Patient perspectives of diagnostic delay for suspicious oral mucosal lesions

Abstract

Background: This study aimed to investigate patient experiences regarding the discovery of and subsequent referral for suspicious oral mucosal pathology. The population under investigation were patients of an oral medicine clinic in Australia who had been referred for oral lesions suspected for malignancy. Methods: A self-completed questionnaire gathered information regarding patient experiences and beliefs leading up to diagnosis at their review appointments. Results: Fifty-four per cent of participants knew about their mucosal pathology before referral. The highest proportion of delay occurred between self-discovery of a lesion and seeking help. Ninety-one per cent of self-aware participants had reason for seeking help in relation to their mucosal pathology. The three most common reasons for this was the desire for an explanation, being advised by a health care provider or presence of pain. Conclusions: Some patients were unaware of their own oral mucosal pathology and some seek help only when worried, in pain or following advice. Practitioners should examine the oral mucosa to detect suspicious oral mucosal pathology since patients may not be aware of its existence.

Missed opportunities for oral cancer screening in Australia

“…The research study pack containing an introductory cover letter, participant information form, participant informed consent, the questionnaire and professionally addressed and stamped envelope for return of questionnaire was mailed, utilising the modified Dillman method known to increase response rates, to those patients who were recently diagnosed with an oral cancer (excluding lip) three months prior to ethical clearance date in a retrospective manner. [30][31][32][33] In addition, new patients attending the RBWH Head and Neck Clinic who were diagnosed with an oral cancer (excluding lip) were approached on the day of their attendance with a research study pack by the approved site coordinator or their delegate that was independent from the researchers. The participants were able to freely and passively consent and complete the questionnaire at the clinic or return the questionnaire via prepaid mail.…”

Opportunities for achieving early diagnosis of oral cancer within the medical profession in Australia

“…Another Australian study investigated 101 patients referred with a suspicious oral lesion to a private oral medicine clinic. 187 These patients reported being far more aware of oral cancer, with 91.8% having heard about someone with oral cancer. 187 Patients in this study expected that both GDPs and GMPs should check for and be able to explain oral mucosal pathology, raising the question of whether the general public might expect similar standards of care.…”

“…As recruitment in a retrospective manner, the research study pack was mailed, utilising the modified Dillman method known to increase response rates, to patients who were recently diagnosed with an oral cancer (excluding lip) three months prior to the ethical clearance date (April 2014). 31,[187][188][189] In a prospective manner, new patients attending the RBWH Head and Neck Clinic until January 2015 who…”

“…These packs were mailed, utilising the modified Dillman method known to increase response rates, to those GMPs randomly selected by practice address within the catchment of referral to the RBWH Head and Neck Clinic. 31,[187][188][189] The GMSs were invited to participate during intern training days on commencement with Queensland Health, and were able either to consent to, complete, and return the questionnaire at this training meeting, or to return the questionnaire via pre-paid mail. The questionnaire responses were initially identifiable to allow a follow-up phone call for clarification of responses if required and to award the incentive ("the new iPad"), which was randomly drawn by the chief investigator at the conclusion of data collection.…”

“…187 Of interest is that private patients in this private oral medicine clinic expected that both GDPs and GMPs should check for and be able to explain oral mucosal pathology, raising the question of whether the general public might expect similar standards of care. 187 The demographics of these two Australian cohorts are very different, making comparison between the two groups difficult; however, there is an obvious wide divide in awareness of oral cancer when private and public patients are compared.…”