Primary Health Care Approaches to Control Oral Cancer-Intervention Programs

Oral cancer remains a lethal disease, 5-year survival is around 50%. The incidence has been rising in many countries particularly in Europe and the public awareness of mouth cancer is low. The Major risk factors are known but interventions directed at high-risk populations particularly among low socio-economic groups have been meager. Low socioeconomic status is an independent risk factor particularly in older groups. Early detection of the disease by opportunistic screening has been advocated but there are inequalities in screening performances within as well as between countries largely based on available resources: training and manpower. In a WHO collaborative project the feasibility of screening the oral cavity using primary health care workers in Sri Lanka has been reported and the approach serves as a model for all low-income countries. This strategy may assist in control of oral cancer in high-incidence countries.

In the UK, November is Mouth Cancer Action Month and a leading charity has teamed up with dental organisations to use Social Media to promote early detection by raising awareness and by encouraging dentists and hygienists to be vigilant in the detection of mouth cancer. There is some evidence that interventions delivered at an individual level can promote cancer awareness over the short term, but there is no evidence that these promote early presentation with cancer symptoms. Furthermore, interventions delivered to communities are difficult to measure.

The talk will address the failures to implement screening for oral cancer or in increasing public awareness on early symptoms particularly among vulnerable groups globally. The need for Continuing Professional Education on oral cancer to primary care Physicians and Dentists is being addressed in Europe (www.oralcancerldv.org)  by providing e-learning material to improve skills in the early detection and tobacco cessation that could be translated to all European languages. It is proposed that GOHIRA while promoting oral health advocacy will also create cooperation among institutions and government agencies to raise awareness on oral cancer.