Abstract
This analytical, cross-sectional, observational study aimed to evaluate the perception of dentists working at the public system of the state of Rio Grande do Sul, southern Brazil, regarding academic training to treat oral lesions, adoption of preventive measures for oral cancer, and attitude toward the need to perform oral biopsies. The sample consisted of questionnaires filled out by 192 dentists (153 women and 39 men) working in primary health care who participated in training activities on oral cancer diagnosis in July 2016. To enroll in the training activities, the professionals completed an online questionnaire to evaluate their perceptions regarding oral cancer issues. With respect to preventive measures, 96.88% of dentists reported performing full mouth examination, 87.50% reported providing tobacco cessation counseling, and 51.04% reported giving advice on excessive alcohol consumption. In addition, 72.40% and 44.79% of dentists considered, respectively, clinical training and theory instruction in oral medicine to be insufficient during undergraduate school. Only 8.33% reported performing biopsies in daily clinical routine, and almost 90% reported referring the patient to a specialist from the public system or universities. Lack of experience was the main reason not to perform a biopsy. The dentists in our sample recognize the importance of preventive measures for oral cancer, but few of them perform biopsies regularly. Therefore, there is a need for continuing education actions including practical training.
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Data Availability
The raw data generated in this study are available from the corresponding author on request.
References
Petersen PE (2009) Oral cancer prevention and control - the approach of the World Health Organization. Oral Oncol 45(4-5):454–460
Warnakulasuriya S (2009) Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 45(4-5):309–316
Abreu PM, Valle IB, Damasceno TCD, Có ACG, Pansini PF, Podestá JRV, Souza ED, Rocha RM, Curado MP, Mehanna H, von Zeidler SV (2020) Human Papillomavirus E6/E7 mRNA detection by in situ hybridization in oral cavity squamous cell carcinoma. Arch Oral Biol 116:104746
Mariz B, Kowalski LP, William WN Jr, de Castro G, Jr Chaves A, Santos M, de Oliveira TB, Araújo A, Normando A, Ribeiro A, Brandão TB, Vargas PA, Lopes MA, Santos-Silva AR, Latin American Cooperative Oncology Group - Brazilian Group of Head and Neck Cancer (2020) Global prevalence of human papillomavirus-driven oropharyngeal squamous cell carcinoma following the ASCO guidelines: a systematic review and meta-analysis. Crit Rev Oncol Hematol 156:103116
Sundberg J, Öhman J, Korytowska M, Wallström M, Kjeller G, Andersson M, Horal P, Lindh M, Giglio D, Kovács A, Sand L, Hirsch JM, Magda Araújo Ferracini L, de Souza A, Parlatescu I, Dobre M, Hinescu ME, Braz-Silva PH, Tovaru S, Hasséus B (2021) High-risk human papillomavirus in patients with oral leukoplakia and oral squamous cell carcinoma-a multi-centre study in Sweden, Brazil and Romania. Oral Dis 27(2):183–192
van der Waal I (2013) Are we able to reduce the mortality and morbidity of oral cancer; some considerations. Med Oral Patol Oral Cir Bucal 18(1):e33–e37
Instituto Nacional de Cancer José Alencar Gomes da Silva. 2015. Estimativa 2016: incidência de câncer no Brasil. Rio de Janeiro: INCA. http://www.inca.gov.br/estimativa/2016/estimativa-2016-v11.pdf. Accessed at 26 Dez 2017.
Instituto Nacional de Cancer José Alencar Gomes da Silva. 2013. Estimativa 2014: incidência de câncer no Brasil. Rio de Janeiro: INCA. http://bvsms.saude.gov.br/bvs/publicacoes/estimativa_2014_incidencia_cancer_brasil.pdf. Accessed at 26 Dez 2017.
Rogers SN, Brown JS, Woolgar JA, Lowe D, Magennis P, Shaw RJ, Sutton D, Errington D, Vaughan D (2009) Survival following primary surgery for oral cancer. Oral Oncol 45(3):201–211
Borges DM, Sena MF, Ferreira MA, Roncalli AG (2009). Mortality for oral cancer and socioeconomic status in Brazil. Cad Saude Publica 2009; 25(2):321-327. [in Portuguese]
Gajendra S, Cruz GD, Kumar JV (2006) Oral cancer prevention and early detection: knowledge, practices, and opinions of oral health care providers in New York State. J Cancer Educ 21(3):157–162
Kujan O, Duxbury AJ, Glenny AM, Thakker NS, Sloan P (2006) Opinions and attitudes of the UK’s GDPs and specialists in oral surgery, oral medicine and surgical dentistry on oral cancer screening. Oral Dis 12(2):194–199
Seoane-Leston J, Velo-Noya J, Warnakulasuriya S, Varela-Centelles P, Gonzalez-Mosquera A, Villa-Vigil MA et al (2010) Knowledge of oral cancer and preventive attitudes of Spanish dentists. Primary effects of a pilot educational intervention. Med Oral Patol Oral Cir Bucal 15(3):e422–e426
Seoane J, Warnakulasuriya S, Varela-Centelles P, Esparza G, Dios PD (2006) Oral cancer: experiences and diagnostic abilities elicited by dentists in North-western Spain. Oral Dis 12(5):487–492
Razavi SM, Zolfaghari B, Foroohandeh M, Doost ME, Tahani B (2013) Dentists' knowledge, attitude, and practice regarding oral cancer in Iran. J Cancer Educ 28(2):335–341
Hertrampf K, Wenz HJ, Koller M, Grund S, Wiltfang J (2013) Early detection of oral cancer: dentists' opinions and practices before and after educational interventions in Northern-Germany. J Craniomaxillofac Surg 41(8):e201–e207
Shimpi N, Bharatkumar A, Jethwani M, Chyou PH, Glurich I, Blamer J et al (2016) Knowledgeability, attitude and behavior of primary care providers towards oral cancer: a pilot study. J Cancer Educ 33(2):359–364
Güneri P, Epstein JB (2014) Late stage diagnosis of oral cancer: components and possible solutions. Oral Oncol 50(12):1131–1136
Sankaranarayanan R, Ramadas K, Amarasinghe H, Subramanian S, Johnson N (2015). Oral cancer: prevention, early detection, and treatment. In H. Gelband (Eds.) et. al., Cancer: disease control priorities, third edition (Volume 3). The International Bank for Reconstruction and Development / The World Bank
Alqutaibi AY, Borzangy S, Al-Maweri SA, Aboalrejal A (2020) Early detection of oral cancer and potentially malignant disorders: experiences, practices, and beliefs of prosthodontists practicing in Saudi Arabia. J Prosthet Dent S0022-3913(20):30434
World Health Organization (2011) Cancer. Rio de Janeiro: WHO. http://www.who.int/sdhconference/declaration/Rio_political_declaration_portuguese.pdf. Accessed 30 Oct 2020.
Scully C, Malamos D, Levers BG, Porter SR, Prime SS (1986) Sources and patterns of referrals of oral cancer: role of general practitioners. Br Med J (Clin Res Ed) 293(6547):599–601
Ergun S, Ozel S, Koray M, Kürklü E, Ak G, Tanyeri H (2009) Dentists' knowledge and opinions about oral mucosal lesions. Int J Oral Maxillofac Surg 38(12):1283–1288
Gobbo M, Ottaviani G, Rupel K, Zoi V, Di Lenarda R, Biasotto M, Poropat A (2020) Self-perception and physician's awareness on early detection of tongue cancer: experience of the Oral Medicine Unit of Trieste. Minerva Stomatol 69(2):95–99
Braun LW, Martins MAT, Romanini J, Rados PV, Martins MD, Carrard VC (2020) Continuing education activities improve dentists' self-efficacy to manage oral mucosal lesions and oral cancer. Eur J Dent Educ 25:28–34. https://doi.org/10.1111/eje.12574
Wan A, Savage NW (2010) Biopsy and diagnostic histopathology in dental practice in Brisbane: usage patterns and perceptions of usefulness. Aust Dent J 55(2):162–169
López Jornet P, Velandrino Nicolás A, Martínez Beneyto Y, Fernández Soria M (2007) Attitude towards oral biopsy among general dentists in Murcia. Med Oral Patol Oral Cir Bucal 12(2):E116–E121
Hassona Y, Scully C, Shahin A, Maayta W, Sawair F (2016) Factors influencing early detection of oral cancer by primary health-care professionals. J Cancer Educ 31(2):285–291
Frola MI, Barrios R (2017) Knowledge and attitudes about oral cancer among dental students after Bologna plan implementation. J Cancer Educ 32(3):634–639
Leonel A, Soares C, Lisboa de Castro JF, Bonan P, Ramos-Perez F, Perez D (2019) Knowledge and attitudes of primary health care dentists regarding oral cancer in Brazil. Acta stomatologica Croatica 53(1):55–63
Warnakulasuriya KA, Nanayakkara BG (1991) Reproducibility of an oral cancer and precancer detection program using a primary health care model in Sri Lanka. Cancer Detect Prev 15(5):331–334
Horowitz AM, Drury TF, Goodman HS et al (2000b) Oral pharyngeal cancer prevention and early detection: dentists’ opinions and practices. J Am Dent Assoc 131:453–462
Macpherson LM, McCann MF, Gibson J, Binnie VI, Stephen KW (2003) The role of primary healthcare professionals in oral cancer prevention and detection. Br Dent 195(5):277–281
Colella G, Gaeta GM, Moscariello A, Angelillo IF (2008 Apr) Oral cancer and dentists: knowledge, attitudes, and practices in Italy. Oral Oncol 44(4):393–399. https://doi.org/10.1016/j.oraloncology.2007.05.005
Reed SG, Cartmell KB, Duffy NG, Wahlquist AE, Sinha D, Hollinger A, Bode A, Alberg AJ, Day TA (2010) Oral cancer preventive practices of South Carolina dentists and physicians. Journal of Cancer Education, January 16
Kumar M, Nanavati R, Modi TG, Dobariya C (2016) Oral cancer: etiology and risk factors: a review. J Can Res Ther 12:458–463
Seoane J, Varela-Centelles P, Tomás I, Seoane-Romero J, Diz P, Takkouche B (2012) Continuing education in oral cancer prevention for dentists in Spain. J Dent Educ 76(9):1234–1240
Instituto Nacional de Câncer (2007). Estimativas 2008: incidência de câncer no Brasil. Rio de Janeiro: Instituto Nacional de Câncer. http://bvsms.saude.gov.br/bvs/publicacoes/estimativa_incidencia_cancer_2008.pdf. Accessed 26 Dez 2017.
Cancer Research (2011) Cancer mortality statistics. Oxford: Cancer Research UK; http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oral-cancer/mortality#heading-Two. Accessed 26 Dez 2017.
Morita MC, Haddad AE, de Araújo ME, Nobre MÁS, Cecchetto SJ, Campos LRC, de Toledo OA, Pucca Junior G, de Pordeus IA, Antoniazzi JH, Barreto LMS (2010) Perfil atual e tendências do cirurgião-dentista brasileiro. Dental Press, Maringá [in Portuguese]
Haddad AE, Pierantoni CR, Ristoff D, Xavier IM, Giolo J, Silva LB (2006) A trajetória dos cursos de graduação na área da saúde: 1991-2004. Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira, Brasília [in Portuguese]
Al-Maweri SA, Al-Soneidar WA, Dhaifullah E, Halboub ES, Tarakji B (2017) Oral cancer: awareness and knowledge among dental patients in Riyadh. J Cancer Educ 32(2):308–313
Nasser M (2011) Evidence summary: is smoking cessation an effective and cost-effective service to be introduced in NHS dentistry? Br Dent J 210(4):169–177
Archanjo AB, Assis ALEM, Oliveira MM, Mendes SO, Borçoi AR, Maia LL, Souza RP, Cicco R, Saito KC, Kimura ET, Carvalho MB, Nunes FD, Tajara EH, Santos MD, Nogueira BV, Trivilin LO, Pinheiro CJG, Álvares-da-Silva AM (2020) Elemental characterization of oral cavity squamous cell carcinoma and its relationship with smoking, prognosis and survival. Sci Rep 10(1):10382
Kadashetti V, Shivakumar KM, Choudhary M, Patil S, Gawnde M (2020) Awareness and knowledge of tobacco associated risk of development of oral cancer and oral potentially malignant disorders among patients visiting a dental college. J Family Med Prim Care 9(5):2244–2247
Carrard VC, Roxo Gonçalves M, Rodriguez Strey J, Pilz C, Martins M, Martins MD, Schmitz CA, Dal Moro RG, D'Ávila OP, Rados D, Harzheim E, Gonçalves MR (2018) Telediagnosis of oral lesions in primary care: the EstomatoNet Program. Oral Dis 24(6):1012–1019
Shaila M, Shetty P, Madonna Decruz A, Pai P (2013) The self-reported knowledge, attitude and the practices regarding the early detection of oral cancer and precancerous lesions among the practising dentists of Dakshina Kannada- a pilot study. J Clin Diagn Res 7(7):1491–1494
Torres-Pereira CC, Angelim-Dias A, Melo NS, Lemos CA Jr, de Oliveira EMF (2012) Strategies for management of oral cancer in primary and secondary healthcare services. Cad Saúde Pública 28(Suppl):s30–s39 [in Portuguese]
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The authors thank Rosely de Andrade Vargas for her assistance in the final revision of the manuscript.
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jéssica Rodriguez Strey, Bianca Dutra Guzenski, and Vinicius Coelho Carrard. The first draft of the manuscript was written by Jéssica Rodriguez Strey, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This study was previously approved by the local Research Ethics Committee (protocol no. WebGPPG/HCPA 16-0548), and it was in accordance with the 1964 Helsinki Declaration.
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Strey, J.R., Roxo-Gonçalves, M., Guzenski, B.D. et al. Oral Medicine Experience and Attitudes Toward Oral Cancer: An Evaluation of Dentists Working in Primary Health Care. J Canc Educ 37, 1621–1628 (2022). https://doi.org/10.1007/s13187-021-01999-z
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DOI: https://doi.org/10.1007/s13187-021-01999-z