Oral cancer awareness and knowledge among dental students in Saudi Arabia

Supervised by:

Prof.Hossam Kandilchairman of diagnostic sciences ,Riyadh colleges of dentistry and pharmacy

Dr.Abdulmohesn AlRabiaAssistant Professor,king Abdulaziz medical city.

Research group of:

•Abdulaziz M, AlSakr•Feras AlSultan

•Sultan S, AlShmmani•Abdurhman k, AlAkras

• Ibrahim M,Ababtain

Outline:

• Introduction and review of literature.

• Materials and methods.

• Results

• Discussion

• Conclusion

• References

Introduction and review of literature

• Oral cancer is major health problem in many parts of the world , especially in developing countries. More than 500,000 patients are estimated to have oral cancer globally 389,000 new cases per year , this is the 10th most common cancer in the world[1].

• Incidence in Saudi Arabia[2].

• Life style , attitude and tobacco use or (shamma) as it is called in this sub region have an intimate causal relationship with development of oral cancer[3] .

• Early detection of oral cancers makes them more amenable to treatment, thus reducing morbidity and allowing the greatest chance of cure [3,4].

• Lack of general dental practitioner knowledge has also been shown to contribute to delays in referral and treatment[5].

Was to assess the oral cancer awareness of future general dental practitioners by assessing undergraduate dental

students knowledge , prevention and early detection of oral cancer.

:The aim of this study

Materials and methods:

• In march 2012 , questionnaire was delivered during routine clinics and lectures to third, fourth and fifth year clinical dental students of six dental schools in Saudi Arabia.

• the survey comprised twenty two questions

:Materials and methods

These questions investigate :• oral mucosal examination habits• knowledge and delivery of advice on risk factors for oral

cancer.• opportunity to examine patients with oral lesions• point of referral selection.• Knowledge of clinical appearance .• opinions on sufficiency of individual knowledge on oral cancer

detection and prevention.• desire for further information/training and the format of such

information/training.

Materials and methods:

. The questionnaire required approximately ten minutes to complete.

• The participating students were made aware that the data would be used for research purposes.

• The study was approved by research center ,Riyadh colleges of dentistry and pharmacy.

• The completed questionnaires were then entered in SPSS version 16 .

• The results have been presented in format of tables and figures. The results were analyzed using the chi square (χ2)

Results:

• The respondents were 212 male represents 55.6% and 169 female represent 44.6% whose

ages ranged from 21 to 25.• The number of respondents from each dental school and sex distribution are shown in this table:

• 480 questionnaires were administrated, and 381 completed, giving response 79.4%

Dental school Male

(n)

Female

(n)

King saud university 35 33

Riyadh colleges 40 35

Dammam university 36 33

King Abdulaziz unv. 33 36

Ibn sena dental school 34 32

King Khalid university 34 0

Total 212 169

Results: • A majority of students 94.5% n=360 examine oral mucosa routinely and they will advise

their patients about risk factor of oral cancer when they graduated .

• only 21.1% ; n=83 of students had opportunity to examine patients with oral lesions. While 78.7 % n=300 have not been observed biopsy during their training .

• responses of students to questions related to awareness and knowledge regarding risk factors of oral cancer (i.e. smoking ,chewing tobacco , heavily and aged over fifty years)as shown in this table:

(NO%) (YES%) RISK FACTOR

21,7 78,2 The age if > 50

21,7 78,2 Smoking Tobacco

2,3 97,6 Chewing Tobacco

Results:• Smoking tobacco and alcohol consumption ( 63.5 %; n=242) were the most

common etiological factors identified by students as shown in this figure:

0

10

20

30

40

50

60

70 63.51

18.37

13.91

4.19

Results:responses of students to questions related to signs of oral cancer are shown

in this table:

NO% Yes% Clinical appearance

24,4 75,5 White patch in patient mouth

37,0 62,9 Ulcer that does not heal

70,8 29,1 Red patch in patient mouth

47,2 52,4 Painless ulcer

Results:• the most common sites of oral cancer that identified by students are shown are

shown in the this figure:

The Tongue

The Floor of mouth

The Palate

The Gingiva

05

101520253035

23.8824.67

17.85 33.85

Results: • The majority dental students selected Oral Medicine and Oral and Maxillofacial

Surgery as the point of referral for a patient with an oral cancer as, shown in this figure:

0204060

11.81

48.03

21.786.56 11.81

Where do you refer a patient if suspected oral cancer

•Approximately 55% of students felt that they don’t have sufficient knowledge concerning and early detection of oral concerning oral cancer .

• they requested further information regarding oral cancer with a seminar being the most popular form of further information .

:DISSCUSTION

• the result of this study confirmed that there are overall deficiency in oral cancer awareness and knowledge amongst undergraduate dental students. This finding was similar to that of previous studies conducted in Nigeria, United Kingdom, Canada and United States 6,7,8,9.

• this study showed that majority of students ( 94.5 percent) examine oral mucosa

routinely. this result similar to previous study in the University of Dundee reported that majority of students (97 percent) examine oral mucosa routinely 10

• research done in Armed forces hospital reported that the tongue is most common site affected by oral malignancy. in this study , the students reported that the most common site is gingiva (33.85 percent) followed by floor of mouth ( 24.7 percent )11.

: DISSCUSTION

• Our study showed that (78.7 percent) of students have not observed biopsy while, previous study showed that (61.5 percent) had observed a biopsy of oral malignant lesions in Nigeria and (79 percent) of students the observed Biopsy during their clinical training in spain12,13.

• The incidence of oral cancer in population of Gizan region of saudi Arabia is estimated to be approximately20%,which is significantly higher than other regions in the kingdome.14

• The role of dental student in Gizan.

Conclusion:• This study showed persistence of a poor level of awareness

regarding oral cancer in the next generation of dental practitioners. This study revealed a need for a more structured teaching program, with increased emphasis on the early signs and symptoms of oral malignancies and increased involvement in examination and biopsies of malignant and premalignant lesions by the students. Preventive activities through educating patients about the risks associated with etiological factors and smoking cessation need to be emphasized in the school curriculum to enable students to help their patients make choices for healthier lifestyles.

References: • 1.Boring CC, Squires TS, Tong T, Montgomery S. Cancer Statistics 1994;44:7–26.

• 2.S al-balawi ,A Nwokku managment of oral cancer in tertiary care hospital. Saudi med 2002 vol .23 (20);156-159

• 3. Johnson NW, Warnakulsuriya KAAS. Epidemiology and Aetiology of Oral Cancer in the United Kingdom. Comm Dent Health. 1993;10:13–29.

• 4.Speight PM, Morgan PR. The Natural History of Oral Cancer and Precancer. Comm Dent Health. 1993;10:31–415.Schnetler JF. Oral Cancer Diagnosis and Delays in Referral. Br J Oral Maxillofac Surg. 1992;30:210–213. doi: 10.1016/0266-4356(92)90262-H

• 5. - Aziza AlMobeerik oral and upper Aero-Digestive Tract Malignancy: A review of five years experience. Annals of Saudi medicine, vol 18, NO 3, 1998.

•6. Schnetler JF. Oral Cancer Diagnosis and Delays in Referral. Br J Oral Maxillofac Surg. 1992;30:210–213. doi: 10.1016/0266-4356(92)90262-H

7 .Carter LM, Ogden GR. Oral cancer awareness of general medical and general dental practitioners. Br Dent J 2007;

8. Uti OG, Fashina AA. Oral cancer education in dental schools: knowledge and experience of Nigerian undergraduate students.J Dent Educ 2006; 70:676–80

9. Clovis JB, Horowitz AM, Poel DH. Oral and pharyngeal cancer: knowledge and opinions of dentists in British Columbia and Nova Scotia. J Can Dent Assoc 2002; 68:415–20 10.laclan m, carter, grham odgen ,oreal cancer awareness among medical and dental students, BMC Med Educ. 2007; 7: 44.

11-Horowitz AM, Goodman HS, Yellowitz JA, Nourjah PA. The need for health promotion in oral cancer prevention and early detection. J public health den 1996 fall 56 (6) :319 -30 12-Chowdhury MT, Pau A, Croucher R. Bangladeshi dental students' knowledge, attitudes and behaviour regarding tobacco control and oral cancer. J Cancer Educ. 2010 Sep;25(3):391-5.13-Winn DM. Epidemiology of cancer and other systemic effects associated with the use of smokeless tobacco Adv Dent Res. 1997 Sep;11(3):313-21