A review of oral cancer screening and detection in the metropolitan Detroit cancer control program.

In summarizing the experience of the twenty-seven months of the oral cancer screening and detection program the data indicate: 1.) Cancers were detected at earlier stages than is reported nationally. Further investigation is needed to determine whether there is a correlation between early detection and increased survival. (Kaufman 1980). 2.) The detection of fifteen precancerous lesions is significant in that intervention may have precluded malignant transformation. 3.) Of those found with oral cancers, eight were symptomatic and two were asymptomatic, while in the premalignant group five were symptomatic and seven were asymptomatic. On the basis of these data, it appears that the symptomatic group chose the screening program as a pathway of entry into the medical system. The motivation for this choice requires investigation. Possible hypotheses are: screening by a registered dental hygienist and in a familiar setting was less threatening than by a physician or dentist in a formal medical setting. The reputation of the MCF, as a center of excellence in cancer control, may have contributed to the willingness to be screened. 4.) The incidental detection of five skin and three laryngeal cancers was an aid to cancer control. 5.) The program successfully trained and utilized registered dental hygienists in oral cancer screening thereby demonstrating an economical use of professional health resources. Follow-up is needed to ascertain whether their training is successfully applied in private practice. 6.) Efforts to reach the high risk population were less productive than expected because, while target screening sites serviced heavy drinkers and smokers, their populations were sometimes less than 40 years-of-age. This finding suggests a need for more refined strategies for accessing high risk populations.