Early detection of oral cancer by oral health practitioners

Methods: A survey was developed drawing on the literature and distributed following three oral cancer screening workshops held in regional Queensland.

Results: The 39 participants comprised 22 oral health therapists, 12 dental hygienists and 5 dental therapists, with an average of 7.8 years since graduation. Most participants (79.5%) did not agree that patients will detect an oral mucosal change and 92.3% agreed that screening should be performed for all new and recall patients. The majority (79.5%) agreed oral cancer would be encountered in their practising career and 71.8% had detected a suspicious lesion, yet only 63.2% had referred a suspicious lesion. Most participants (74.4%) felt comfortable discussing the presence of a suspicious lesion with patients and 94.9% agreed it was the role of the dental practitioner to screen rather than the doctor. In terms of barriers to oral cancer screening, 41% of participants stated time and 23.1% stated lack of financial incentives. A higher proportion agreed lack of confidence (56.5%) and training (69.2%) were barriers. The majority (78.5%) believed they could influence a patient to cease smoking and most (87.2%) felt they should provide tobacco cessation advice. All participants felt their understanding of oral pathology and mucosal screening had improved following the workshop and that they would screen differently (87.2%) and more often (76.3%). Despite this, most still believed that further education regarding both oral pathology (94.9%) and screening (79.5%) was needed.

Conclusions: Whilst lack of time and financial incentives were perceived to be impediments to mucosal screening , lack of confidence and training were the most prevalent barriers This issue should be addressed through implementation of effective continuing education courses targeting oral cancer screening and referral practices.