The dentist as a referral source of first episode head and neck cancer patients

Amsel, Z; Strawitz, Joseph G.; Engstrom, Paul F.

doi:10.14219/jada.archive.1983.0391

Cited by 25 publications

(17 citation statements)

References 2 publications

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“…These dysfunctional symptoms were also in the histories retrieved from medical charts before hospital admission [2]. We could not obtain adequate information about this point in the literature, and therefore we do not know whether these data reflect only a local situation.…”

Section: Discussionmentioning

confidence: 98%

Clinical presentation of patients with oral squamous cell carcinoma when first seen by dentists or physicians in a teaching hospital in Brazil

et al. 2003

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The ability to diagnose oral cancer depends in part on the knowledge, attitudes, and practices of the health professional. On the other hand, the patients' choice of health professional depends on their perceptions of the ability of such professionals to diagnose and treat what they believe their health problem is. In this study, we investigated the clinical profiles of patients with oral cancer (n=354) when first seen by dentists (n=129) or physicians (n=225) in a teaching hospital. The charts of patients with oral squamous cell carcinoma were analyzed for the following variables: age, sex, race, signs and symptoms by the time of presentation to the health professional, size and site of the tumor since first manifestation, and clinical stage of the disease. Our results demonstrate that dentists and physicians assessed patients comparably regarding age, sex, and race. Patients complaining of dysphagia and odynophagia were seen more often by physicians than dentists (45/225 vs 9/129 [20.0% vs 7.0%] and 30/225 vs 4/129 [13.3% vs 3.1%], respectively), whereas those with local pain and burning preferentially sought dentists (77/129 vs 56/225 [59.7% vs 24.9%] and 4/129 [3.1%] vs 0/225, respectively). Physicians diagnosed oropharyngeal (45/208 vs 9/116 [21.6% vs 7.8%]) and lip lesions (71/208 vs 7/116 [34.1% vs 6.0%]) more often, whereas dentists saw more cases of cancer of the alveolar ridge (42/116 vs 7/208 [36.2% vs 3.4%]) and floor of the mouth (19/116 vs 10/208 [16.4% vs 4.8%]). Our findings suggest that patients have different perceptions of the roles of dentistsand physicians regarding the ability to diagnose and treat oral lesions. Signs, symptoms, and location of the cancer lesions appear to be the most important variables associated with the choice of health professional.

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Section: Discussionmentioning

confidence: 98%

Clinical presentation of patients with oral squamous cell carcinoma when first seen by dentists or physicians in a teaching hospital in Brazil

et al. 2003

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“…There are no reports relating professional diagnostic delay either with sociodemographic features of the clinicians, or with their health experiences. However, there are a number of studies investigating a hypothetical relationship between the academic degrees of the clinicians and how this relates to the rapidity of diagnosis‐ particularly between dentists and general medical practitioners‐ with equivocal results (Adams et al , 1974; Amsel et al , 1983; Scully et al , 1986; Gorsky and Dayan, 1995; Allison et al , 1998b; Holmes and Homer, 2003; Llewellyn et al , 2004). Certain research groups find that general medical practitioners refer oral cancer patients quicker than do dentists, putting this down to a higher index of suspicion by the former (Scully et al , 1986; Schnelter, 1992), whereas other researchers attribute this phenomenon to the high prevalence of ulcerated lesions within the oral cavity caused by inflammatory processes and to the low incidence of oral cancer (Onizawa et al , 2003).…”

Section: What Makes a Healthcare Professional Delay Oral Cancer Diagnmentioning

confidence: 99%

Is early diagnosis of oral cancer a feasible objective? Who is to blame for diagnostic delay?

et al. 2010

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Worldwide, oral cancer has one of the lowest survival rates and poor prognosis remains unaffected despite recent therapeutic advances. Reducing diagnostic delay to achieve earlier detection is a cornerstone to improve survival. Thus, intervention strategies to minimize diagnostic delays resulting from patient factors and to identify groups at risk in different geographical areas seem to be necessary. The identification of a 'scheduling delay' in oral cancer justifies the introduction of additional educational interventions aimed at the whole health care team at dental and medical practices. The access to and the kind of healthcare system in a particular country are also relevant in this context, particularly the referral system. The design of a simple, clear, fail-safe, fast-track referral scheme for those suspected with cancer may diminish greatly the length of the delay. Moreover, there is a need for future investigations, which are methodologically adequate, that consider cultural and geographical aspects and use patient survival as the final outcome, that are able to recognize the agents/factors responsible for diagnostic delay by patients as well as healthcare providers and those attributable to the healthcare systems.

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“…1 However, other large-scale research has revealed no significant difference in professional delay of oral malignancies between dentists and physicians, 2-6 whereas other publications conclude that dentists refer patients at earlier stages than physicians do. [7][8][9][10][11] According to Holmes et al, 11 oral-or oropharyngeal-squamous cell carcinoma (SCC) patients referred from dental offices were of significantly lower stage (TMN 1.94) than those referred from medical offices (TMN 3.00). As many as 72% of patients referred by physicians and ENT specialists were of advanced stages and only 21% of the patients referred by dentist and dental hygienists.…”

Section: Dentist Versus Doctormentioning

confidence: 99%

Dentist versus doctor

Zadik¹

2005

Br Dent J

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The dentist as a referral source of first episode head and neck cancer patients

Cited by 25 publications

References 2 publications

Clinical presentation of patients with oral squamous cell carcinoma when first seen by dentists or physicians in a teaching hospital in Brazil

Clinical presentation of patients with oral squamous cell carcinoma when first seen by dentists or physicians in a teaching hospital in Brazil

Is early diagnosis of oral cancer a feasible objective? Who is to blame for diagnostic delay?

Dentist versus doctor

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