Clinical Significance
GPs and dentists should work together to identify and refer patients at risk of oral cancer. In addition, there are opportunities to perform
Over 6500 people are newly diagnosed with oral cancer each year in the United Kingdom. Worldwide, oral/pharyngeal cancer is the sixth most common cancer seen. Survival is poor, perhaps because patients tend to be diagnosed when their disease is at an advanced stage rather than early on. As a result, earlier detection is the goal, especially since most oral cancers are preceded by clinically evident lesions that could facilitate early diagnosis. National initiatives have focused on increasing
The 200 participants were randomly selected from those patients who participated in the 2010 Cancer Patient Experience Survey. A semi-structured questionnaire was mailed to each one, asking which symptoms of oral cancer prompted them to seek a GP or other health care provider visit, how long they waited before they saw the health care provider, what kept them from seeking treatment, and the outcomes of the consultations. One hundred sixty-one patients (81%) responded. Of these 68% were men; 90%
Fifty-seven percent of the patients were referred for secondary care by their GP, 32% by their dentist, and 2% by an emergency department visit; data on referral were missing for 9% of the patients.
Ninety-eight percent had noticed at least one symptom before seeing a GP or dentist. Of these, 72% reported at least one of the five most common symptoms (mouth ulcer, lump in the face or neck, pain or soreness in the mouth or throat, red or white patches in the mouth, or a lump in the mouth) (Fig. 1
GPs play a significant role in identifying and referring patients with oral cancer to appropriate secondary care providers. Barriers to early diagnosis include not realizing a symptom is serious, being worried about the outcome, being too busy, having difficulty getting an appointment, or being afraid or embarrassed to see the doctor. Clinical Significance GPs and dentists should work together to identify and refer patients at risk of oral cancer. In addition, there are opportunities to perform
Crossman T, Warburton F, Richards MA, et al: Role of general practice in the diagnosis of oral cancer. Br J Oral Maxillofac Surg 54:208-212, 2016
Reprints available from T Crossman, Div of Public Health and Primary Care, Brighton and Sussex Medical School, Mayfield House, Univ of Brighton, Falmer BN1 9PH, UK; e-mail: [email protected]