Oral Health, U.S. 2002 Annual Report
Section 13: ORAL AND PHARYNGEAL CANCER
| 13.2 |
Oral and pharyngeal cancer screening |
The American Cancer Society recommends an oral cancer examination annually for everyone 40 years of age and older (Smith et al., 2002), while both the Canadian Task Force on the Periodic Health Examination in 1994 and the U.S. Preventive Services Task Force in 1996 found no evidence for or against periodic screening for oral cancer (Hawkins et al., 1999).
Data from the 1992 Cancer Control Supplement to the National Health Interview Survey indicated that only 15% of those aged 40 years and older report ever having had an oral cancer examination, and only 48% of these had one in the past year (Horowitz & Nourjah, 1996; Martin et al., 1996).
More than 75% of oral cancers can be identified either visually or through palpation in a comprehensive oral exam (CDC, 1992). Such an exam is accomplished by a thorough examination of the head and neck, including palpation of lymph nodes and an intra-oral examination including the tongue, oral and pharyngeal mucosal tissues, lips, and intra-oral palpation of the lymph nodes. The mouth is easily accessible to noninvasive examination (Mashberg & Samit, 1995). Although diagnosis at later stages is associated with decreased survival and increased treatment morbidity and progression to these stages is thought to take several years, thorough studies examining the relationship between oral cancer screening, stage at diagnosis, and treatment outcome have not been conducted.
Low oral cancer screening rates may be the result of a lack of public awareness concerning oral cancer signs, symptoms, and risk factors (Horowitz et al., 1990; Horowitz & Nourjah, 1996; Horowitz et al., 1998). In addition, many dentists do not routinely perform oral cancer exams, particularly on the edentulous (Horowitz et al., 2000). Because more adults seek care from physicians than from dentists, it has been suggested that medical personnel be educated on the importance of routinely doing oral cancer detection examination of patients at high risk and be trained in the proper procedures for these examinations (Goodman et al., 1995).
SOURCE OF DATA
The analyses reported here are based on the National Health Interview Survey (NHIS), 1992 and 1998, National Center for Health Statistics, Centers for Disease Control and Prevention.
- Differences by race/ethnicity (Figure 13.2.1)
- The percentage of non-Hispanic whites reporting an oral cancer exam in the past year was greater than the percentage of non-Hispanic blacks or Hispanics.
- Differences by gender
- The percentages of males and females reporting oral cancer exams in the past year are similar.
- Differences by federal poverty level and education (Figure 13.2.1)
- Those living below the federal poverty level were less likely to report an oral cancer exam in the past year than those at or above the federal poverty level.
- Those with 12 years of education or less were less likely to report an oral cancer exam in the past year than those with more than 12 years of education.
- Trend by race/ethnicity (Figure 13.2.2)
- The percentages of those reporting an oral cancer exam in the past year increased markedly between the NHIS interviews of 1992 and 1998 for all three racial/ethnic groups examined.
Bullets reference data that can be found in Table 13.2.1.
REFERENCES
Centers for Disease Control and Prevention. Current trends in examinations for oral cancer-United States, 1992.
MMWR 1994;43(11):198–200.
Goldman HS, Yellowitz JA, Horowitz AM. Oral cancer prevention. The role of family practitioners.
Arch Fam Med 1995;4(7):628–636.
Hawkins RJ, Wang EE, Leake JL. Preventive health care, 1999 update: prevention of oral cancer mortality. The Canadian Task Force on Preventive Health Care.
J Can Dent Assoc 1999;65(11):617.
Horowitz AM, Nourjah P, Gift HC. U.S. adult knowledge of risk factors and signs of oral cancer.
J Am Dent Assoc 1990;126:39–45
Horowitz AM, Nourjah PA. Factors associated with having oral cancer examinations among U.S. adults 40 years of age or older.
J Public Health Dent 1996;56:331–335.
Horowitz AM, Moon HS, Goodman HS, Yellowitz JA. Maryland adults' knowledge of oral cancer and having oral cancer examinations.
J Public Health Dent 1998;58:281–287.
Horowitz AM, Drury T, Goodman HS, Yellowitz JA. Oral pharyngeal cancer prevention and early detection.
J Am Dent Assoc 2000;131:453–462.
Martin LM, Bouquot JE, Wingo PA, Heath CW Jr. Cancer prevention in the dental practice: oral cancer screening and tobacco cessation advice.
J Public Health Dent 1996;56:336–340.
Mashberg A, Samit A. Early diagnosis of asymptomatic oral and oropharyngeal squamous cancers.
CA-Cancer J Clin 1995;45:328–351.
Smith RA, Cokkinides V, von E, et al. American Cancer Society guidelines for the early detection of cancer.
CA Cancer J Clin 2002;52(1):8–22.
Figure 13.2.1. Percentage of adults aged 40 and older who reported having had an oral cancer examination in the past year
 [D]
Data source: 1998 National Health Interview Survey, National Center for Health Statistics, Centers for Disease Control and Prevention.
Figure 13.2.2. Trends in percentage of adults aged 40 and older who reported having had an oral cancer examination in the past year by race/ethnicity
 [D]
Data source: 1992 and 1998 National Health Interview Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention.
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