Clinical presentation of patients with oral squamous cell carcinoma when first seen by dentists or physicians in a teaching hospital in Brazil

Abstract

The ability to diagnose oral cancer depends in part on the knowledge, attitudes, and practices of the health professional. On the other hand, the patients' choice of health professional depends on their perceptions of the ability of such professionals to diagnose and treat what they believe their health problem is. In this study, we investigated the clinical profiles of patients with oral cancer (n=354) when first seen by dentists (n=129) or physicians (n=225) in a teaching hospital. The charts of patients with oral squamous cell carcinoma were analyzed for the following variables: age, sex, race, signs and symptoms by the time of presentation to the health professional, size and site of the tumor since first manifestation, and clinical stage of the disease. Our results demonstrate that dentists and physicians assessed patients comparably regarding age, sex, and race. Patients complaining of dysphagia and odynophagia were seen more often by physicians than dentists (45/225 vs 9/129 [20.0% vs 7.0%] and 30/225 vs 4/129 [13.3% vs 3.1%], respectively), whereas those with local pain and burning preferentially sought dentists (77/129 vs 56/225 [59.7% vs 24.9%] and 4/129 [3.1%] vs 0/225, respectively). Physicians diagnosed oropharyngeal (45/208 vs 9/116 [21.6% vs 7.8%]) and lip lesions (71/208 vs 7/116 [34.1% vs 6.0%]) more often, whereas dentists saw more cases of cancer of the alveolar ridge (42/116 vs 7/208 [36.2% vs 3.4%]) and floor of the mouth (19/116 vs 10/208 [16.4% vs 4.8%]). Our findings suggest that patients have different perceptions of the roles of dentistsand physicians regarding the ability to diagnose and treat oral lesions. Signs, symptoms, and location of the cancer lesions appear to be the most important variables associated with the choice of health professional.

Oral cancer: experiences and diagnostic abilities elicited by dentists in North‐western Spain

“…Early diagnosis is a foremost step for reducing cancer mortality (Boyle et al , 2003), as identification of smaller lesions allows less aggressive and debilitating treatments. Unfortunately, diagnosis is often made in advanced stages (III or IV) of the disease and, thus the prognosis is poor and the morbidity and mortality high (Sankaranarayanan et al , 1990; Rubright et al , 1996; De Faria et al , 2003).…”

Is early diagnosis of oral cancer a feasible objective? Who is to blame for diagnostic delay?

“…In these situations, an opportunistic oral examination should be performed for these patients during routine medical examinations (Penchansky and Thomas, 1981;Allison et al, 1998b;Horowitz et al, 2000;Yellowitz et al, 2000). Clinical presentation of oral cancer first seen by a dentist or physician could also be somewhat different (De Faria et al, 2003) and dentists may diagnose lower stage cancers (Holmes and Homer, 2003). Understanding practices of dental health professionals is vital to assess their contribution to reduce any delays in cancer prevention (Kujan et al, 2006).…”

Simulation for training in oral cancer biopsy: A surgical model and feedback from GDPs

“…Early diagnosis is critically essential and may have the most impact for improving survival and cure rates (3,4). The standard for detection remains on visual examination and palpation followed by tissue biopsy and histopathological diagnosis (5), being the latter the gold standard for diagnostic procedures and mandatory for every lesion suspicious for malignancy (6), which is paramount for an early detection of oral cancer (7,8).…”