As
early detection of oral cancers is associated with better survival,
oral cancer screening should be included in dental visits for adults.
This study examines the rate and predictors of oral cancer screening
exams among U.S. adults with a recent dental visit.
Methods
Individuals
aged ≥30 years who received a dental visit in the last 2 years, in the
2011–2016 National Health and Nutrition Examination Survey were analyzed
in December 2018. Weighted multivariable logistic regression models
examined the likelihood of intraoral and extraoral oral cancer screening
exams, adjusting for age, sex, race/ethnicity, education, marital
status, poverty income ratio, health insurance, tobacco smoking, and
alcohol consumption. Subgroup analyses were conducted among
races/ethnicities, smokers, and alcohol consumers. Statistical
significance was set at p<0 .01.="" p="">
Results
A
total of 37.6% and 31.3% reported receiving an intraoral and extraoral
oral cancer screening exam, respectively. Minority racial/ethnic groups
versus white, non-Hispanics, less-educated versus more-educated,
uninsured and Medicaid-insured versus privately insured, and low-income
versus high-income participants were less likely to have received
intraoral or extraoral oral cancer screening exams. There was no
difference in the likelihood of being screened based on smoking status.
Alcohol consumers were more likely to be screened. Among subgroups,
less-educated and low-income individuals were less likely to be
screened.
Conclusions
A
significantly higher proportion of minority race/ethnicity and low SES
individuals report not receiving an oral cancer screening exam, despite a
recent dental visit. This selective screening by dental professionals
is incompliant with guidelines and concerning because these groups are
more likely to present with an advanced stage of oral cancer at
diagnosis. An understanding of the reasons for discriminatory oral
cancer screening practices could help develop effective interventions.
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