Self-awareness of premalignant oral lesions among veterans attending six U.S. Veterans Affairs Medical Centers |
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| Authors: | Diane C Shugars DDS MPH PhD; Margo Adesanya DDS; Scott R Diehl PhD; Robert S Redman DDS MSD PhD; Kevin J Malley DDS; Rebeka G Silva DDS; Sam E Farish DDS; Thomas Francis DDS; Robert M Craig DDS; Trina Jones-Richardson DDS; C Richard Buchanan DDS; Ruth Jordan Amit Chattopadhyay DDS PhD; Deborah E Winn PhD |
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| Institution: | Departments of Dental Ecology (School of Dentistry) and Microbiology and Immunology (School of Medicine), University of North Carolina at Chapel Hill, N.C.;Division of Population and Health Promotion Sciences, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Md.;Department of Oral Biology and Center for Pharmcogenomics and Complex Disease Research, University of Medicine and Dentistry of New Jersey, Newark, N.J.;Department of Veterans Affairs Medical Centers;50 Irving Street NW, Washington, D.C.;1900 E. Main Street, Danville, Ill.;4150 Clement Street, San Francisco, Calif.;1670 Clairmont Road, Decatur, Ga.;508 Fulton Street, Durham, N.C.;7400 Merton Minter Boulevard, San Antonio, Texas;Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, D.C.;Johnston, Zabor, McManus, Inc., Research Triangle Park, N.C.;Department of Epidemiology, University of Kentucky College of Public Health, Lexington, Ky;Clinical and Genetic Epidemiology Research Branch, Division of Cancer Control and Population Studies, National Cancer Institute, Bethesda, Md. |
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| Abstract: | Early identification is key to reducing the morbidity and mortality of oropharyngeal cancer. This study identified factors associated with self-awareness among patients newly diagnosed with a premalignant oral lesion. Data describing sociodemographics, medical/dental histories, tobacco/alcohol use and oral health were obtained by questionnaire and clinical examination of 73 veterans at six U.S. Veterans Affairs Medical Centers. Lesion types included homogenous and non-homogenous leukoplakia, smokeless tobacco lesion (STL), papilloma, lichen planus and erythroplakia. Prior to diagnosis, 29 subjects (39.7%) were unaware of their lesion. In bivariate analyses, lesion self-awareness was associated with anatomic location, multifocal/generalized appearance, pain, oral sores, and cigar use (p<0.05). Awareness varied with lesion diagnosis and was more likely with STL and less likely with homogenous leukoplakia (p<0.05). In multivariate analyses, awareness was predicted by the presence of a lesion on easily visible mucosa (adjusted odds ratio, OR=11.2) and a history of mouth sores (OR=11.2). These findings identified marked variations in patient self-awareness of oral premalignant conditions. |
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| Keywords: | oral cancer oropharynx awareness premalignant conditions oral leukoplakia oral ulcer |
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