Gelažius Rokas, Gervickas Albinas, Petronis Žygimantas, Vaičiūnaitė Eglė
Department of Maxillofacial, Faculty of Dentistry, Lithuanian University of Health Sciences, Eivenių g. 2, LT-50161 Kaunas Lithuania.
Stomatologija. 2019;21(3):83-91.
Oral cancer is an increasing global health problem, with oral and pharyngeal cancer reported as being the 11th most common malignancy mortality reason. Studies show that even 77% of deaths from oral cancers occurred in less developed regions. Gladly, in some countries mortality from oral cancer is decreasing due to timely proper treatment. Concerning diagnostic and treatment progress, the ability of dental practitioners and physicians to recognize and diagnose oral cancer as early as possible and send patients to the appropriate specialist as quickly as possible is of great significance, and in order to achieve that, doctors must continuously improve their knowledge.
The research was carried out across ten cities located in Lithuania and their districts. In the implementation of the main tasks, the subjects were divided into two groups: A - 256 randomly selected dentists; B - 114 randomly selected physicians. Equal questionnaires were compiled for both groups. The questionnaire divided into 3 parts: 1) demographic data 2) part is devoted to assessing experience in the field of primary oral cancer diagnostic (POCD). 3) part was intended to evaluate the knowledge of POCD and oncological vigilance.
The main results of the present study indicate that 208 dentists and 99 physicians (total n=307) answered that they had been visited by a patient with oral cancer. 200 dentists and 73 physicians (total n=273) answered that they had diagnosed or suspected a case of oral cancer. 211 dentists and 61 physicians (n=272) state that they examine the patient's oral cavity for oncodiagnostic reasons. 205 dentists and all surveyed physicians responded (altogether n=319) that they received enough knowledge about oral cancer from their university studies. All the surveyed physicians and even 247 dentists (altogether n=361) said they wanted to have an annual oral cancer diagnosis week at their workplace (free supplementary education and POCD). Most assessed doctors claim that their knowledge about the primary diagnosis of oral cancer is average (n=162) only 16.8% dentists and 25.4% physicians evaluate patient's alcohol usage, contrastingly even 68.4% and 73.7% respectively evaluate patient's tobacco usage in the anamnesis. Regarding the correctly answered questions concerning the most common type of oral cancer, the present study shows low results: 70.3% and 61.4% of dentists and physicians accordingly.
Healthcare providers such as dentists and physicians take up a big part in POCD. Physicians as well as the majority of dentists in Lithuania demonstrate a lack of information regarding mean symptoms of oral cancer and do not perform as thorough anamnesis as foreign clinics, that is why they may often fail to identify oral cancer at an early stage. The vast majority of physicians and dentists in Lithuania who participated in the present study agreed that oral cancer awareness should be raised. Therefore, more education on POCD should be included in dental curriculums.
口腔癌是一个日益严重的全球健康问题,口腔和咽癌被报告为第11大常见恶性肿瘤死亡原因。研究表明,甚至77%的口腔癌死亡发生在欠发达地区。令人欣慰的是,在一些国家,由于及时恰当的治疗,口腔癌死亡率正在下降。关于诊断和治疗进展,牙科医生和医生尽早识别和诊断口腔癌并尽快将患者转至合适专科医生的能力具有重要意义,为了实现这一点,医生必须不断提高他们的知识水平。
该研究在立陶宛的十个城市及其辖区开展。在执行主要任务时,研究对象被分为两组:A组——256名随机选取的牙医;B组——114名随机选取的医生。为两组编制了相同的问卷。问卷分为三个部分:1)人口统计学数据;2)部分用于评估原发性口腔癌诊断(POCD)领域的经验;3)部分旨在评估POCD知识和肿瘤学警觉性。
本研究的主要结果表明,208名牙医和99名医生(共307人)回答曾有口腔癌患者就诊。200名牙医和73名医生(共273人)回答曾诊断或怀疑过口腔癌病例。211名牙医和61名医生(共272人)表示他们出于肿瘤诊断原因检查患者口腔。205名牙医和所有接受调查的医生(共319人)回答他们在大学学习中获得了足够的口腔癌知识。所有接受调查的医生以及甚至247名牙医(共361人)表示他们希望在工作场所设立年度口腔癌诊断周(免费补充教育和POCD)。大多数接受评估的医生声称他们对口腔癌初步诊断的知识水平一般(共162人),只有16.8%的牙医和25.4%的医生评估患者的饮酒情况,相比之下,分别有68.4%和73.7%的医生在病历中评估患者的吸烟情况。关于口腔癌最常见类型的正确回答问题,本研究结果较低:牙医和医生的正确率分别为70.3%和61.4%。
牙医和医生等医疗服务提供者在POCD中占很大比例。立陶宛的医生以及大多数牙医在口腔癌平均症状方面缺乏信息,并且不像国外诊所那样进行全面的病历分析,这就是为什么他们可能经常无法在早期识别口腔癌。参与本研究的立陶宛绝大多数医生和牙医一致认为应该提高口腔癌意识。因此,牙科课程中应纳入更多关于POCD的教育内容。