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患者报告从美国口腔卫生保健提供者处获得的口腔癌筛查和戒烟咨询:2015-2016 年全国健康和营养检查调查。

Patient-reported receipt of oral cancer screenings and smoking cessation counseling from US oral health care providers: National Health and Nutrition Examination Survey, 2015-2016.

出版信息

J Am Dent Assoc. 2019 Dec;150(12):995-1003. doi: 10.1016/j.adaj.2019.07.017.

Abstract

BACKGROUND

Oral health care providers are encouraged to screen for oral cancer (OC) and oropharyngeal cancer (OP) and promote smoking cessation to their patients. In this study, the authors investigated the prevalence and correlates of receiving OC and OP screening and tobacco and OC and OP counseling from oral health care providers.

METHODS

The authors analyzed self-reported survey data from the National Health and Nutrition Examination Survey 2015-2016 for participants who reported a dental visit. They created different samples for each subanalysis and categorized them according to smoking status. The authors calculated weighted proportions and adjusted odds for receiving tobacco counseling and screening for OC and OP in a dental office.

RESULTS

Overall, 25.85% of US adults 30 years or older who had ever visited an oral health care professional received OC and OP screening. Odds of receiving an OC and OP screening were lower among current cigarette smokers than among never cigarette smokers (adjusted odds ratio [AOR], 0.47; 95% confidence interval [CI], 0.30 to 0.74) and among non-Hispanic blacks (AOR, 0.36; 95% CI, 0.22 to 0.59), Mexican Americans (AOR, 0.23; 95% CI, 0.10 to 0.53), non-Hispanic Asians (AOR, 0.21; 95% CI, 0.13 to 0.35), and those of other races (AOR, 0.39; 95% CI, 0.24 to 0.65), than among non-Hispanic whites. Participants with a high school education or more had higher odds of receiving an OC and OP screening (AOR, 1.88; 95% CI, 1.04 to 3.43) and counseling for screening (AOR, 1.64; 95% CI, 1.07 to 2.51) than did those with less than a high school education. Participants with family incomes of 400% or more of the federal poverty guideline had higher odds of receiving OC and OP screening (AOR, 5.17; 95% CI, 2.06 to 12.94) but lower odds of receiving tobacco counseling (AOR, 0.45; 95% CI, 0.24 to 0.82) than did participants with family incomes of less than 100% of the federal poverty guideline.

CONCLUSIONS

Oral health care providers underscreen for OC and OP among high-risk groups, including current cigarette smokers, minorities, and people of low socioeconomic status. The authors charge oral health care educators to include OC and OP screening and smoking cessation counseling in training and continuing education programs to increase the confidence of oral health care providers.

PRACTICAL IMPLICATIONS

Potential to influence change on current pre-doctoral clinical training programs and to increase opportunities for continuing education courses that review the importance of, as well as, how to successfully complete smoking cessation counseling.

摘要

背景

鼓励口腔卫生保健提供者对口腔癌(OC)和口咽癌(OP)进行筛查,并向患者提供戒烟建议。在这项研究中,作者调查了口腔卫生保健提供者对 OC 和 OP 筛查以及烟草和 OC 和 OP 咨询的接受情况及其相关因素。

方法

作者分析了 2015-2016 年全国健康和营养检查调查中报告过牙科就诊的参与者的自我报告调查数据。他们为每个亚分析创建了不同的样本,并根据吸烟状况对其进行了分类。作者计算了在牙科办公室接受烟草咨询和 OC 和 OP 筛查的加权比例和调整后的比值比(OR)。

结果

总体而言,30 岁及以上的曾接受过口腔卫生保健专业人员治疗的美国成年人中,有 25.85%接受了 OC 和 OP 筛查。与从不吸烟的成年人相比,当前吸烟者(调整后 OR,0.47;95%置信区间 [CI],0.30 至 0.74)和非西班牙裔黑人(调整后 OR,0.36;95% CI,0.22 至 0.59)、墨西哥裔美国人(调整后 OR,0.23;95% CI,0.10 至 0.53)、非西班牙裔亚洲人(调整后 OR,0.21;95% CI,0.13 至 0.35)和其他种族(调整后 OR,0.39;95% CI,0.24 至 0.65)接受 OC 和 OP 筛查的可能性较低。具有高中或以上学历的参与者接受 OC 和 OP 筛查(调整后 OR,1.88;95% CI,1.04 至 3.43)和接受筛查咨询(调整后 OR,1.64;95% CI,1.07 至 2.51)的可能性高于具有高中学历以下的参与者。家庭收入达到联邦贫困线 400%或以上的参与者接受 OC 和 OP 筛查的可能性更高(调整后 OR,5.17;95% CI,2.06 至 12.94),但接受烟草咨询的可能性较低(调整后 OR,0.45;95% CI,0.24 至 0.82)低于家庭收入低于联邦贫困线 100%的参与者。

结论

口腔卫生保健提供者对包括当前吸烟者、少数民族和社会经济地位较低者在内的高危人群的 OC 和 OP 筛查不足。作者要求口腔卫生保健教育者将 OC 和 OP 筛查以及戒烟咨询纳入培训和继续教育计划中,以提高口腔卫生保健提供者的信心。

实践意义

有可能影响当前口腔医学预科临床培训课程的改革,并增加继续教育培训课程的机会,这些课程审查成功完成戒烟咨询的重要性和方法。

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