Characteristics and predictors of oral cancer knowledge in a predominantly African American community

Osazuwa-Peters, Nosayaba; Hussaini, Adnan S.; Sujijantarat, Nanthiya; Ganesh, R; Snider, Matthew; Thompson, Devin; Varvares, Mark A.

doi:10.1371/journal.pone.0177787

Cited by 29 publications

(20 citation statements)

References 48 publications

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“…Additional factors that could be contributing to the later presentation of black patients include mistrust toward the health care system, lower level of public awareness, and lower rates of dental care services and oral screening examinations. 22-25 To our knowledge, the effectiveness of an oral screening program implemented among a diverse racial/ethnic community has not been investigated. In addition, it is unclear if the lower rate of surgery treatment among blacks compared to the other racial/ethnic groups is a result of late presentation or other factors such as inappropriate treatment and patient preference.…”

Section: Discussionmentioning

confidence: 99%

Association of Race/Ethnicity, Stage, and Survival in Oral Cavity Squamous Cell Carcinoma: A SEER Study

Choi

Swanson

et al. 2019

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ObjectiveSurvival differences in oral cancer between black and white patients have been reported, but the contributing factors, especially the role of stage, are incompletely understood. Furthermore, the outcomes for Hispanic and Asian patients have been scarcely examined.Study DesignRetrospective, population-based national study.SettingSurveillance, Epidemiology, and End Results 18 Custom database (January 1, 2010, to December 31, 2014).Subjects and MethodsIn total, 7630 patients with primary squamous cell carcinoma in the oral cavity were classified as non-Hispanic white (white), non-Hispanic black (black), Hispanic, or Asian. Cox regression was used to obtain unadjusted and adjusted hazard ratios (HRs) of 5-year mortality for race/ethnicity with sequential adjustments for stage and other covariates. Logistic regression was used to examine the relationship between race/ethnicity and stage with adjusted odds ratios (aORs).ResultsThe cohort consisted of 75.0% whites, 7.6% blacks, 9.1% Hispanics, and 8.3% Asians. Compared to whites, the unadjusted HR for all-cause mortality for blacks was 1.68 (P < .001), which attenuated to 1.15 (P = .039) after adjusting for stage and became insignificant after including insurance. The unadjusted HRs for all-cause mortality were not significant for Hispanics and Asians vs whites. Compared to whites, blacks and Hispanics were more likely to present at later stages (aORs of 2.63 and 1.42, P < .001, respectively).ConclusionThe greater mortality for blacks vs whites was largely attributable to the higher prevalence of later stages at presentation and being uninsured among blacks. There was no statistically significant difference in mortality for Hispanics vs whites or Asians vs whites.

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Section: Discussionmentioning

confidence: 99%

Association of Race/Ethnicity, Stage, and Survival in Oral Cavity Squamous Cell Carcinoma: A SEER Study

Choi

Swanson

et al. 2019

OTO Open

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“…It is unlikely that the objectives of the Healthy People 2020 initiative mentioned above will be reached at the current rate of increase in the diagnosis of late‐stage HNC. In the absence of a mortality benefit for asymptomatic mass screenings, as per the US Preventive Services Task Force oral cancer screening guideline, it is critical that there is sustained public awareness and education regarding the early detection of HNC, and prevention through cancer risk mitigation practices . This is particularly important because late‐stage disease often requires multimodality treatment and has a poorer prognosis than early‐stage disease.…”

Section: Discussionmentioning

confidence: 99%

Rising incidence of late‐stage head and neck cancer in the United States

Thompson‐Harvey

Yetukuri

Hansen

et al. 2019

Cancer

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Background The current study was conducted to determine whether the incidence of late‐stage head and neck cancer (HNC) is decreasing and to estimate the risk of late‐stage HNC diagnosis based on race and sex. Methods Age‐adjusted incidence rates for patients aged ≥18 years with stage IV HNC were abstracted from the Surveillance, Epidemiology, and End Results database (2004‐2015). Rates were stratified by race, sex, and age. Joinpoint regression estimated annual percent changes (APCs) in rates over time, and logistic regression estimated adjusted odds ratios (aORs). Results There were 57,118 patients with stage IV HNC in the current study cohort, with an average age of 61.9 years. From 2004 to 2015, the age‐adjusted incidence rates for stage IV HNC significantly increased by 26.1% (6.11 per 100,000 person‐years in 2004 to 7.70 per 100,000 person‐years in 2015). White and Asian/Pacific Islander/American Indian/Alaska Native patients had significant increases in incidence (APC for white patients, 3.03 [P < .01] and APC for other races, 1.95 [P < .01]), whereas rates among black patients remained stable but were highest across racial groups. Incidence was higher among males compared with females. When restricted only to patients with stage IVC (metastatic) HNC, there remained a significant increase in incidence, especially for oropharyngeal cancer, which showed a 22.9% increase (0.21 per 100,000 person‐years in 2004 vs 0.25 per 100,000 person‐years in 2015). Despite a decreasing overall incidence of stage IV HNC in black patients (aOR, 1.28; 95% CI, 1.22‐1.34) they, along with males (aOR, 3.95; 95% CI, 3.80‐4.11), had significantly increased risks of being diagnosed with late‐stage HNC. Conclusions There is an increasing incidence of late‐stage HNC in the United States, with male patients and black individuals faring the worst.

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“…33 Patient awareness about oral cancer in particular has been shown to be poor in the United States and around the world. [34][35][36][37][38] A large observational study in India found that brochures about oral cancer including details about how to perform a mouth self-examination significantly increased awareness about oral cancer and its risk factors. 39 Another study in Florida found that a highway billboard campaign effectively increased awareness about oral cancer in surrounding communities.…”

Section: Discussionmentioning

confidence: 99%

“…With regards to health literacy, more than one‐third of patients in the United States are estimated to have limited health literacy based on a task‐oriented assessment that was conducted on approximately 19 000 adults in 2003 33 . Patient awareness about oral cancer in particular has been shown to be poor in the United States and around the world 34‐38 . A large observational study in India found that brochures about oral cancer including details about how to perform a mouth self‐examination significantly increased awareness about oral cancer and its risk factors 39 .…”

Section: Discussionmentioning

confidence: 99%

Access to preventive care services and stage at diagnosis in head and neck cancer

et al. 2020

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Background Decreased access to preventive care services has been proposed as a mechanism for the association between low socioeconomic status (SES) and advanced stage at diagnosis in patients with head and neck squamous cell carcinoma (HNSCC). Methods Retrospective analysis of patients diagnosed with HNSCC in North Carolina between 2002 and 2006. Results A total of 1108 patients with HNSCC were included in the study. In the multivariable analysis, use of annual routine dental services (OR 0.7, 95% CI 0.5‐0.9) and colonoscopy in the past 10 years (OR 0.7, 95% CI 0.5‐0.9) were associated with lower odds of advanced T stage at diagnosis. Having no insurance (OR 1.8, 95% CI 1.1‐2.9), an income <$20 000 (OR 1.6 95% CI 1.03‐2.6), and >10 pack‐years tobacco use (OR 1.5, 95% CI 1.04‐2.2) were associated with advanced T stage at diagnosis. Conclusion Use of preventive care services and SES independently predict stage at diagnosis in HNSCC.

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Characteristics and predictors of oral cancer knowledge in a predominantly African American community

Cited by 29 publications

References 48 publications

Association of Race/Ethnicity, Stage, and Survival in Oral Cavity Squamous Cell Carcinoma: A SEER Study

Association of Race/Ethnicity, Stage, and Survival in Oral Cavity Squamous Cell Carcinoma: A SEER Study

Rising incidence of late‐stage head and neck cancer in the United States

Access to preventive care services and stage at diagnosis in head and neck cancer

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