Volume 2 Issue 1 ISSN:
Assessment of Awareness and Knowledge of Oral Cancer Among Dental Students in Faisalabad Medical University
Maleeha Naseer1, Saneela Mamoon2, Sana Mehmood Qureshi3, Omer Sefvan Janjua4, Muhammad Hammad*, Saad Hameed5.
1 House Officer in PMC Dental Institute, Faisalabad Medical University, Faisalabad 38000, Pakistan
2 House Officer in PMC Dental Institute, Faisalabad Medical University, Faisalabad 38000, Pakistan
3 Department of Oral and Maxillofacial Pathology, PMC Dental Institute, Faisalabad Medical University, Faisalabad 38000, Pakistan
4,5, Department of Oral and Maxillofacial Surgery, PMC Dental Institute, Faisalabad Medical University, Faisalabad 38000, Pakistan
*Corresponding Author: Dr. Muhammad Hammad BDS, FCPS Resident., Department of Oral and Maxillofacial Surgery, PMC Dental Institute, Faisalabad Medical University, Faisalabad 38000, Pakistan.
Received Date: November 28, 2020
Publication Date: January 01, 2021
Statement of novelty: Study done first time, never done before in our setup and it will add to the knowledge of readers.
Conflict of Interest: None to declare.
Setting: The study was conducted in the department of Oral and Maxillofacial surgery, Allied Hospital Faisalabad.
Abstract
Background: Oral cancer is one of the leading causes of death and disability in the subcontinent. Early detection will surely decrease its mortality rate.
Setting: The study was conducted among Dental students of Faisalabad Medical University.
Methods and materials: A descriptive cross-sectional questionnaire-based study was conducted in students attending the 2nd year, 3rd year and final year BDS classes in Faisalabad Medical University to assess the knowledge of oral cancer. The questionnaire was distributed among all the students electronically after obtaining willingness. Data were then analyzed using SPSS version 20.
Results: A total of 125 dental students took part in the study. Females were one hundred (80%) and males were twenty-five (20%). 82% of students agreed that family history plays an important role in oral malignancy. Regarding risk factors, 96% of the students could identify the use of tobacco as a real risk factor for oral cancer. Only 61.6% identified old age as a risk factor, 58.4% of students said that low consumption of fruits and vegetables is a risk factor, 63.2% knew that lip cancer related to sun exposure and 87.2% could correctly identify the use of alcohol as a risk factor for oral cancer.72% of students agreed that they know treatment options and 38.0% know of early detection and the opinion changes from the second year to final year.
Conclusion The basic knowledge of the students about oral cancer is not adequate to prevent and treat this disease. So, it is necessary to improve the dental student's knowledge about oral cancer.
Keywords Awareness, Knowledge, Oral Cancer, Dental Students.
Assessment of Awareness and Knowledge of Oral Cancer Among Dental Students in Faisalabad Medical University
Introduction
The incidence of oral cancer is rising in many countries, especially in developing countries (1) . Oral cancer is a malignant neoplasm arising from the squamous epithelium of the oro-pharyngeal region, hence termed Oral Squamous Cell Carcinoma (OSCC).(2) OSCC includes cancer of the lips, tongue, cheeks, floor of the mouth, alveolus and hard and soft palate.
Some studies have shown the prevalence of OSCC to be at sixth position among all malignancies (3) whereas a study reported it to be the 10th most common among men. (4) Asian countries like India, Pakistan, Bangladesh and Sri Lanka are considered as the flag bearers (25 % new cases every year) in the world of cancer. (3) One of the dreadful aspects of oral cancer is that in its initial stages, it is disguised as normal tissue. It goes unrecognized, being painless with minimal physical alterations. Later on, it may progress from spots, crusts, thick eroded and rough areas to velvety (white /red) fragments. It may become associated with unexplained bleeding, lethargy, insensibility in any of the affected areas. (5)
An understanding of the etiological factors will be helpful in the prevention of this malignant disease. Alcohol consumption and tobacco use in all its forms (cigarettes, cigars and pipe smokers) are considered prime carcinogens. (6) Physical factors that notably enhance the chances of cancer include exposure to ultraviolet radiation and x-rays. Some strains of human papillomavirus (HPV) are also implicated in cancer development. (7) Excessive sun exposure and genetic predisposition are also considered as factors. (8)
Although SCC can easily be diagnosed in routine oral examinations, lack of awareness of doctors compounded by patient’s negligence and ignorance, results in delayed recognition of cancer, resulting in poor prognosis. Patients who are diagnosed in the early stages have better survival rates with little post-treatment disfigurement. It increases the quality of life and lowers treatment costs but this requires vigilance on behalf of doctor and patient, thus necessitating proper training to the dental students regarding oral cancer (9-10).
American Dental Association Centre for Disease Control and Prevention in 1996 and the National Institute of Dental Research/National Institutes of Health, stated that health care professionals should know about oral cancer, its risk factors, sign and symptoms and they should also know how to perform an oral cancer examination in a patient. (11)
Thus, the rationale of our research was to assess the knowledge and awareness of oral malignancy among dental students of Faisalabad Medical University. The results of the study can help the faculty in planning and amending the dental curriculum of the university so that students can understand the concepts related to OSCC in a better way and this will ultimately be beneficial for patients suffering from OSCC.
Material and Methods
In February 2020, a cross-sectional questionnaire-based study was conducted among the dental students who were attending the 2nd year, 3rd year, and final year BDS at Faisalabad Medical University. A total of 125 students were enrolled in the study including 2nd year, 3rd year, and final year. A specially designed questionnaire was developed and distributed among students electronically. The questionnaire consisted of 10 questions to assess basic knowledge and awareness about oral cancer prevention, risk factors, early detection and referral of oral cancer patients by dentists. The first six questions comprised of yes or no questions, the next four were multiple-choice questions. Students have explained the purpose of the study. Willingness was obtained from all the participants. The results were entered in SPSS version 20 for statistical analysis. The responses were coded as numeric values to facilitate the data entry and analysis and association was observed between different classes of dental students using the Chi-square test. At least a 95% level of significance (p<0.05) was considered significant.
Results
The total participants were one hundred and twenty-five (125). There were one hundred females (80%) and twenty-five males (20%). The response rate was 100%. Out of 125 respondents, the second-year students were 37 (29.6%), the third year were 42 (33.6%) and the final year was 46 (36.8%).
The frequencies and percentages of the various variable have been depicted in Table 1(Figure 1, 2). The responses vary significantly from the second year, third year and final year students.
Discussion
Early identification of oral and oropharyngeal cancer is very important to ensure better survival rates (12). It is of crucial importance that undergraduate dental students grasp adequate information concerning early identification and referral of carcinoma patients. Our study reports the knowledge of oral cancer among undergraduate dental students of Faisalabad Medical University.
In our study, 65% of students agreed that family history plays an important role in oral cancer which is comparable to 61% as reported by Gaddikeri et al (13) but they are less than findings reported by Kumar and Harshini (97%) (14) and Soares et al (75%) (15)
Regarding risk factors, 96 % of students reported tobacco as a risk factor is similar to studies done by Chan et al (98%) (16), Soares at el (92%) (15) and Hamdy et al (95%) (17) while a study conducted by Rahman et al reported it to be 83% (18). 87% of students reported alcohol as a risk factor similar to findings in a study done by Soares et al (84%) (15) but less than studies reported by Chan et al (92.7%) (16), 58% of the students identified low consumption of fruit and vegetables as a potential risk factor. Some workers have reported a lower risk of oral cancer with a higher intake of fruits and vegetables. (19) Dental students should be informed about the protective role of fruit and vegetables in OSCC.
Furthermore, 72% of participants were aware of the treatment modalities for the management of oral cancer which is similar to the study done by Gaddikeri et al (77%). (13) A study by Kumar and Harshini showed slightly more awareness among the dental students (84%) (14) Perhaps more clear guidelines and protocol on management of oral cancer should be taught in the dental school which will help in early diagnosis of disease and turn good prognosis.
Our results showed that the majority of the students knew that the early detection of oral cancer improves survival rate (92%). 88% contemplated that SCC is the most common oral cancer and these findings are consistent with the study by Chan et al (88%) (16)
In our study, only 36.8 % of students felt that they had sufficient knowledge which is less than studies reported by Hamdy et al (61%) (17) which signifies that there is an increased need for undergraduate dental students to be educated regarding etiology, risk factors, diagnosis and management of oral cancer.
The knowledge of oral cancer should be instilled upon the dental students during their course of study and the majority of our dental students agreed to it (92.8%). This is very much by studies conducted by Kumar and Harshini (96% ) (14) and Hamady et al (80%) (17).
Lack of awareness revealed that our students failed to recognize the importance of site involvement. The tongue is the most common site for oral malignancy (20) but the majority of our respondents were not aware of this fact (72%). This should be taken into consideration that 73-74% population of the other surveys (Uti et al and Chan et al) (21-16) identified the tongue as the most common site.
Lastly, referral to oral and maxillofacial surgeons (omfs) was the most preferred choice (58.4%) by students when they suspect a patient with oral cancer. This is analogous to the findings of Kolenko et al who found that omfs was the most frequently selected point of referral (55%) (22). such preference can be explained by the availability of separate oral and maxillofacial department at Faisalabad Medical University.
Conclusion
The basic knowledge of the students about oral cancer is not adequate to cure as well as prevent this appalling disease. About one-third of the population considered their knowledge of oral cancers adequate. More than 90% of the students wanted to get more knowledge so this entails the necessity to improve dental student's knowledge about oral cancer via upgrading theoretical and practical curricula, thus they can help the patients to stop smoking tobacco and alcohol and contribute to oral cancer prevention. Morbidity and mortality can be reduced if future dentists have adequate working knowledge of oral cancer.
References
Volume 2 Issue 1 January 2021
©All rights reserved by Dr. Muhammad Hammad
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