Is detecting oral cancer in general dental practices a realistic expectation? A population-based study using population linked data in Scotland

• Main Authors: Conway, D.I (Author), Gibson, J. (Author), McMahon, A.D (Author), Purkayastha, M. (Author)
• Format: Article
• Language: English
• Published: Nature Publishing Group 2018
• Subjects: early cancer diagnosis; Early Detection of Cancer; Facilities and Services Utilization; general practice; General Practice, Dental; human; Humans; incidence; Incidence; Mouth Neoplasms; mouth tumor; professional practice; Professional Practice Location; register; Registries; Scotland; social class; Social Class
• Online Access: View Fulltext in Publisher

 Introduction Despite the increasing burden of oral cancer (OC) – including oral cavity (OCC) and oropharyngeal cancer (OPC) – it remains a relatively low-volume disease in Scotland, with anecdotal evidence suggesting that dentists only see between one and two cases in their practising careers. Aims To examine, for the first time on a population-basis via data linkage, whether early detection by general dental practices (GDP) is a realistic expectation by i) estimating the number of OC cases/year a dentist in Scotland may encounter over time, accounting for the deprivation level of practice location and dental registration/ attendance rates, and ii) assessing whether patients attended GDPs two years pre-diagnosis. Materials and methods Scottish Cancer Registry data on all OC cases (2010-2012), published NHS Scotland dental workforce and registration/participation statistics, and individual patient data linked with NHS dental service activity were analysed. Results Dentists were estimated to potentially encounter one case of OC every 10 years, OCC every 16.7 years, and OPC every 25 years. However, 53.7% of OC patients had made no dental contact two years pre-diagnosis. Conclusion Strategies for early detection must consider the rarity of OC incidence and poor dental attendance patterns. These results highlight the importance of improving access and uptake of dental services among those at highest risk to increase the opportunities for early detection. © 2018, Nature Publishing Group. All rights reserved.