Lifestyle Risk Factor-Related Oral Cancer Screening in the U.S. NHANES 2013-2016

Objectives: Oral cancers (OC) account for 3% of annual cancer diagnosis in the U.S. Despite its known risk factors and a cancer site that is easily examined, the majority of cases are diagnosed late when prognosis is poor.
Objective: To report OC screening prevalence and assess if known risk factors (smoking, alcohol use) are associated with receiving a screening.
Methods: Adults ≥30 years (n=9,374), who responded to questions on OC screening in the 2013-2016 survey years were included. OC screening (yes/no), smoking (never, former, current) and alcohol use (abstainers, former, non-excessive and excessive current) were self-reported. Using SAS 9.4, survey-logistic regression estimated Odds Ratios and 95% CI of ever and past year OC screening adjusted for age, gender, race/ethnicity, education, income and last dental visit.
Results: One third (33%) reported ever been screened, 66% of whom reported OC screening in the past year. Dentists (77%) and hygienists (14%) provided most screenings. Adjusted OR for ever been screened comparing current and former smokers to non-smokers were 1.09 (0.90, 1.32) and 1.24 (1.02, 1.51) respectively; 1.12 (0.81, 1.55), 1.36 (1.04, 1.79), 1.42 (1.03, 1.97) among former, non-excessive and excessive current drinkers relative to abstainers respectively. Conversely, current and former smokers were significantly less likely than non-smokers to report past year OC screening: 0.51 (0.28, 0.91) and 0.71 (0.51, 0.99) respectively. Similarly, former, non-excessive and excessive current drinkers relative to abstainers, were also less likely to report past year screening: 0.50 (0.30, 0.84); 0.83 (0.49, 1.39); 0.79 (0.50, 1.26) respectively.
Conclusions: Public health efforts should improve access to OC screenings and early diagnosis services for tobacco and alcohol users. Given that the majority of OC screenings occur in dental settings, access to affordable dental services and incorporating OC screenings into routine dental care might ensure that those particularly at risk for OC get timely screenings and earlier diagnosis.