Lesion Evaluation, Screening and Identification of Oral Neoplasia Study: An assessment of high-risk Australian populations

Dost, Fatima, Do, Loc and Farah, Camile S (2015) Lesion Evaluation, Screening and Identification of Oral Neoplasia Study: An assessment of high-risk Australian populations. Community Dentistry and Oral Epidemiology, 44 1: 64-75. doi:10.1111/cdoe.12191

Author Dost, Fatima
Do, Loc
Farah, Camile S
Title Lesion Evaluation, Screening and Identification of Oral Neoplasia Study: An assessment of high-risk Australian populations
Journal name Community Dentistry and Oral Epidemiology   Check publisher's open access policy
ISSN 1600-0528
Publication date 2015-08-11
Year available 2015
Sub-type Article (original research)
DOI 10.1111/cdoe.12191
Open Access Status Not Open Access
Volume 44
Issue 1
Start page 64
End page 75
Total pages 12
Place of publication Hoboken NJ United States
Publisher Wiley-Blackwell Publishing
Collection year 2016
Language eng
Formatted abstract
Objectives: Population-based screening programmes which promote early detection are effective in reducing the burden of disease associated with chronic illness. The efficacy of screening for oral cancer and its preceding lesions appears promising in high-risk groups. The objective of this study is to report on the recruitment experiences and outcomes of the ‘Lesion Evaluation, Screening and Identification of Oral Neoplasia Study’ programme, a multicentre oral mucosal screening programme developed in South East Queensland, Australia.

Methods: Ten screening sites were established within public and private dental clinics, indigenous health clinics and a community pharmacy. Risk assessment was undertaken through a semi-structured interview and self-directed questionnaires. Oral mucosal examination was completed by one of 11 trained and calibrated dentists or oral health therapists, under conventional operatory parameters.

Results: The study ran for 24 months from April 2012 to April 2014. A total of 1498 participants consented to oral mucosal screening, with complete data available for 1252 (83.6%). Almost half (n = 561; 44.8%) were from an area of high disadvantage, and 59.9% reported annual household incomes below $40K (n = 750). Participants from backgrounds experiencing the highest level of disadvantage were more likely to have a history of tobacco use (P = 0.04). Those participants with low income had significantly higher prevalence ratios (PRs) of having suspicious oral mucosal lesions (PR: 3.13 and 5.85, respectively) than the most advantageous. Examiners reported difficulties in recruitment, which stemmed mainly from patient refusal due to time constraints, disinterest or embarrassment relating to their oral condition. Clinician outreach also proved inefficient in participant recruitment.

Conclusions: Population-based screening for oral cancer in the Australian context was effective in identifying people at risk of developing oral lesions, but participant recruitment appears to be a significant barrier to implementation. Further strategies are required to improve the success of such a programme, as we advocate for screening in high-risk populations.
Keyword Mucosal screening
Oral cancer
Oral potentially malignant disorders
Oral squamous cell carcinoma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2016 Collection
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