Psychosocial Factors Associated with Oral Cancer Exams in Rural Florida

Objectives: The purpose of this study was to examine the knowledge and prevalence of mouth and throat cancer (MTC) examinations in a sample drawn exclusively from rural populations within the United States. Methods: Telephone interviews were conducted across rural census tracts throughout North Florida using a survey that had been adapted for cultural appropriateness using cognitive interviews. The sample consisted of 2526 respondents (1132 males and 1394 females; 1797 Whites and 729 African Americans). Results: MTC examination awareness (46%) and lifetime receipt (46%) was higher than reported in statewide studies performed over the past 15 years. Only 19% of the respondents were aware of their examination, whereas an additional 27% reported having the exam when a description was provided, suggesting a lack of communication between many caregivers and rural patients. Surprisingly, anticipated racial/ethnic differences were diminished when adjustments were made for health literacy and several measures of socioeconomic status. Conclusions: These findings support the notion that health disparities are multi-factorial and include characteristics such as low health literacy, lack of access to care, and poor communication between patient and provider.