Hoffman Matthew J, Hale Demetria D, Hale Elijah W
University of North Carolina Greensboro, Greensboro, NC, United States.
High Point University, High Point, NC, United States.
Front Oral Health. 2022 Jun 9;3:923032. doi: 10.3389/froh.2022.923032. eCollection 2022.
Oral cancer is a largely preventable malignancy with many modifiable risk factors, such as tobacco use and proper oral hygiene. Early detection of oral cancer is an important goal for oral healthcare providers, as survival rates for oral cancers diagnosed at an advanced stage are less than half the rates for cancers diagnosed in early stages. As many patients are asymptomatic in early stages, it is crucial for oral healthcare providers to have a high index of suspicion while treating patients at risk for late diagnosis.
To identify characteristics associated with early vs. late stage diagnosis of oral cancer.
We performed a retrospective chart review using the TriNetX database. We identified two cohorts of interest: patients with an initial diagnosis of stage 1 oral cancer, and patients with an initial diagnosis of stage 3 or 4 oral cancer. Statistical comparison of cohort characteristics was completed through the TriNetX statistical software platform.
We identified 386 patients diagnosed at stage 1 and 869 patients diagnosed at stage 3 or 4. We identified several characteristics not previously reported in the literature. Race, BMI between 20 and 29, malnurition, anemia were all associated with late stage diagnosis. Certain medications were also associated with late stage diagnosis, such as heparin derivatives and diclofenac. Our findings also reinforced prior research for characteristics such as nicotine use and ethnicity.
Our findings offer new characteristics that may aid oral healthcare providers in detecting oral cancer at an early stage. Increasing provider awareness of factors that they may not have considered previously could increase the rates of early stage cancer detection, improving overall patient mortality and curative outcomes.
口腔癌在很大程度上是可预防的恶性肿瘤,有许多可改变的风险因素,如烟草使用和良好的口腔卫生。早期发现口腔癌是口腔医疗服务提供者的一个重要目标,因为晚期诊断出的口腔癌生存率不到早期诊断出的癌症生存率的一半。由于许多患者在早期没有症状,对于口腔医疗服务提供者来说,在治疗有晚期诊断风险的患者时保持高度怀疑指数至关重要。
确定与口腔癌早期与晚期诊断相关的特征。
我们使用TriNetX数据库进行了一项回顾性病历审查。我们确定了两个感兴趣的队列:初始诊断为1期口腔癌的患者,以及初始诊断为3期或4期口腔癌的患者。通过TriNetX统计软件平台完成队列特征的统计比较。
我们确定了386例1期诊断的患者和869例3期或4期诊断的患者。我们确定了一些以前文献中未报道的特征。种族、体重指数在20至29之间、营养不良、贫血均与晚期诊断相关。某些药物也与晚期诊断相关,如肝素衍生物和双氯芬酸。我们的研究结果也强化了先前关于尼古丁使用和种族等特征的研究。
我们的研究结果提供了新的特征,可能有助于口腔医疗服务提供者早期发现口腔癌。提高医疗服务提供者对他们以前可能未考虑过的因素的认识,可以提高早期癌症的检测率,改善患者的总体死亡率和治疗效果。