Oral Cavity and Oropharyngeal Cancer Surveillance and Control in Alberta : A Scoping Review

Badri, Parvaneh; Ganatra, Seema; Baracos, Vickie E.

doi:10.12816/0059086

Cited by 3 publications

(2 citation statements)

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“…Compared with screening the entire population, a program targeting the population at high risk for some cancers can direct resources to those most likely to benefit and can potentially lead to better cost-effectiveness and lower false-positive cases . Despite fitting WHO’s criteria for a disease that screening should target, HNC screening has not been implemented in many jurisdictions due to a lack of systematic understanding on whether such a program would meet WHO’s standards, especially on enhancing survival …”

Section: Introductionmentioning

confidence: 99%

“…9 Despite fitting WHO's criteria for a disease that screening should target, 8 HNC screening has not been implemented in many jurisdictions due to a lack of systematic understanding on whether such a program would meet WHO's standards, especially on enhancing survival. [9][10][11][12][13][14][15][16][17][18] We aimed to gather international literature published between 2001 and 2022 to answer 3 questions: (1) what are common techniques used for adult HNC screening; (2) are they effective in increasing HNC detection, especially localized tumor detection; and (3) does screening improve overall and cancer-specific survival? Results of this review will provide general insights on the merits of HNC screening in addition to giving more specific guidance on whether such a program should be universal or risk targeted to meet the needs of populations with different existing prevalence of HNC.…”

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confidence: 99%

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Methods, Detection Rates, and Survival Outcomes of Screening for Head and Neck Cancers

Sykes,

Weisbrod,

Rival

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceHead and neck cancers (HNCs) are often diagnosed at advanced clinical stages during their symptomatic phase, leading to a reduced treatment window and poor survival. Screening programs have been suggested as a mitigation strategy.ObjectiveTo examine the effectiveness of current HNC screening programs in improving diagnosis and survival in adults.Evidence ReviewThis Preferred Reporting Items for Systematic Reviews and Meta-analyses–guided systematic review involved use of peer-reviewed, English-language journal articles identified from MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials between January 1, 2001, and July 15, 2022. Snowballing was applied to retrieve more studies. Eligible articles were original clinical trials and observational studies presenting a universal or risk-targeted screening program of primary HNC in the adult population. Reporting quality was assessed using the JBI’s critical appraisal tools.FindingsDatabase searches yielded 3646 unique citations with an additional 8 studies found via snowballing. Five reviewers assessed the full text of 106 studies. Sixteen articles were ultimately included in the review, involving 4.7 million adults (34.1%-100% male; median age, 30-59 years). Fifteen studies were based in Asia and 1 in Europe (Portugal). Five reported data from randomized clinical trials. An oral inspection conducted once or once every 2 to 3 years was described in 11 studies for screening oral cancer, while multistep screening involving Epstein-Barr virus serologic testing for nasopharyngeal carcinoma delivered every 1 to 4 years was presented in 5. In 4 trials and 6 observational studies, screening significantly increased the detection of localized (stage I/II) tumor or was associated with an increased proportion of diagnoses, respectively, regardless of the population and cancer subsites. Universal screening of asymptomatic adults improved 3- to 5-year overall survival but did not increase cancer-specific survival in 4 trials. Targeted screening improved overall and cancer-specific survival or was associated with improved survival outcomes in 2 trials and 2 observational studies, respectively. Studies had low to medium risks of bias.Conclusions and RelevanceEvidence from the existing literature suggests that a risk-targeted screening program for oral and nasopharyngeal cancers could improve diagnosis and patient survival. Screening adherence, societal cost-effectiveness, and optimal risk stratification of such a program warrant future research, especially in low-incidence settings outside Asia.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Methods, Detection Rates, and Survival Outcomes of Screening for Head and Neck Cancers

Sykes,

Weisbrod,

Rival

et al. 2023

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

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Retrospective study of factors associated with late detection of oral cancer in alberta: A qualitative study

et al. 2022

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Oral cancer continues to be diagnosed in advanced stages, giving patients lower chances of survival. The objective of this study was to explore reasons for delayed diagnosis of oral cancer in Alberta. A retrospective qualitative design was implemented through seven steps suggested for conducting a narrative clinical document. Data was retrieved from the Alberta Cancer Registry database between 2005 and 2017. A sample of initial consultation notes (ICN) of oral and oropharyngeal cancer patients were identified through a purposeful sampling method and added to the study until saturation was achieved. A deductive analysis approach inspired by the model pathways to treatment health care provider (HCP) was employed. From the 34 ICN included in our analysis, five main categories were identified: appraisal interval, help-seeking interval, diagnosis interval, pre-treatment interval, and other contributing factors such as health-related behaviours, system delay, and tumor characteristics. These factors negatively contributed to early detection of oral and oropharyngeal cancers and affect treatment wait time with patients, providers, and the healthcare system. Patient’s lack of awareness, provider’s oversight and prolonged access to care were the main reasons of delay in cancer diagnosis and management in our study. A sustainable plan for public awareness interventions and implementation of a solid curriculum for medical and dental students is needed to enhance their related knowledge, competence in clinical judgement, and treatment managements.

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Factors Associated with Oral Cancerous and Precancerous Lesions in an Underserved Community: A Cross-Sectional Study

Badri

Lai

Ganatra

et al. 2022

IJERPH

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Street-involved people with limited access to regular healthcare have an increased risk of developing oral cancer and a lower survival rate. The objective of this study was to measure the prevalence of oral cancerous/precancerous lesions and determine their associated risk factors in a high-risk, underserved population. In this cross-sectional study, English-speaking adults aged 18 years and older living in a marginalized community in Edmonton were recruited from four non-profit charitable organizations. Data were collected through visual oral examinations and a questionnaire. Descriptive statistics, chi-squared tests, and logistic regressions were applied. In total, 322 participants with a mean (SD) age of 49.3 (13.5) years completed the study. Among them, 71.1% were male, 48.1% were aboriginal, and 88.2% were single. The prevalence of oral cancerous lesions was 2.4%, which was higher than the recorded prevalence in Canada (0.014–1.42: 10,000) and in Alberta (0.011–1.13: 10,000). The clinical examinations indicated that 176 (54.7%) participants had clinical inflammatory changes in their oral mucosa. There was a significant association between clinical inflammatory oral lesions and oral cancerous/precancerous lesions (p < 0.001). Simple logistic regression showed that the risk of the presence of oral cancerous/precancerous lesions was two times higher in participants living in a shelter or on the street than in those living alone (OR = 2.06; 95% CI: 1.15–3.82; p-value: 0.021). In the multiple logistic regression analysis, the risk of oral cancerous/precancerous lesions was 1.68 times higher in participants living in a shelter or on the street vs. living alone after accounting for multiple predictors (OR = 1.67; 95% CI: 1.19–2.37; p-value: 0.022). The results demonstrated a high prevalence of cancerous/precancerous lesions among the study participants, which was significantly associated with clinical inflammatory oral lesions. The evidence supports the need for developing oral cancer screening and oral health promotion strategies in underserved communities.

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Oral Cavity and Oropharyngeal Cancer Surveillance and Control in Alberta : A Scoping Review

Cited by 3 publications

References 0 publications

Methods, Detection Rates, and Survival Outcomes of Screening for Head and Neck Cancers

Methods, Detection Rates, and Survival Outcomes of Screening for Head and Neck Cancers

Retrospective study of factors associated with late detection of oral cancer in alberta: A qualitative study

Factors Associated with Oral Cancerous and Precancerous Lesions in an Underserved Community: A Cross-Sectional Study

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