Top

BMC Oral Health

Published in:

Open Access 01-12-2023 | Oral Cancer | Research

Oral cancer screening knowledge and practices among dental professionals at the University of Toronto

Authors: Dorsa Mavedatnia, Karl Cuddy, Hagen Klieb, Nick Blanas, Jade Goodman, Melanie Gilbert, Antoine Eskander

Published in: BMC Oral Health | Issue 1/2023

Abstract

Introduction

Opportunistic oral cancer screening during visits to the dentist is a non-invasive and accessible option for detection of pre-malignant lesions and early-stage malignancies. The objective of this study was to investigate the knowledge, practices, and attitudes towards oral cancer screening among dentists.

Methods

A 42-item survey was sent to 650 dental professionals affiliated with the University of Toronto. Data regarding training/practice characteristics, knowledge of oral cavity cancer, current screening practices, attitudes towards screening, and remuneration were collected.

Results

Ninety-one dentists responded. Most obtained their dental degree from Canada (71.4%) and were practicing in large urban centers (87.9%). Most dentists correctly identified the oral tongue (87.8%) and floor of mouth (80%) as the two of most common sites of oral cavity cancer but only 56% correctly identified the most common presentation. 91% performed intra/extra oral examinations at every patient visit. Only 9.9% of dentists discussed the risk factors of oral cancer and 33% were not familiar with resources for smoking cessation and alcohol abuse. International medical graduates were more likely to discuss risk factor management than Canadian medical graduates (p < 0.01). Over 80% of dentists referred to a specialist when a suspected lesion was found. The greatest barrier for oral cancer screening was lack of time. Almost all dentists (98.8%) reported that their screening practices do not differ depending on the patient’s insurance status and 63.8% reported compensation would not influence their decision to perform oral examinations.

Conclusion

Most dentists have a good knowledge of the presentation and risk factors associated with oral cavity cancer. Most dentists perform screening with every patient, with no influence from compensation and insurance status. Dentists are therefore an excellent first contact for oral cavity cancer screening for the general public and for high-risk populations.

Available only for authorised users

Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 2009;45(4–5):309–16. https://doi.org/10.1016/j.oraloncology.2008.06.002.CrossRefPubMed

Cancer today. http://gco.iarc.fr/today/home. Accessed 20 June 2022.

Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49. https://doi.org/10.3322/caac.21660.CrossRefPubMed

Ch 2: Estimated current cancer mortality. Cancer Care Ontario. Published December 6, 2019. https://www.cancercareontario.ca/en/statistical-reports/ontario-cancer-statistics-2020/ch-2-estimated-current-cancer-mortality. Accessed 1 Mar 2023

Mifsud M, Eskander A, Irish J, et al. Evolving trends in head and neck cancer epidemiology: Ontario, Canada 1993–2010. Head Neck. 2017;39(9):1770–8. https://doi.org/10.1002/hed.24829.CrossRefPubMed

Laronde DM, Williams PM, Hislop TG, et al. Decision making on detection and triage of oral mucosa lesions in community dental practices: screening decisions and referral. Community Dent Oral Epidemiol. 2014;42(4):375–84. https://doi.org/10.1111/cdoe.12093.CrossRefPubMedPubMedCentral

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30. https://doi.org/10.3322/caac.21166.CrossRefPubMed

Baykul T, Yilmaz HH, Aydin U, Aydin MA, Aksoy M, Yildirim D. Early diagnosis of oral cancer. J Int Med Res. 2010;38(3):737–49. https://doi.org/10.1177/147323001003800302.CrossRefPubMed

Cheung LC, Ramadas K, Muwonge R, et al. Risk-based selection of individuals for oral cancer screening. JCO. 2021;39(6):663–74. https://doi.org/10.1200/JCO.20.02855.CrossRef

10.

Abadeh A, Ali AA, Bradley G, Magalhaes MA. Increase in detection of oral cancer and precursor lesions by dentists: evidence from an oral and maxillofacial pathology service. J Am Dent Assoc. 2019;150(6):531–9. https://doi.org/10.1016/j.adaj.2019.01.026.CrossRefPubMed

11.

Warnakulasuriya S, Fennell N, Diz P, Seoane J, Rapidis A. LDV Lifelong Learning Programme. An appraisal of oral cancer and pre-cancer screening programmes in Europe: a systematic review. J Oral Pathol Med. 2015;44(8):559–70. https://doi.org/10.1111/jop.12267.CrossRefPubMed

12.

Saleh A, Kong YH, Vengu N, Badrudeen H, Zain RB, Cheong SC. Dentists’ perception of the role they play in early detection of oral cancer. Asian Pac J Cancer Prev. 2014;15(1):229–37. https://doi.org/10.7314/apjcp.2014.15.1.229.CrossRefPubMed

13.

Farah CS, Simanovic B, Dost F. Oral cancer in Australia 1982–2008: a growing need for opportunistic screening and prevention. Aust Dent J. 2014;59(3):349–59. https://doi.org/10.1111/adj.12198.CrossRefPubMed

14.

Ariyawardana A, Johnson NW. Trends of lip, oral cavity and oropharyngeal cancers in Australia 1982–2008: overall good news but with rising rates in the oropharynx. BMC Cancer. 2013;13:333. https://doi.org/10.1186/1471-2407-13-333.CrossRefPubMedPubMedCentral

15.

Holmes JD, Dierks EJ, Homer LD, Potter BE. Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis? J Oral Maxillofac Surg. 2003;61(3):285–91. https://doi.org/10.1053/joms.2003.50056.CrossRefPubMed

16.

Gupta A, Sonis S, Uppaluri R, Bergmark RW, Villa A. Disparities in oral cancer screening among dental professionals: NHANES 2011–2016. Am J Prev Med. 2019;57(4):447–57. https://doi.org/10.1016/j.amepre.2019.04.026.CrossRefPubMed

17.

Kogi S, DaSilva J, Mikasa Y, et al. Knowledge and practice of oral cancer screening in teaching faculty-comparison of specialty and year of clinical experience. J Cancer Educ. 2019;34(3):455–62. https://doi.org/10.1007/s13187-018-1323-y.CrossRefPubMed

18.

Mariño R, Haresaku S, McGrath R, et al. Oral cancer screening practices of oral health professionals in Australia. BMC Oral Health. 2017;17(1):151. https://doi.org/10.1186/s12903-017-0439-5.CrossRefPubMedPubMedCentral

19.

Tax CL, Haslam SK, Brillant M, Doucette HJ, Cameron JE, Wade SE. Oral cancer screening: knowledge is not enough. Int J Dent Hyg. 2017;15(3):179–86. https://doi.org/10.1111/idh.12172.CrossRefPubMed

20.

Razavi SM, Zolfaghari B, Foroohandeh M, Doost ME, Tahani B. Dentists’ knowledge, attitude, and practice regarding oral cancer in Iran. J Cancer Educ. 2013;28(2):335–41. https://doi.org/10.1007/s13187-013-0460-6.CrossRefPubMed

21.

Walsh T, Liu JLY, Brocklehurst P, et al. Clinical assessment to screen for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults. Cochrane Database Syst Rev. 2013;11:CD010173. https://doi.org/10.1002/14651858.CD010173.pub2.CrossRef

22.

Kujan O, Glenny AM, Oliver RJ, Thakker N, Sloan P. Screening programmes for the early detection and prevention of oral cancer. Cochrane Database Syst Rev. 2006;3:CD004150. https://doi.org/10.1002/14651858.CD004150.pub2.CrossRef

23.

Cuddy KK, Cobb G. The participation of Ontario oral and maxillofacial surgeons in oral, lip and oropharyngeal cancer. J Can Dent Assoc. 2015;81: f6.PubMed

24.

Aldossri M, Okoronkwo C, Dodd V, Manson H, Singhal S. Dentists’ capacity to mitigate the burden of oral cancers in Ontario. Canada J Can Dent Assoc. 2020;86:k2.PubMed

25.

Clarke AK, Kobagi N, Yoon MN. Oral cancer screening practices of Canadian dental hygienists. Int J Dent Hyg. 2018;16(2):e38–45. https://doi.org/10.1111/idh.12295.CrossRefPubMed

26.

Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004;6(3):e34. https://doi.org/10.2196/jmir.6.3.e34.CrossRefPubMedPubMedCentral

27.

Macpherson LMD, McCann MF, Gibson J, Binnie VI, Stephen KW. The role of primary healthcare professionals in oral cancer prevention and detection. Br Dent J. 2003;195(5):277–81. https://doi.org/10.1038/sj.bdj.4810481. (discussion 263).CrossRefPubMed

28.

López-Jornet P, Camacho-Alonso F, Molina-Miñano F. Knowledge and attitudes about oral cancer among dentists in Spain. J Eval Clin Pract. 2010;16(1):129–33. https://doi.org/10.1111/j.1365-2753.2009.01132.x.CrossRefPubMed

29.

Joseph BK, Sundaram DB, Sharma P. Oral cancer awareness among dentists in Kuwait. Med Princ Pract. 2012;21(2):164–70. https://doi.org/10.1159/000333543.CrossRefPubMed

30.

Decuseara G, MacCarthy D, Menezes G. Oral cancer: knowledge, practices and opinions of dentists in Ireland. J Ir Dent Assoc. 2011;57(4):209–14.PubMed

31.

Hashim R, Abo-Fanas A, Al-Tak A, Al-Kadri A, Ebaid YA. Early Detection of Oral Cancer- Dentists’ Knowledge and Practices in the United Arab Emirates. Asian Pac J Cancer Prev. 2018;19(8):2351–5. https://doi.org/10.22034/APJCP.2018.19.8.2351.CrossRefPubMedPubMedCentral

32.

D’Cruz AK, Vaish R. Risk-based oral cancer screening — lessons to be learnt. Nat Rev Clin Oncol. 2021;18(8):471–2. https://doi.org/10.1038/s41571-021-00511-2.CrossRefPubMedPubMedCentral

33.

Sankaranarayanan R, Ramadas K, Thomas G, et al. Effect of screening on oral cancer mortality in Kerala, India: a cluster-randomised controlled trial. Lancet. 2005;365(9475):1927–33. https://doi.org/10.1016/S0140-6736(05)66658-5.CrossRefPubMed

34.

Sankaranarayanan R, Ramadas K, Thara S, et al. Long term effect of visual screening on oral cancer incidence and mortality in a randomized trial in Kerala. India Oral Oncol. 2013;49(4):314–21. https://doi.org/10.1016/j.oraloncology.2012.11.004.CrossRefPubMed

35.

Thankappan K, Subramanian S, Balasubramanian D, Kuriakose MA, Sankaranarayanan R, Iyer S. Cost-effectiveness of oral cancer screening approaches by visual examination: Systematic review. Head Neck. 2021;43(11):3646–61. https://doi.org/10.1002/hed.26816.CrossRefPubMed

36.

Subramanian S, Sankaranarayanan R, Bapat B, et al. Cost-effectiveness of oral cancer screening: results from a cluster randomized controlled trial in India. Bull World Health Organ. 2009;87(3):200–6. https://doi.org/10.2471/blt.08.053231.CrossRefPubMedPubMedCentral

37.

Kujan O, Duxbury AJ, Glenny AM, Thakker NS, Sloan P. Opinions and attitudes of the UK’s GDPs and specialists in oral surgery, oral medicine and surgical dentistry on oral cancer screening. Oral Dis. 2006;12(2):194–9. https://doi.org/10.1111/j.1601-0825.2005.01188.x.CrossRefPubMed

38.

Strey JR, Roxo-Gonçalves M, Guzenski BD, et al. Oral medicine experience and attitudes toward oral cancer: an evaluation of dentists working in primary health care. J Cancer Educ. 2022;37(6):1621–8. https://doi.org/10.1007/s13187-021-01999-z.CrossRefPubMed

39.

Irani S. Metastasis to head and neck area: a 16-year retrospective study. Am J Otolaryngol. 2011;32(1):24–7. https://doi.org/10.1016/j.amjoto.2009.09.006.CrossRefPubMed

40.

Irani S. Distant metastasis from oral cancer: a review and molecular biologic aspects. J Int Soc Prev Community Dent. 2016;6(4):265–71. https://doi.org/10.4103/2231-0762.186805.CrossRefPubMedPubMedCentral

41.

Awojobi O, Scott SE, Newton T. Patients’ perceptions of oral cancer screening in dental practice: a cross-sectional study. BMC Oral Health. 2012;12:55. https://doi.org/10.1186/1472-6831-12-55.CrossRefPubMedPubMedCentral

42.

Krishna Rao SV, Mejia G, Roberts-Thomson K, Logan R. Epidemiology of oral cancer in Asia in the past decade–an update (2000–2012). Asian Pac J Cancer Prev. 2013;14(10):5567–77. https://doi.org/10.7314/apjcp.2013.14.10.5567.CrossRefPubMed

43.

Xie L, Shang Z. Burden of oral cancer in Asia from 1990 to 2019: Estimates from the Global Burden of Disease 2019 study. PLos One. 2022;17(3):e0265950. https://doi.org/10.1371/journal.pone.0265950.CrossRefPubMedPubMedCentral

44.

Noel CW, Sutradhar R, Li Q, et al. Association of immigration status and Chinese and south Asian ethnicity with incidence of head and neck cancer. JAMA Otolaryngol Head Neck Surg. 2020;146(12):1125–35. https://doi.org/10.1001/jamaoto.2020.4197.CrossRefPubMed

45.

Alaizari NA, Al-Maweri SA. Oral cancer: knowledge, practices and opinions of dentists in yemen. Asian Pac J Cancer Prev. 2014;15(14):5627–31. https://doi.org/10.7314/apjcp.2014.15.14.5627.CrossRefPubMed

46.

Gaballah K, Faden A, Fakih FJ, Alsaadi AY, Noshi NF, Kujan O. Diagnostic accuracy of oral cancer and suspicious malignant mucosal changes among future dentists. Healthcare (Basel). 2021;9(3):263. https://doi.org/10.3390/healthcare9030263.CrossRefPubMed

47.

Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2017;3:CD001292. https://doi.org/10.1002/14651858.CD001292.pub3.CrossRefPubMed

48.

Warnakulasuriya S. Effectiveness of tobacco counseling in the dental office. J Dent Educ. 2002;66(9):1079–87.CrossRefPubMed

49.

Chestnutt IG, Binnie VI. Smoking cessation counselling–a role for the dental profession? Br Dent J. 1995;179(11–12):411–5. https://doi.org/10.1038/sj.bdj.4808944.CrossRefPubMed

50.

McNeely J, Wright S, Matthews AG, et al. Substance use screening and interventions in dental clinics: survey of practice-based research network dentists on current practices, policies and barriers. J Am Dent Assoc. 2013;144(6):627–38.CrossRefPubMedPubMedCentral

51.

Zangiabadi S, Costanian C, Tamim H. Dental care use in Ontario: the Canadian community health survey (CCHS). BMC Oral Health. 2017;17:165. https://doi.org/10.1186/s12903-017-0453-7.CrossRefPubMedPubMedCentral

52.

Wang L, Cheng L, Yuan B, Hong X, Hu T. Association between socio-economic status and dental caries in elderly people in Sichuan Province, China: a cross-sectional study. BMJ Open. 2017;7(9):e016557. https://doi.org/10.1136/bmjopen-2017-016557.CrossRefPubMedPubMedCentral

53.

Gazzaz AZ, Carpiano RM, Aleksejuniene J. Socioeconomic status, social support, and oral health-risk behaviors in Canadian adolescents. J Public Health Dent. 2021;81(4):316–26. https://doi.org/10.1111/jphd.12478.CrossRefPubMed

54.

Bhatti T, Rana Z, Grootendorst P. Dental insurance, income and the use of dental care in Canada. J Can Dent Assoc. 2007;73(1):57.PubMed

55.

News · NB· C. Everything we know about the Liberal-NDP dental care proposal | CBC News. CBC. Published March 23, 2022. https://www.cbc.ca/news/politics/liberal-ndp-dental-plan-1.6393981. Accessed 28 June 2022

56.

Cho YI, Johnson TP, Vangeest JB. Enhancing surveys of health care professionals: a meta-analysis of techniques to improve response. Eval Health Prof. 2013;36(3):382–407. https://doi.org/10.1177/0163278713496425.CrossRefPubMed

57.

Cook JV, Dickinson HO, Eccles MP. Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study. BMC Health Serv Res. 2009;9:160. https://doi.org/10.1186/1472-6963-9-160.CrossRefPubMedPubMedCentral

58.

Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50(10):1129–36. https://doi.org/10.1016/s0895-4356(97)00126-1.CrossRefPubMed

Title: Oral cancer screening knowledge and practices among dental professionals at the University of Toronto
Authors: Dorsa Mavedatnia
Karl Cuddy
Hagen Klieb
Nick Blanas
Jade Goodman
Melanie Gilbert
Antoine Eskander
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Oral Cancer
Oral Cavity Carcinoma
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03062-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Oral cancer screening knowledge and practices among dental professionals at the University of Toronto

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Quality of web-based Arabic health information on dental implants: an infodemiological study

Oral health and self-rated health in community-dwelling older adults in Colombia

Compositional and functional changes in the salivary microbiota related to oral leukoplakia and oral squamous cell carcinoma: a case control study

Effect of oral gargle containing Lespedeza cuneata extract on periodontal health improvement and disease prevention: a randomized, controlled clinical trial

Enhanced in vitro antibacterial effect against Enterococcus faecalis by using both low-dose cetylpyridinium chloride and silver ions

Application of computer-aided design and 3D-printed template for accurate bone augmentation in the aesthetic region of anterior teeth