Oral Cancer Awareness and its Determinants among a Selected Malaysian Population

Objective: To assess oral cancer awareness, its associated factors and related sources of information among a selected group of Malaysians. Methods: A cross-sectional survey was conducted on all Malaysian ethnic groups aged >= 15 years old at eight strategically chosen shopping malls within a two week time period. Data were analysed using chi-square tests and multiple logistic regression. Significance level was set at alpha<0.05. Results: Most (84.2%) respondents had heard of oral cancer. Smoking was the most (92.4%) recognized high risk habit. Similar levels of awareness were seen for unhealed ulcers (57.3%) and red/white patches (58.0%) as signs of oral cancer. Age, gender, ethnicity, marital status, education, occupation and income were significantly associated with oral cancer awareness (p<0.05). Conclusions: There was a general lack of awareness regarding the risk habits, early signs and symptoms, and the benefits of detecting this disease at an early stage. Mass media and health campaigns were the main sources of information about oral cancer. In our Malaysian population, gender and age were significantly associated with the awareness of early signs and symptoms and prevention of oral cancer, respectively.Article Link: http://koreascience.or.kr/article/ArticleFullRecord.jsp?cn=POCPA9_2013_v14n3_195

Oral cancer in the UK: to screen or not to screen.

Although oral squamous cell carcinoma accounts for only a small proportion of malignant neoplasms in the UK, oral cancer incidence and mortality rates have been rising in recent years. The natural history of oral cancer is not adequately understood at present and there is very little information about the epidemiology of precancerous lesions in the UK. There are also insufficient data to provide firm evidence that the percentage of cases arising de novo is greater in the UK and the Western world as compared to the Indian subcontinent. Screening for oral cancer by visual examination is simple, inexpensive and causes little discomfort; however, there is no evidence for the effectiveness of screening for oral cancer either in reducing mortality from the disease or in reducing the incidence of invasive disease by detection and treatment of precancerous lesions. There is currently insufficient evidence to recommend population screening for oral cancer in the UK. Measures aimed at primary prevention of the disease may be a more feasible method of disease control at present

The role of primary healthcare professionals in oral cancer prevention and detection

AIM: To investigate current knowledge, examination habits and preventive practices of primary healthcare professionals in Scotland, with respect to oral cancer, and to determine any relevant training needs. SETTING: Primary care. METHOD: Questionnaires were sent to a random sample of 357 general medical practitioners (GMPs) and 331 dental practitioners throughout Scotland. Additionally, focus group research and interviews were conducted amongst primary healthcare team members. RESULTS: Whilst 58% of dental respondents reported examining regularly for signs of oral cancer, GMPs examined patients' mouths usually in response to a complaint of soreness. The majority of GMPs (85%) and dentists (63%) indicated that they felt less than confident in detecting oral cancer, with over 70% of GMPs identifying lack of training as an important barrier. Many practitioners were unclear concerning the relative importance of the presence of potentially malignant lesions in the oral cavity. A high proportion of the GMPs indicated that they should have a major role to play in oral cancer detection (66%) but many felt strongly that this should be primarily the remit of the dental team. CONCLUSION: The study revealed a need for continuing education programmes for primary care practitioners in oral cancer-related activities. This should aim to improve diagnostic skills and seek to increase practitioners' participation in preventive activities

Prevention and early diagnosis of oral carcinoma in construction workers in Italy: a pilot project

Objectives: A research project on occupational exposure in relation to oral carcinoma was periodic compulsory check-ups, oral examinations were performed to detect pathologies and the prevalence of potentially neoplastic oral conditions and a selfassessment questionnaire was administered to all of the subjects. The questionnaire was structured to collect information regarding demographic and clinical characteristics, risk habits (tobacco and alcohol consumption) and oral health habits, and to allow an assessment of knowledge about oral cancer, related risk factors and early signs. Results: The study cohort included people with different ethnicities, and there were significant differences in clinical characteristics between Italians and other Europeans. The subjects showed a good knowledge about oral cancer and related risk factors (with correct answers provided to &gt;50% of the questions) but insufficient knowledge about the early signs of oral carcinoma (correct-answer rates of 16–42%). There were high rates of habits that are potentially harmful to oral health, such as smoking (43.8%) and alcohol consumption (57%). The daily habit of brushing teeth was present in 92.6% of the subjects, but they had a low propensity to undergo regular dental examinations. The percentage of subjects with pathologies of the oral cavity was 18.6%. Conclusions: Despite the smallness of the sample, this pilot project could facilitate the acquisition of valid and cost-effective data for the primary prevention of oral cancer through information and educational campaigns on the related risk factors

Prevalence of Oral Cancer in Adolescents Related to Areca (Betel) Nut Chewing, Using Tobacco and Other Additives in Saipan, Northern Marianas Islands: A Review of Literature

Oral cancer can involve the lip, tongue, mouth and pharynx. It is the sixth most prevalent cancer worldwide. One of the leading causes of Oral Cancerin the Commonwealth of the Northern Mariana Islands (CNMI) is chewing betel nut with tobacco and other additives. The International Agency for Research on Cancer (IARC) linked areca nut, betel quid with tobacco and betel quid without tobacco as carcinogenic to humans. Areca nut, also known as betel nut comes from the areca palm tree. The use of areca nut is common throughout the Pacific, and is widespread in Papua New Guinea, Solomon Islands, Guam, the Federated States of Micronesia, Palau, CNMI and the Marshall Islands. The objective of this review is to gather published data related to oral cancer in adolescents as a result of chewing betel nut, using tobacco and other additives; and whether these studies address prevalence in adolescents in Saipan, CNMI. The literature searches were done electronically on World Health Organization, Journal of Dental Research, Center for Pacific Islands Studies/University of Hawai\u27i, IARC websites and Google search using keywords. A cross-sectional survey study (Oakley at el 2005) of 169 students shows 63.4% use areca nut regularly. It was more prevalent among male (73%) than females (54%). The mean age in starting to chew areca nut was 12.0, while some starting at age 10 or younger. The betel quid mixture included powdered lime and pepper betel leaf. Tobacco use was also widely prevalent among schoolchildren. Oral pathological lesions were noted during screening examinations. Areca (betel) nut chewing with the use of tobacco and other additives is increasingly observed among adolescents in Saipan. Further studies are needed on the prevalence of oral cancer in adolescents related to areca nut chewing, using tobacco and other additives and how to decrease oral cancer risk in this age group

Cancer anorexia: hypothalamic activity and its association with inflammation and appetite-regulating peptides in lung cancer

Background Energy homeostasis is mediated by the hypothalamus, whose inflammation-induced functional derangements contribute to the onset of anorexia in cancer. By using functional magnetic resonance imaging (fMRI), we determined the patterns of hypothalamic activation after oral intake in anorexic (A), non-anorexic (NA) cancer patients, and in controls (C). Methods Lung cancer patients were considered. Hypothalamic activation was recorded in A and NA patients and in C by fMRI, before (T0), immediately after (T1) the administration of an oral nutritional supplement, and after 15 min (T2). The grey of the hypothalamus and Blood Oxygen Level Dependent (BOLD) intensity were calculated and normalized for basal conditions. Interleukin (IL)-1, IL-6, tumour necrosis factor (TNF)-α, ghrelin, and leptin plasma levels were measured. A statistical parametric mapping was used. Results Thirteen lung cancer patients (7 M, 6 F; 9A, 4NA) and 2 C (1 M, 1 F) were enrolled. Controls had the lowest BOLD intensity. At all-time points, anorexic patients showed lower hypothalamic activity compared with NA (P &lt; 0.001) (T0: 585.57 ± 55.69 vs. 667.92 ± 33.18, respectively; T1: 536.50 ± 61.70 vs. 624.49 ± 55.51, respectively; T2: 556.44 ± 58.51 vs. 615.43 ± 71.50, respectively). Anorexic patients showed greater BOLD signal reduction during T0–T1 than NA (8.5% vs. 6.80%, P &lt; 0.001). Independently from the presence of anorexia, BOLD signals modification before and after oral challenge correlated with basal values of IL-1 and ghrelin (P &lt; 0.001). Conclusions Hypothalamic activity in A cancer patients is reduced respect to NA and responds differently to oral challenges. This suggests a central control of appetite dysregulation during cancer anorexia, before, and after oral intake

Pharyngeal and Cervical Cancer Incidences Significantly Correlate with Personal UV Doses Among Whites in the United States

Because we found UV-exposed oral tissue cells have reduced DNA repair and apoptotic cell death compared with skin tissue cells, we asked if a correlation existed between personal UV dose and the incidences of oral and pharyngeal cancer in the United States. We analyzed the International Agency for Research on Cancer\u27s incidence data for oral and pharyngeal cancers by race (white and black) and sex using each state\u27s average annual personal UV dose. We refer to our data as ‘white’ rather than ‘Caucasian,’ which is a specific subgroup of whites, and ‘black’ rather than African-American because blacks from other countries around the world reside in the U.S. Most oropharyngeal carcinomas harboured human papilloma virus (HPV), so we included cervical cancer as a control for direct UV activation. We found significant correlations between increasing UV dose and pharyngeal cancer in white males (p=0.000808) and females (p=0.0031) but not in blacks. Shockingly, we also found cervical cancer in whites to significantly correlate with increasing UV dose (p=0.0154). Thus, because pharyngeal and cervical cancer correlate significantly with increasing personal UV dose in only the white population, both direct (DNA damage) and indirect (soluble factors) effects may increase the risk of HPV-associated cancer

Interventions for preventing oral mucositis for patients with cancer receiving treatment

Background: Treatment of cancer with chemotherapy is becoming increasingly more effective but is associated with short and long-term side effects. Oral side effects remain a major source of illness despite the use of a variety of agents to prevent them. Objectives: To evaluate the effectiveness of oral (and topical) prophylactic agents for oral mucositis and oral candidiasis in patients with cancer (excluding head and neck cancer), compared with placebo or no treatment. Search Strategy: Computerised MEDLINE, EMBASE, CINAHL, CANCERLIT, the Cochrane Controlled Trials Register and the Cochrane Oral Health Group Specialist Register search up to July 1999. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted to identify trials and obtain additional information. Selection Criteria: Studies were selected if they met the following criteria: design - random or quasi-random allocation of participants; participants - anyone with cancer receiving chemotherapy (excluding head and neck cancer); interventions - prophylactic agents prescribed to reduce oral conditions arising from cancer or its treatment; outcomes - mucositis and oral candidiasis. Data Collection and Analysis: Information regarding methods, participants, interventions and outcome measures and results were independently extracted, in duplicate, by two reviewers (JC &amp; HW). Specialist advice was sought to categorise interventions. Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out using the Jadad criteria (Jadad 1998). The Cochrane Oral Health Group statistical guidelines were followed and relative risk values calculated using random effects models where significant heterogeneity was detected (P &lt; 0.1). Main Results: Thirty-eight reports of trials were initially included. Two were duplicate reports and nine were excluded as there was no useable information. Of the 27 useable studies 14 had data for mucositis comprising 945 randomised patients and 15 included data for oral candidiasis with 1164 randomised patients. Of the eight prophylactic agents used for mucositis only one, ice chips, was effective (Relative risk 0.57, 95% CI 0.43 to 0.77, chi-square for heterogeneity = 0.26 (df = 1), p = 0.61). The NNT to prevent one extra case of mucositis over the baseline incidence using ice chips was 4 (95%CI: 3 to 7). The NNT for when the baseline incidence of mucositis in the population ranges from 50% to 80% are 5 to 4 respectively. There is evidence that antifungal agents which are partially or fully absorbed from the gastrointestinal tract prevent oral candidiasis and that the partially absorbed agents may be more effective than the fully absorbed agents. The RR for partially absorbed agents was 0.13 (95% CI 0.06 to 0.27, chi-square for heterogeneity = 5.3 (df = 3), P = 0. 15). The NNT to prevent one extra case of oral candidiasis over the baseline incidence using partially absorbed drugs was 3 (95% CI: 3 to 5). The NNT for when the baseline incidence of oral candidiasis in the population ranges from 30% to 70% are 4 to 2 respectively. The general reporting of RCT's was poor however the median Jadad score was acceptable and improved further when the authors provided additional information. The sensitivity analysis confirmed the findings for oral candidiasis. Reviewer's Conclusions: There is some evidence that ice chips prevent mucositis. None of the other prophylactic agents included in this review prevented mucositis. There is evidence that prophylactic use of antifungal agents which are absorbed or partially absorbed from the gastrointestinal tract reduce the clinical signs of oral candidiasis, and the partially absorbed drugs may be more effective. Future trials in this area should address the link between oral and general health including outcomes relevant to the patient. Collaboration between medical and dental teams is indicated.</p