Public awareness of oral cancer and associated risk factors is low

Abstract

The incidence of oral cancer continues to rise in the UK, especially in Scotland. Most of these cancers are diagnosed at advanced stages, resulting in extensive treatments, impaired function and poor outcomes. Early diagnosis remains an important predictor of prognosis and survival.The aim of this study was to examine the responses of young oral cancer patients in Scotland to the symptoms of their emerging condition, to understand the ways they seek help and to investigate delay caused by not recognising symptoms associated with oral cancer. This work is the first detailed investigation focusing exclusively on the experiences of young oral cancer patients, their symptom recognition and paths to referral, in Scotland.The study included 15 patients under 45 years of age, who were diagnosed with oral cancer in the three years before the study and resided in central Scotland. The most common cancer site was the tongue, as it was reported in seven participants. In addition, the study population included comparable numbers of men and women, seven and eight, respectively.Interviews were conducted using a semi-structured interview schedule, which was initially piloted on adult volunteers among oral cancer patients known to the study organisers. Furthermore, a timeline was drawn up for each interviewee to maintain a picture of the chronology of significant events and to enable some analyses of reported delays.To better understand the findings of this study as well as factors pertaining to delays in seeking care, the results will be discussed in light of the Health Belief Model. This model was first developed in the 1950s by a group of U.S. Public Health Service researchers who wanted to explain why so few people were participating in programs to prevent and detect disease. 1 Subsequent amendments to the model were made as late as 1988. The model addresses the individual's perceptions of the threat posed by a health problem (susceptibility, severity), the benefits of avoiding the threat and factors influencing the decision to act (barriers, cues to action and self-efficacy). 2 The following six constructs of the Health Belief Model will be used to examine the perceptions and actions of study participants in terms of controlling their illness.• Perceived susceptibility is the individual's assessment of their risk of getting the condition. In this study, several interviewees, even those who were aware of oral cancer, said that they had not expected their own diagnosis and did not think their symptoms were indicative of cancer.• Perceived severity refers to the patient's belief that the condition has serious consequences. Most study participants (n=12) indicated that they did not, at first, think their symptoms were serious. Most assumed they had a minor condition, such as an abscess or ulcer.• Perceived benefits of taking action to reduce susceptibility to the condition or its severity were not explicitly discussed in this study.Nonetheless, patients' perception that seeing a clinician may not improve their condition or sav...

Oral cavity squamous cell carcinomas in patients with no identified risk factors: Feeling like an outsider

“…No association was thus made between these cancers and HPV, alcohol or tobacco use. Unlike lung cancer, HNSCC is less known to be caused by smoking (Patton et al, 2004) or alcohol consumption (Viswanathan & Wilson, 2004), even in people who suffer these cancers (Al-Dakkak, 2010;Fabian et al, 1996;Lowry & Craven, 1999).Third, the absence of an identified cause marked the participants' experience of cancer in a way that varied over the course of the disease and the care pathway. After the intense reaction following delayed diagnosis, the absence of a cause and the recurrent questioning about smoking/drinking led patients to feel stigma and injustice before the onset of treatment.…”