Perceptions and Practices of General Practitioners towards Oral Cancer and Emerging Risk Factors among Indian Immigrants in Australia: A Qualitative Study

Abstract

Background: In Australia, Indian immigrants are one of the fastest-growing communities. Since oral cancer is widespread in India, the indulgence of Indians in customs of areca (betel) nut use in Australia may be linked to the recent rise in oral cancer cases. Since GPs (general practitioners) are primary healthcare providers, it is pivotal to ensure the oral cancer awareness of GPs. This study aimed to explore oral cancer risk-related knowledge, beliefs, and clinical practices of GPs in Australia. Methods: Fourteen semi-structured interviews were conducted with GPs practicing across New South Wales and Victoria. Purposive and snowball sampling were used for recruitment. Data were analysed through a directed content analysis approach. Results: All GPs were knowledgeable of major oral cancer causative factors including tobacco and alcohol, but some had limited understanding about the risks associated with areca nut preparations. Positive attitudes were evident, with all participants acknowledging the importance of oral cancer risk assessment. Most GPs recalled not performing oral cancer routine check-ups. Conclusion: GPs presented good oral cancer knowledge except for emerging risk factors such as areca nut use. Varied beliefs and inconsistent clinical practices relating to oral cancer screening is concerning. Accessible oral cancer training around emerging risk factors may benefit GPs.

Knowledge, Attitudes and Practices of Indian Immigrants in Australia towards Oral Cancer and Their Perceived Role of General Practitioners: A Cross-Sectional Study

“…A number of respondents also questioned the competency of GPs to advise them on oral cancer. These findings are not unforeseen as a recent qualitative study involving GPs in Australia raised similar concerns regarding their limited knowledge around new oral cancer risk factors, inconsistent clinical practices relating to routine oral cancer check-ups and referrals [ 37 ]. These views were supported by the findings of a review that explored the knowledge, attitudes and practices of general practitioners in developed countries regarding oral cancer [ 47 ].…”

“…The study questionnaire was initially developed using existing survey items identified from a comprehensive literature review [ 17 , 47 ] as well as preliminary exploratory work around oral cancer in Australia [ 31 , 37 ]. The questionnaire development was informed by the KAB model and Health belief model.…”

“…Trained health professionals, for example, general practitioners (GPs) can play a key role in promoting health-seeking behaviours in at-risk population groups [ 33 , 34 , 35 , 36 ]. Nonetheless, a study exploring the perspectives and clinical practices of general practitioners (GPs) in this area revealed the need to raise awareness about new evolving oral cancer risk factors such as betel quid use among at-risk populations such as Indian immigrants [ 37 ]. Considering these emerging findings, it is important to conduct further research to shed more light on this important area of cancer care in the Australian healthcare system.…”

“…The primary aim of this study is to explore the knowledge, attitudes and practices of Indian immigrants in Australia towards oral cancer and their perceived role of general practitioners. This study was part of a broader mixed-methods study that also explored the oral cancer-related knowledge and clinical practices of GPs in Australia, especially among high-risk populations such as Indian immigrants [ 37 ]. This research was informed by both the knowledge, attitude and behaviour (K-A-B) model and the health belief model (HBM).…”

The incidence trends of oral cancers worldwide from 1988 to 2012 and the prediction up to 2030

“…Oceania has always maintained a high level of OC incidence. Due to the geographical proximity of Oceania and South Asia, developed countries like Australia have more immigrants from South Asia, and studies have shown that their knowledge about OC is at a relatively low level 41,42 . In addition, the HPV infection rate of indigenous people in Oceania far exceeds the international average levels, which is also one of the reasons for the high incidence of OCs 43 .…”