations (<10%) with their patients. Conclusion Asymptomatic diagnosis of oral cancer at an earlier stage of disease is possible in the primary medical setting but increased awareness and knowledge are required in both patients and health practitioners.

Perceptions and Practices of General Practitioners towards Oral Cancer and Emerging Risk Factors among Indian Immigrants in Australia: A Qualitative Study

“…This study also implies that GPs could adopt patient-specific decision-making strategies in their clinical practices for the identification of oral cancer through opportunistic screening of high-risk populations such as Indian immigrants who are known to be engaged in tobacco and/or alcohol consumption or chew betel/areca nut [ 73 , 74 ]. Being the primary contact for accessing healthcare, it becomes more crucial for GPs to engage in duties of oral cancer prevention counselling, initial screening, and routine oral/mouth check-ups [ 75 ].…”

Improving Oral Cancer Outcomes with Imaging and Artificial Intelligence

“…There is a need to raise awareness and institute continuing education programs for general dentists on this topic. Moreover, there is a lack of knowledge and awareness from the general population, which serves as a barrier to seeking early diagnosis (Laronde et al 2014; Hashim et al 2019; Webster et al 2019). In current clinical practice, due to lack of knowledge and reliance on subjective analyses of clinical features, screening accuracy by dentists remains poor (Sardella et al 2007; Epstein et al 2012; Yang et al 2018; Grafton-Clarke et al 2019, Ries et al 2019).…”

A keratinised lump on the lateral surface of the tongue

“…In Australia, the five-year overall survival rate ranges from 25% to 85% depending on disease stage. 8 Reducing diagnostic and treatment delay is important for improving patient outcomes. OSCCs double in size every three months, 9 so it is imperative that general practitioners initiate appropriate referral pathways for suspected OSCC.…”