In a nationwide project to fight oral cancer through prevention and early detection, the National Cancer Institute has awarded $1.2 million to researchers at the University of California, San Francisco School of Dentistry to create a program of oral cancer prevention in collaboration with the American Dental Association (ADA).
Oral cancer strikes more than 30,000 Americans and accounts for more than 9,000 deaths each year in the U.S. Despite advances in oral cancer treatment, only about one-half of all persons diagnosed with the disease survive more than five years.
“Early detection is the most important approach in decreasing the morbidity and mortality of oral cancer,” said Sol Silverman, Jr., DDS, UCSF professor of oral medicine and principal investigator of the five-year project. Silverman is a consultant to the ADA Council on Access, Prevention and Interprofessional Relations and a pioneer and expert in oral cancer education, patient care and research.
The UCSF researchers will develop and implement a continuing education program focusing on oral cancer prevention education for practicing dentists in the U.S. Key components will include risk assessment and risk reduction for tobacco and alcohol use, chemoprevention, early detection and diagnosis.
Data indicate that the majority of at-risk Americans do not benefit from oral cancer screening from their primary care professionals, and survival rates have not significantly changed in the past 20 years, according to Silverman.
The plan is to increase dentists’ skills in early detection of oral cancer because, thus far, this is the most important approach in decreasing morbidity and mortality of oral cancer.
Barbara Gerbert, PhD, UCSF professor and chair of the division of behavioral sciences, is principal investigator of the UCSF portion of the project, working with Silverman and the ADA to evaluate the educational program by surveying dentists before, immediately after and six months after participating in the program. Gerbert has conducted extensive research in the field of evaluating health care providers’ knowledge, attitudes and behaviors, with particular emphasis on ways to support the provider’s risk assessment and intervention activities.
A recent study in the American Journal of Public Health (June, 2002) confirmed that many dentists frequently neglect to ask patients about their tobacco use; however, more than 95 percent of surveyed dentists said they were willing to receive training in tobacco cessation services. Improving the dentists’ screening and smoking cessation skills could greatly increase smoking cessation, according to the researchers. “More than half of all tobacco users visit the dentist at least once a year, and patients in the 20 to 44-year-old age group are more likely to visit a dentist than a physician,” Gerbert said.
“Many patients want help quitting tobacco use,” Gerbert explained. “Dentists have an excellent opportunity to screen and counsel patients as well as provide a number of effective resources. This project will prepare dentists to become a more significant part of our overall efforts to fight tobacco and its health effects,” she said.
During the first year of the project, investigators will formulate the course and materials, train educators to present the course and develop the outcome assessment tools. In the fall of 2003, the courses will be presented to dentists nationwide.
This project will also explore the potential use of the standardized continuing education program for other health care professionals, for instance, dental hygienists, nurse practitioners and primary care physicians.
Key collaborators on the grant include Dale Danley, MPH, UCSF analyst; Stuart Gansky, DrPH, UCSF assistant professor of preventive and restorative dental sciences; Jane McGinley, RDH, MBA, manager of preventive health activities for the ADA; and K. Vendrell Rankin, DDS, associate professor of public health sciences, Baylor College of Dentistry.