Most Study Participants Not Aware of Oral Cancer Risk Factors, Examinations

Aug. 23, 2002
Increasing risk factor awareness can improve early detection and decrease mortality.

Most participants in a large East Coast study demonstrated a lack
of knowledge about oral cancer risk factors, awareness of oral cancer examinations and the importance of early detection, according to researchers in this month's Journal of the American Dental Association (JADA).

The study also suggests that oral cancer screenings can target and attract people at high risk of developing oral cancer and potentially educate them about the disease's risk factors and early signs, the authors said.

In the study, four dental schools in the New York state and New Jersey area, as well as New York City's Office of Oral Health, Programs and Policies, conducted three days of oral cancer screenings during June 1999. As part of the screening, the authors conducted a survey.

"Through the survey, we wanted to determine the participants' knowledge of oral cancer risk factors, assess their awareness and history of oral cancer examinations, and identify the predictors associated with oral cancer awareness," explained lead author Gustavo D. Cruz, D.M.D., assistant professor and director of public health, New York University College of Dentistry.

The 803 study participants were racially and ethnically diverse. Sixty-six percent were aged 40 or older, 43 percent had a history of smoking and nine percent were likely to have had a history of alcohol abuse.

Survey results revealed 66 percent of the subjects had heard about oral cancer, but only 39 percent reported having heard of an oral cancer examination, and only 12 percent reported ever having an oral cancer examination.

Knowledge about risk factors varied greatly, according to the authors. Seventy-six percent of the subjects knew tobacco as a risk factor for oral cancer, but only 25 percent knew about alcohol as a risk. Twenty-five percent of the participants knew excessive sunlight was a risk factor for lip cancer.

The study also revealed that race/ethnicity, education level and knowledge of risk factors for oral cancers were predictors of awareness of an oral cancer examination. But only knowledge and possible history of alcohol abuse were predictors of having a history of oral examinations.

Oral and pharyngeal or throat cancers account for three percent of all diagnosed cancers in the United States. The American Cancer Society's 2002 estimates for oral cancers include 28,900 new cases and 7,400 deaths. With early diagnosis and treatment, the disease is curable.

Major risk factors for oral cancer include alcohol and tobacco use, as well as sun exposure for lip cancer. Tobacco use is responsible for 90 percent of the cancers. Heavy smokers and frequent alcohol users older than 40 years of age are at the highest risk, according to the study.

The authors concluded that dissemination of information about oral cancer and the awareness of the disease, especially among those who have risk factors, might lead to a reduction of risk factors and early detection.

"Our findings underscore the need for and importance of educational efforts," Dr. Cruz said, "because knowledge of oral cancer risk factors was the only common predictor of the study subject's awareness of an oral cancer examination and having a history of oral cancer examinations."

(Note: This study was published in the Journal of the American Dental Association, but does not necessarily reflect the policies or opinions of the ADA. For more oral health information, please visit