Griner Stacey B, Digbeu Biai, Farris Alexandra N, Williams Blair, Neelamegam Malinee, Thompson Erika L, Kuo Yong-Fang
School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA.
Office of Biostatistics & Data Science, University of Texas Medical Branch, Galveston, TX, 77555, USA.
Cancer Causes Control. 2025 May;36(5):509-520. doi: 10.1007/s10552-024-01954-5. Epub 2025 Jan 7.
Oral cavity (OC) and oropharyngeal (OP) cancer rates have increased annually rising in the U.S. and Texas. Dental providers could play a key role in lowering OC/OP cancer rates through prevention and screening, but Texas faces a significant shortage of dental health professionals, affecting access to dental care, including OC/OP cancer prevention and early detection. This study aims to explore the link between OC/OP cancer rates and these dental shortage areas in Texas.
We analyzed OC/OP cancer incidence in Texas using SEER-Medicare data for patients aged 65 and over from 2012 to 2017. Rates per 100,000 were stratified by age, gender, and dental health provider shortage area (DHPSA) status (yes/no). Zero-Inflated Poisson Regression models were used to adjust for patient characteristics in studying cancer incidence, Late-stage diagnoses were assessed using logistic regression.
The incidence rate was 27.3 per 100,000 people in Texas. DHPSA counties had lower incidence rates (24.3 per 100,000) compared to non-DHPSA counties (29.8 per 100,000; p = 0.0423). Among patients with OC/OP diagnoses, those living in a DHPSA county had lower odds of advanced stage diagnoses (aOR: 0.79; CI: 0.64-0.96) than those in non-DHPSA counties.
The findings highlight the complex link between dental providers and OC/OP cancer diagnoses, noting differences in indicators of need based on DHPSA location. Limited local dental services may lead to underreported cancer cases. Further research on dental service usage could improve OC/OP outcomes by prioritizing interventions from dental professionals.
在美国和得克萨斯州，口腔癌（OC）和口咽癌（OP）的发病率逐年上升。牙科医疗服务提供者可通过预防和筛查在降低OC/OP癌症发病率方面发挥关键作用，但得克萨斯州面临牙科保健专业人员严重短缺的问题，这影响了包括OC/OP癌症预防和早期检测在内的牙科护理服务的可及性。本研究旨在探讨得克萨斯州OC/OP癌症发病率与这些牙科短缺地区之间的联系。
我们使用2012年至2017年65岁及以上患者的监测、流行病学和最终结果（SEER）-医疗保险数据，分析了得克萨斯州OC/OP癌症的发病率。每10万人的发病率按年龄、性别和牙科保健服务提供者短缺地区（DHPSA）状态（是/否）进行分层。在研究癌症发病率时，使用零膨胀泊松回归模型对患者特征进行调整，使用逻辑回归评估晚期诊断情况。
得克萨斯州的发病率为每10万人27.3例。与非DHPSA县（每10万人29.8例；p = 0.0423）相比，DHPSA县的发病率较低（每10万人24.3例）。在被诊断为OC/OP的患者中，居住在DHPSA县的患者晚期诊断的几率（调整后的比值比：0.79；置信区间：0.64 - 0.96）低于非DHPSA县的患者。
研究结果突出了牙科医疗服务提供者与OC/OP癌症诊断之间的复杂联系，指出了基于DHPSA位置的需求指标差异。当地有限的牙科服务可能导致癌症病例报告不足。对牙科服务使用情况的进一步研究可通过优先考虑牙科专业人员的干预措施来改善OC/OP的治疗结果。
