Screening and referral of oral mucosal pathology: a check-up of Australian dentists

Allen, Kristine; Farah, Camile S.

doi:10.1111/adj.12261

Cited by 37 publications

(63 citation statements)

References 28 publications

(51 reference statements)

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“…31 In conflict with this, participants in our study responded that only 9% had a GDP ever perform an oral cancer screening examination on them and only 6% had a GDP ever discuss their risk factors for oral cancer with them. Perhaps the definition provided for an oral cancer screening examination would make these participants think that no GDP had palpated their neck or face and therefore they had never been formally screened.…”

mentioning

confidence: 76%

“…[170][171][172][173] A recent study of 640 GDPs in Australia showed that over 90% regularly perform oral mucosal screening examinations for all patients. 31 Australian GDPs reported lack of training, confidence, time, and financial incentives as barriers to performing mucosal screening to at least some degree. 31 While most Australian GDPs manage referrals for oral mucosal pathology appropriately and promptly, only half believe in following up with the referred patients and only half believe they could influence a patient to quit smoking.…”

Section: General Medical and Dental Practitionersmentioning

confidence: 99%

“…31 Australian GDPs reported lack of training, confidence, time, and financial incentives as barriers to performing mucosal screening to at least some degree. 31 While most Australian GDPs manage referrals for oral mucosal pathology appropriately and promptly, only half believe in following up with the referred patients and only half believe they could influence a patient to quit smoking. 31 The intent of GMPs to conduct oral cancer screening has been investigated utilising the Theory of Planned Behaviour and this has identified barriers to conducting oral examinations for screening purposes in general medical practice.…”

Section: General Medical and Dental Practitionersmentioning

confidence: 99%

“…31 While most Australian GDPs manage referrals for oral mucosal pathology appropriately and promptly, only half believe in following up with the referred patients and only half believe they could influence a patient to quit smoking. 31 The intent of GMPs to conduct oral cancer screening has been investigated utilising the Theory of Planned Behaviour and this has identified barriers to conducting oral examinations for screening purposes in general medical practice. The results suggest considerable potential for improving intention to perform oral cancer screening in general practice.…”

Section: General Medical and Dental Practitionersmentioning

confidence: 99%

“…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…”

Section: Participant Recruitmentmentioning

confidence: 99%

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

Webster¹

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Most oral cancers lack early symptoms that would prompt a patient to seek diagnosis; hence at presentation more than 60% of patients are diagnosed with stage III or IV advanced disease. Survival rates and morbidity are dramatically improved if the disease is treated at an early stage, preferably asymptomatic in stage one. Therefore, early detection of oral cancer and oral potentially malignant lesions in the asymptomatic phase via an oral cancer screening examination is important.The core objective of this thesis is to determine whether asymptomatic diagnosis of oral cancer at an early stage of disease is achievable in Australia. We achieve this by evaluating the awareness of, and attitudes toward, oral cancer and opportunistic screening held by recently-diagnosed oral cancer patients, experienced general medical practitioners, and recentlygraduated medical students. From these studies we found that participants with oral cancer had poor awareness of oral cancer and poor knowledge of risk factors prior to diagnosis. Nearly all were over 40 years of age and most consumed tobacco or alcohol or both, suggesting a target population for opportunistic screening in the primary healthcare setting. Patient, professional, and total diagnostic ii delay were better than in many other countries. In the asymptomatic phase before diagnosis, participants with oral cancer were more likely to visit a GMP over a General Dental Practitioner (GDP), and likely to do so multiple times each year, identifying significant opportunities for GMPs to perform opportunistic oral cancer screening.We also found that Australian GMPs and GMSs have an inadequate level of knowledge of oral cancer, OPMLs, risk factors, and inadequate skill in performing opportunistic oral cancer screening examinations. At the present level of knowledge and confidence, it would be unlikely for a GMP to conduct a thorough visual and tactile oral cancer screening examination even if a highrisk individual presented to his or her clinic. Only 7% of participants with oral cancer were diagnosed in the asymptomatic phase, and all were diagnosed by health practitioners with a dental qualification.We conclude that asymptomatic diagnosis of oral cancer at an early stage of disease is achievable in the primary medical healthcare setting in Australia via opportunistic oral cancer screening. Initiating a consultation with a GMP or GDP for an oral cancer screening examination would require a patient to have an improved awareness of oral cancer and knowledge of his or her personal risk factors for developing it. To increase opportunistic oral cancer screening activity from Australian GMPs, interventions need to ensure that GMPs and GMSs reach competence in risk factors for oral cancer, identifying high-risk populations, diagnostic confidence, and skill in performing the nine-step visual and tactile opportunistic oral cancer screening examination.iii

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mentioning

confidence: 76%

Section: General Medical and Dental Practitionersmentioning

confidence: 99%

Section: General Medical and Dental Practitionersmentioning

confidence: 99%

Section: General Medical and Dental Practitionersmentioning

confidence: 99%

Section: Participant Recruitmentmentioning

confidence: 99%

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

Webster¹

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Ultrasensitive detection of tumor‐specific mutations in saliva of patients with oral cavity squamous cell carcinoma

Shanmugam

Hariharan

Hasina

et al. 2021

Cancer

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BACKGROUND: Oral cavity squamous cell carcinoma (OCSCC) is the most common head and neck malignancy. Although the survival rate of patients with advanced-stage disease remains approximately 20% to 60%, when detected at an early stage, the survival rate approaches 80%, posing a pressing need for a well validated profiling method to assess patients who have a high risk of developing OCSCC. Tumor DNA detection in saliva may provide a robust biomarker platform that overcomes the limitations of current diagnostic tests. However, there is no routine saliva-based screening method for patients with OCSCC. METHODS: The authors designed a custom nextgeneration sequencing panel with unique molecular identifiers that covers coding regions of 7 frequently mutated genes in OCSCC and applied it on DNA extracted from 121 treatment-naive OCSCC tumors and matched preoperative saliva specimens. RESULTS: By using stringent variant-calling criteria, mutations were detected in 106 tumors, consistent with a predicted detection rate ≥88%. Moreover, mutations identified in primary malignancies were also detected in 93% of saliva samples. To ensure that variants are not errors resulting in false-positive calls, a multistep analytical validation of this approach was performed: 1) re-sequencing of 46 saliva samples confirmed 88% of somatic variants; 2) no functionally relevant mutations were detected in saliva samples from 11 healthy individuals without a history of tobacco or alcohol; and 3) using a panel of 7 synthetic loci across 8 sequencing runs, it was confirmed that the platform developed is reproducible and provides sensitivity on par with droplet digital polymerase chain reaction. CONCLUSIONS: The current data highlight the feasibility of somatic mutation identification in driver genes in saliva collected at the time of OCSCC diagnosis.

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Advances in Early Detection and Diagnostic Adjuncts in Oral Cavity Cancer

Farah

Bhatia

Lalla

et al. 2016

Contemporary Oral Oncology

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Screening and referral of oral mucosal pathology: a check-up of Australian dentists

Cited by 37 publications

References 28 publications

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

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

Ultrasensitive detection of tumor‐specific mutations in saliva of patients with oral cavity squamous cell carcinoma

Advances in Early Detection and Diagnostic Adjuncts in Oral Cavity Cancer

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