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Sociodemographic Factors Affect Oral Cancer Screenings

When oral cancers are discovered in the early stage, the survival rate is 82.8% versus 28% when the disease is found after metastasis; therefore, it is important to implement preventive measures for early diagnosis of oral cancer. Researchers evaluated rates of oral cancer among those who have been to the dentist in the past two years to determine if sociodemographic factors, like income or race, predict discrepancies in the rate of diagnosis and found that a significantly high amount of minority patients with lower incomes do not receive oral cancer exams.

"We wanted to look specifically at the population that has access to dental care and report having access to a dentist," stated first author, Avni Gupta, BDS, MPH, research scientist at the Brigham's Center for Surgery and Public Health. "Our results indicate that the selection of patients for screening isn't based on the high-risk profile for oral cancer, but on sociodemographic characteristics. This is not appropriate. All patients should be receiving oral cancer screenings, but providers aren't screening these groups, and this may be why they are presenting with more advanced cancer."

For this study, published in The American Journal of Preventive Medicine, researchers analyzed participants who visited the dentist in the past two years. Patients self-reported if their dentist gave them an intraoral or extraoral exam, both of which are procedures to check for cancer. The intraoral exam involves the dentist pulling on the tongue and feeling the mouth to detect for any cancerous lesions, and for the extraoral exam, the dentist feels the patient's neck for any tumors.

The results revealed that only 37.6% of participants who saw the dentist received an intraoral exam, and only 31.3% received an extraoral exam. Rates of receiving the preventive exams were lower among racial minorities, lower-income groups, and those who were uninsured or publicly insured.

"Just providing access is not enough—it matters what type of care patients are able to access," Ms. Gupta commented. "We talk a lot about disparities in medical care, but the quality of dental care services is important, too. We need to better understand the barriers that dental care providers face in order to ensure that patients get the same level and quality of care regardless of sociodemographic factors."

For More Information

Gupta A, Sonis S, Uppaluri R, et al (2019). Disparities in oral cancer screening among dental professionals: NHANES 2011-2016. Am J Prev Med. [Epub ahead of print] DOI:10.1016/j.amepre.2019.04.026

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