Reiter P L, Wee A G, Lehman A, Paskett E D
The Ohio State University, Columbus, Ohio, USA.
Rural Remote Health. 2012;12:2184. Epub 2012 Dec 17.
Residents of Appalachia may benefit from oral cancer screening given the region's higher oral and pharyngeal cancer mortality rates. The current study examined the oral cancer screening behaviors and recent dental care (since dentists perform most screening examinations) of women from Ohio Appalachia.
Women from Ohio Appalachia were surveyed for the Community Awareness Resources Education (CARE) study, which was completed in 2006. A secondary aim of the CARE baseline survey was to examine oral cancer screening and dental care use among women from this region. Outcomes included whether women (n=477; cooperation rate = 71%) had ever had an oral cancer screening examination and when their most recent dental visit had occurred. Various demographic characteristics, health behaviors and psychosocial factors were examined as potential correlates. Analyses used multivariate logistic regression.
Most women identified tobacco-related products as risk factors for oral cancer, but 43% of women did not know an early sign of oral cancer. Only 15% of women reported ever having had an oral cancer screening examination, with approximately 80% of these women indicating that a dentist had performed their most recent examination. Women were less likely to have reported a previous examination if they were from urban areas (OR=0.33, 95% CI: 0.13-0.85) or perceived a lower locus of health control (OR=0.94, 95% CI: 0.89-0.98). Women were more likely to have reported a previous examination if they had had a dental visit within the last year (OR=2.24, 95% CI: 1.03-4.88). Only 65% of women, however, indicated a dental visit within the last year. Women were more likely to have reported a recent dental visit if they were of a high socioeconomic status (OR=2.83, 95% CI: 1.58-5.06), had private health insurance (OR=2.20, 95% CI: 1.21-3.97) or had consumed alcohol in the last month (OR=2.03, 95% CI: 1.20-3.42).
Oral cancer screening was not common among women from Ohio Appalachia, with many missed opportunities having occurred at dental visits. Education programs targeting dentists and other healthcare providers (given dental providers are lacking in some areas of Ohio Appalachia) about opportunistic oral cancer screening may help to improve screening in Appalachia. These programs should include information about populations at high risk for oral cancer (eg smokers) and how screening may be especially beneficial for them. Future research is needed to examine the acceptability of such education programs to healthcare providers in the Appalachian region and to explore why screening was less common among women living in urban areas of Ohio Appalachia.
鉴于阿巴拉契亚地区口腔和咽癌死亡率较高，该地区居民可能会从口腔癌筛查中受益。本研究调查了俄亥俄州阿巴拉契亚地区女性的口腔癌筛查行为以及近期的牙科护理情况（因为大多数筛查检查由牙医进行）。
对俄亥俄州阿巴拉契亚地区的女性进行了社区意识资源教育（CARE）研究调查，该研究于2006年完成。CARE基线调查的一个次要目标是调查该地区女性的口腔癌筛查和牙科护理使用情况。结果包括女性（n = 477；合作率 = 71%）是否曾接受过口腔癌筛查检查以及她们最近一次看牙医的时间。研究了各种人口统计学特征、健康行为和社会心理因素作为潜在的相关因素。分析采用多变量逻辑回归。
大多数女性将与烟草相关的产品视为口腔癌的危险因素，但43%的女性不知道口腔癌的早期症状。只有15%的女性报告曾接受过口腔癌筛查检查，其中约80%的女性表示最近一次检查是由牙医进行的。如果女性来自城市地区（OR = 0.33，95% CI：0.13 - 0.85）或认为健康控制源较低（OR = 0.94，95% CI：0.89 - 0.98），她们报告曾接受过检查的可能性较小。如果女性在过去一年内看过牙医（OR = 2.24，95% CI：1.03 - 4.88），她们报告曾接受过检查的可能性较大。然而，只有65%的女性表示在过去一年内看过牙医。如果女性社会经济地位较高（OR = 2.83，95% CI：1.58 - 5.06）、拥有私人健康保险（OR = 2.20，95% CI：1.21 - 3.97）或在过去一个月内饮酒（OR = 2.03，95% CI：1.20 - 3.42），她们报告最近看过牙医的可能性较大。
在俄亥俄州阿巴拉契亚地区的女性中，口腔癌筛查并不常见，在看牙医时存在许多错过的机会。针对牙医和其他医疗保健提供者（鉴于俄亥俄州阿巴拉契亚地区的某些地区缺乏牙科服务提供者）开展关于机会性口腔癌筛查的教育项目，可能有助于改善阿巴拉契亚地区的筛查情况。这些项目应包括有关口腔癌高危人群（如吸烟者）以及筛查对他们可能特别有益的信息。未来需要进行研究，以检验此类教育项目对阿巴拉契亚地区医疗保健提供者的可接受性，并探讨为何在俄亥俄州阿巴拉契亚地区城市地区的女性中筛查不太常见。
