Early oral cancer diagnosis: The Aarhus statement perspective. A systematic review and meta‐analysis

Seoane, Juan; Álvarez-Nóvoa, Pablo; Gómez, Isabel Neira; Takkouche, Bahi; Dios, Pedro Diz; Warnakulasiruya, Saman; Seoane-Romero, Juan M.; Varela‐Centelles, Pablo

doi:10.1002/hed.24050

Cited by 81 publications

(94 citation statements)

References 52 publications

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“…Many risk factors for OC have been described, but smokeless and smoking tobacco, alcohol, and viral infection especially human papillomavirus (HPV) are among the fundamental factors for disease occurrence (Johnson et al, ; Somatunga et al, ). The diagnosis of OC in the early stage and subsequently early intervention with the required therapy have a positive impact on increasing the rate of survival up to 5 years (Lopez‐Jornet et al, ; Seoane et al, ; Tax et al, ). Fortunately, OC is one of the disease that can be discovered in the early stage through routine visual and tactile inspection of oral mucosa (Colella, Gaeta, Moscariello, & Angelillo, ).…”

Section: Introductionmentioning

confidence: 99%

Oral‐cancer knowledge, practice, and attitude assessment of dentists in Upper Egypt: A cross‐sectional study

Khattab

Elheeny

Tony

2019

Clinical & Exp Dental Res

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The aims of this study were to investigate the knowledge, attitude, and practice of dentists in Upper Egypt with regard to oral cancer (OC). Out of 1,200 licensed dental practitioners list, 424 dentists were randomly selected from three governorates in Upper Egypt (Minia, Assuit, and Sohag). The sample size was calculated using the equation considering the knowledge of dentists about OC, confidence level, and margins of error; then, an additional number of dentists were added to guard against nonresponse. Data were collected by face‐to‐face interview using 44 items divided into four sections; first part demonstrates sociodemographic. The second part concerned with the knowledge about OC clinical presentation and diagnosis (12 multiple‐choice questions) as well as its risk factors (17 close‐end questions). The third part consists of six questions focused on the practice of participants, and finally, the last part measures attitude of dentists. The chi‐square test was used to compare between the two or more proportions. A correlation was used for describing the relationship or association between two mutually numerical dependent variables. p < 0.05 was considered to indicate significance. Rate of response was 94.3%. The overall knowledge level in the current study was 31.8%. The awareness about OC risk factors was high especially, smoking tobacco and alcohol consumption. Also, over 80% of dentists identified family history and human papillomavirus (HPV) as risk factors. Only 37.5% of participants performed regular screening of oral mucosa, and 26.5% reported lymph‐node examination. Regarding attitude, only one quarter of dentists attended continuing educating programs about OC. A statistically significant relation ( p < 0.0001) between knowledge level and most demographic variables was detected. There was a fair positive correlation ( r = 0.47) between practice and knowledge scores. A predominant trouble among dentists in Upper Egypt was regarding OC knowledge and practice. Continues education and training programs are highly recommended.

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Section: Introductionmentioning

confidence: 99%

Oral‐cancer knowledge, practice, and attitude assessment of dentists in Upper Egypt: A cross‐sectional study

Khattab

Elheeny

Tony

2019

Clinical & Exp Dental Res

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“…To overcome these difficulties, the Aarhus guidelines have suggested standardised time intervals within a conceptual framework and the abandonment of the term “diagnostic delay.” The events considered in this model (detection of bodily changes, perception of reasons to discuss symptoms with a healthcare professional, first consultation with a healthcare professional, diagnosis and treatment start) define four single time intervals (appraisal, help‐seeking, diagnostic and pre‐treatment) . This framework is dynamic and bidirectional, without a pre‐defined starting point, and allows multiple paths to reach the final diagnosis . This permits the design and monitoring of interventions aimed at decreasing the time elapsed since the first symptom/sign until the treatment is implemented, improving this way the prognosis of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…11 This framework is dynamic and bidirectional, without a pre-defined starting point, and allows multiple paths to reach the final diagnosis. 11,12 This permits the design and monitoring of interventions aimed at decreasing the time elapsed since the first symptom/sign until the treatment is implemented, improving this way the prognosis of the disease. The Aarhus Statement suggests a "model of pathways to treatment" which considers as contributing factors those that depend on the patient, on the healthcare provider (HCP) and on the healthcare system, taking also into account those factors related to the tumour itself.…”

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confidence: 99%

The length of patient and primary care time interval in the pathways to treatment in symptomatic oral cancer. A quantitative systematic review

Varela‐Centelles

Seoane

López-Cedrún

et al. 2017

Clinical Otolaryngology

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Objectives: To examine the relative length of the patient and primary care intervals in symptomatic oral cancer.Design: Quantitative systematic review. Search strategy: Oral cancer OR oral squamous cell carcinoma OR oropharyngeal cancer AND time interval OR diagnostic delay.Setting: Primary and secondary care.Participants: Oral and oropharyngeal cancer patients. Main outcome measures:We computed five measures (patient, primary care, diagnosis, total diagnosis and total treatment intervals). Most studies did not provide any dispersion measure. We then used the sample size of each study to compute a weighted average of the mean intervals. When the median was provided, we assumed normality of the distribution of the means and used the median as a proxy of the mean.Results: A total of 1089 articles were identified, and 22 met the inclusion criteria, reporting on 2710 patients from Europe, USA, India, Australia, Japan, Argentina and Iran. The weighted average of patient interval was 80.3 days. Primary care interval was five times shorter: 15.8 days. The diagnostic interval was appreciably shorter (47.9 days) when compared with the patient interval during symptomatic period.Conclusions: Patient interval represents the major component of waiting times since the detection of the first signs/symptoms to the definitive diagnosis of oral cancer. Thus, strategies focused on high-risk patients should be prioritised. Interventions aimed at optimising the health systems should be implemented by monitoring and facilitating diagnostic and treatment pathways of patients with oral cancer.

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“…6,11 Education and periodic surveillance as part of a screening activity can raise awareness and thereby lead to detection of asymptomatic lesions. 18 Thanks to the high coverage rate of national health insurance in Taiwan, this study cohort could be readily referred to specialists for prompt diagnosis and treatment. 17 A metaanalysis study indicated that more oral carcinomas can be detected at an early stage if the diagnostic delay in primary care is shortened.…”

Section: Discussionmentioning

confidence: 99%

Malignant development in patients with oral potentially malignant disorders detected through nationwide screening: Outcomes of 5‐year follow‐up at a single hospital

et al. 2019

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Background: Although survival rate and quality of life are improved if patientswith oral carcinoma can be detected early, however, such lesions are usually asymptomatic; therefore, it is hard to raise awareness. Screening has proved to be cost-effective for early detection. Methods: Sixty-two patients with oral carcinomas and 555 patients with oral potentially malignant disorders (OPMDs) who were detected through screening were examined the relationship between clinicopathological features and follow-up outcomes.Results: The 5-year cumulative cancer-free interval rate was 94.1%, and the annual malignant transformation rate was 1.16%. The rate of interval carcinoma development from Candida hyperplasia, oral submucous fibrosis, homogeneous leukoplakia, non-homogenous leukoplakia, and verrucous hyperplasia, was 13.6%, 5.7%, 4.6%, 12.1%, and 21.3%, respectively. Significant independent risk factors for interval carcinoma development were heavy betel quid chewing, verrucous hyperplasia, and surgery refusal. Conclusions: Well-designed risk assessment, treatment, and surveillance program could lead to earlier cancer detection and thereby reduce mortality and morbidity. K E Y W O R D Shigh-risk, interval carcinoma, oral carcinoma, oral potentially malignant disorders, screening, surgery refusal

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Early oral cancer diagnosis: The Aarhus statement perspective. A systematic review and meta‐analysis

Abstract: A longer time interval from first symptom to referral for diagnosis is a risk factor for advanced stage and mortality of oral cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2182-E2189, 2016.

Cited by 81 publications

References 52 publications

Oral‐cancer knowledge, practice, and attitude assessment of dentists in Upper Egypt: A cross‐sectional study

Oral‐cancer knowledge, practice, and attitude assessment of dentists in Upper Egypt: A cross‐sectional study

The length of patient and primary care time interval in the pathways to treatment in symptomatic oral cancer. A quantitative systematic review

Malignant development in patients with oral potentially malignant disorders detected through nationwide screening: Outcomes of 5‐year follow‐up at a single hospital

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