Horowitz A M, Drury T F, Goodman H S, Yellowitz J A
National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Md. 20892-6401, USA.
J Am Dent Assoc. 2000 Apr;131(4):453-62. doi: 10.14219/jada.archive.2000.0201.
The five-year survival rate for patients in the United States diagnosed with oral pharyngeal cancer is 52 percent, which suggests that these cancers are diagnosed at late stages. The authors conducted this study to determine U.S. dentists' opinions and practices regarding oral cancer prevention and early detection.
The authors mailed a pretested survey to 7,000 randomly selected general practitioners. A total of 3,200 dentists provided information on how they conduct oral cancer examinations, their use of health history questions to assess patients' oral cancer risks and their oral cancer training and practices. The authors carried out analyses using unweighted data; both bivariate and logistic analytical techniques at a P < or = .01 level of significance were used.
On average, dentists assessed about five of the eight health history items on the survey. Eighty-six percent indicated that they did not conduct oral cancer examinations on edentulous patients 18 years of age or older; 81 percent, however, reported that they conducted oral cancer examinations for 100 percent of their patients 40 years of age or older on their initial appointment.
The reported practices of these dentists regarding oral cancer, in conjunction with their opinions about key aspects of these practices and their training, point to a need for systematic educational updates in oral cancer prevention and early detection.
Dentists need to determine their patients' risks for oral cancers and provide routine and comprehensive oral cancer examinations.
在美国,被诊断为口咽癌的患者的五年生存率为52%,这表明这些癌症在晚期才被诊断出来。作者开展这项研究以确定美国牙医在口腔癌预防和早期检测方面的观点及做法。
作者向7000名随机选取的全科医生邮寄了一份经过预测试的调查问卷。共有3200名牙医提供了有关他们如何进行口腔癌检查、使用健康史问题评估患者口腔癌风险以及他们的口腔癌培训和做法的信息。作者使用未加权数据进行分析;采用了双变量和逻辑分析技术,显著性水平为P≤0.01。
平均而言,牙医评估了调查问卷上八项健康史项目中的约五项。86%的牙医表示他们不对18岁及以上的无牙患者进行口腔癌检查;然而,81%的牙医报告称,他们在患者40岁及以上首次就诊时会对100%的患者进行口腔癌检查。
这些牙医报告的关于口腔癌的做法,连同他们对这些做法关键方面及其培训的看法,表明有必要对口腔癌预防和早期检测进行系统性的教育更新。
牙医需要确定患者患口腔癌的风险,并提供常规且全面的口腔癌检查。