Screening and Risk Factors for Oral and Pharyngeal Cancer Patients

Objective: This study examined characteristics of patients diagnosed with oral and pharyngeal cancer and identified tobacco and alcohol use and treatment patterns. Methods: Trained interviewers administered questionnaires to patients receiving treatment for oral and pharyngeal cancer at UF Cancer Center/Shands Hospital. Based on medical chart abstraction of TNM summary staging, patients were classified as ‘early' (Stage I or II) or ‘advanced' (Stage III or IV) staging. Results: Forty-eight patients (35 males, 13 females; age=56 y) were interviewed. Thirteen reported they never smoked, 15 were past smokers, and 20 were current smokers. Three reported they never drank, 13 were past drinkers, and 32 were current drinkers. Twenty-nine percent reported they were both a current smoker and a current drinker and 6% reported having never smoked or drank. Frequently, initial suspicion of abnormality was noticed by patients (73%) rather than by a healthcare professional. Fifty-four percent of patients diagnosed at early stages had visited a dentist within the 2 years preceding diagnosis, compared to 46% of patients diagnosed at advanced stages (p >.1). Of those with a regular dentist and seen in the past 2 years, 40% reported that the dentist held their tongue with gauze and examined the ventral surface at last visit versus 60% who did not. Out of the 40% that received an oral cancer exam, 50% were diagnosed in advanced stages. Conclusion: The level of tobacco and alcohol use suggests these were high risk individuals for oral and pharyngeal cancer. Of those who saw a dentist in the previous 2 years, less than half reported having an oral cancer screening. These results indicate that dentists and dental hygienists may not be following published recommendations about conducting oral cancer exams on high risk patients. Research supported by a UFCD Student Summer Research Fellowship (NPC) and NIH NCI DE-01622.