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Head & Neck Cancer: Current Perspectives, Advances, and Challenges pp 73–86Cite as

Challenges in Community-Based Head and Neck Cancer Prevention Programs

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Abstract

The most promising opportunities for improving both prevention and early detection of cancers of the oral cavity and oropharynx lie in community-based programs to promote routine risk assessment and counseling and regular oral examinations in at-risk populations. The communities in which interventions are needed include both the at-risk populations themselves and also the clinicians who deliver health care to them. The former are generally not well informed about either risks or early detection, and the latter are neither adequately trained nor sufficiently attentive to the need for early detection in their patients. This chapter describes community-based intervention programming in practical terms. It identifies barriers to prevention and early detection, and describes community-based intervention strategies that are designed to overcome those barriers. Many of the challenges are not unique to oral cancers. These include general problems of adherence to practice recommendations for prevention and early detection of various diseases. Such problems are associated with lack of awareness, lack of access to adequate care, and conflicting priorities. Some other challenges are somewhat unique to oral cancers: relatively low concern for oral health as opposed to systemic health, limited access to oral health services, multiple signs and symptoms associated with oral cancers (many of which mimic other ailments such as infections), and associations between oral cancer incidence and patient risk profiles that compound access issues and lead to numerous other health care problems or co-morbidities which may either take precedence or simply mask the presence of oral cancers.

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Abbreviations

HPV:

human papillomavirus

US:

United States

PLANET:

plan, link, network with evidence-based tools

LED:

light emitting diode

References

  1. Elwood JM, Sutliffe SB (2010) Cancer control and the burden of cancer. In: Elwood JM, Sutliffe SB (eds) Cancer control. Oxford University Press, New York, pp 3–19

    Google Scholar 

  2. Israel BA, Schulz AJ, Parker EA et al (2003) Critical issues in developing and following community based participatory research principles. In: Minkler M, Wallerstein N (eds) Community-based participatory research for health. Jossey-Bass, San Francisco

    Google Scholar 

  3. American Cancer Society (2012) Oral cavity and oropharyngeal cancer. Retrieved 9 Apr 2012, from: http://www.cancer.org/Cancer/OralCavityandOropharyngealCancer/DetailedGuide

  4. Thompson B, Kinne S (1999) Social change theory: applications to community health. In: Bracht N (ed) Health promotion at the community level: 2 new advances. Sage, Thousand Oaks, pp 29–46

    Chapter  Google Scholar 

  5. Wallerstein N, Duran B (2003) The conceptual, historical, and practice roots of community based participatory research and related participatory traditions. In: Minkler M, Wallerstein N (eds) Community-based participatory research for health. Jossey-Bass, San Francisco

    Google Scholar 

  6. Goodman RM, Steckler A (1989) A model for the institutionalization of health promotion programs. Fam Community Health 11:63–78

    Article  Google Scholar 

  7. Sarriott EG, Winch PJ, Ryan LJ, Edison J, Bowie J, Swedberg E, Welch R (2004) Qualitative research to make practical sense of sustainability in primary health care projects implemented by non-governmental organizations. Int J Heal Plan Manag 19:3–22

    Article  Google Scholar 

  8. Thompson JD (1967) Organizations in action. McGraw-Hill, New York

    Google Scholar 

  9. Rogers EM (2003) Diffusion of innovations, 5th edn. The Free Press, New York

    Google Scholar 

  10. National Cancer Institute. SEER stat fact sheets: oral cavity and pharynx. Retrieved 13 Apr 2012 from: http://seer.cancer.gov/statfacts/html/oralcav.html#references

  11. Rothman AJ (2004) Is there nothing more practical than a good theory?”: why innovations and advances in health behavior change will arise if interventions are used to test and refine theory. Int J Behav Nutr Phys Act 1:11

    Article  PubMed  Google Scholar 

  12. Downey SM, Wages J, Jackson SF, Estabrooks PA (2012) Adoption decisions and implementation of a community-based physical activity program: a mixed methods study. Heal Promot Pract 13(2):175–182

    Article  Google Scholar 

  13. Kretzmann JP, McKnight JL (1993) Building Communities from the Inside out: a path toward finding and mobilizing a community’s assets. Acta, Chicago

    Google Scholar 

  14. Rissel C, Bracht N (1999) Assessing community needs, resources, and readiness: building on strengths. In: Bracht N (ed) Health promotion at the community level: 2 new advances. Sage, Thousand Oaks, pp 59–71

    Chapter  Google Scholar 

  15. Glanz K, Rimer BK, Lewis FM (eds) (2002) Health behavior and health education, theory, research and practice, 3rd edn. Jossey-Bass, San Francisco

    Google Scholar 

  16. Pitiphat W, Diehl SR, Laskaris G, Cartsos V, Douglass CW, Zavras AI (2002) Factors associated with delay in the diagnosis of oral cancer. J Dent Res 81:192–197

    Article  PubMed  CAS  Google Scholar 

  17. de Boer MF, Sanderson RJ, Damhuis RAM, Meeuwis CA, Knegt PP (1997) The effects of alcohol and smoking upon the age, anatomic sites and stage in the development of cancer of the oral cavity and oropharynx in females in the south west Netherlands. Eur Arch of Otorhinolaryngol 254:177–179

    Article  Google Scholar 

  18. Kowalski LP, Franco EL, Torloni H, Fava AS, Sobrinho JA, Ramos G et al (1994) Ateness of diagnosis of oral and oropharyngeal carcinoma: factors related to the tumour, the patient and health professionals. Eur J Cancer B Oral Oncol 30B:167–173

    Article  PubMed  CAS  Google Scholar 

  19. Elwood JM, Gallagher RP (1985) Factors influencing early diagnosis of cancer of the oral cavity. Can Med Assoc J 133:651–656

    CAS  Google Scholar 

  20. Allison P, Franco E, Black M, Feine J (1998) The role of professional diagnostic delays in the prognosis of upper aerodigestive tract carcinoma. Oral Oncol 34:147–153

    Article  PubMed  CAS  Google Scholar 

  21. Wildt J, Bundgaard T, Bentzen SM (1995) Delay in the diagnosis of oral squamous cell carcinoma. Clin Otolaryngol 20:21–25

    Article  PubMed  CAS  Google Scholar 

  22. Flamant R, Hayem M, Lazar P, Denoix P (1964) Cancer of the tongue: a study of 904 cases. Cancer 17:377–385

    Article  PubMed  CAS  Google Scholar 

  23. Franco EL, Dib LL, Pinto DS, Lobardo V, Contesini H (1993) Race and gender influences on the survival of patients with mouth cancer. J Clin Epidemiol 46:37–46

    Article  PubMed  CAS  Google Scholar 

  24. Alonge OK, Narendran S (2004) Oral cancer knowledge and practices of dentists along the Texas-Mexico border. J Cancer Educ 19(1):6–11

    Article  PubMed  Google Scholar 

  25. Cruz GD, Ostroff JS, Kumar JV, Gajendra S (2005) Preventing and detecting oral cancer: oral health care providers’ readiness to provide health behavior counseling and oral cancer examinations. J Am Dent Assoc 136(5):594–601

    PubMed  Google Scholar 

  26. Patton LL, Elter JR, Southerland JH, Strauss RP (2005) Knowledge of oral cancer risk factors and diagnostic concepts among North Carolina dentists: implications for diagnosis and referral. J Am Dent Assoc 136(5):602–610

    PubMed  Google Scholar 

  27. Silverman S (2005) Controlling oral and pharyngeal cancer: can dental professionals make a difference? J Am Dent Assoc 136(5):576–577

    PubMed  Google Scholar 

  28. LeHew CW, Kaste LM (2007) Oral cancer prevention and early detection practices of Illinois dentists. J Pub Health Dent 67(2):89–93

    Article  Google Scholar 

  29. LeHew CW, Epstein JB, Kaste LM, Choi YK (Spring 2010) Assessing oral cancer early detection: clarifying dentists’ practices. J Pub Health Dent 70(2):93–100

    Google Scholar 

  30. Epstein JB, Sciubba JJ, Banasek TE, Hay LJ (2009) Failure to diagnose and delayed diagnosis of cancer: medicolegal issues. J Am Dent Assoc 141:1494–1503

    Google Scholar 

  31. Mashberg A (2000) Diagnosis of early oral and oropharyngeal squamous carcinoma: obstacles and their amelioration. Oral Oncol 36:253–255

    Article  PubMed  CAS  Google Scholar 

  32. Brown E, Manski R (2004) Dental services: use, expenses, and sources of payment, 1996–2000. MEPS research findings no. 20. AAHRQ publication no 04–0018. Agency for Healthcare Research and Quality, Rockville, MD

    Google Scholar 

  33. Netuveli G, Sheiham A, Watt RG (2006) Does the ‘inverse screening law’ apply to oral cancer screening and regular dental check-ups? J Med Screen 13:47–50

    Article  PubMed  Google Scholar 

  34. Drilea SK, Reid BC, Li C, Hyman JJ, Manski RJ (2005) Dental visits among smoking and nonsmoking US adults in 2000. Am J Health Behav 29(5):62–471

    Article  Google Scholar 

  35. Epstein JB, Gorsky M, Cabay RJ, Day T, Gonsalves W (2008) Screening for and diagnosis of oral premalignant lesions and oropharyngeal squamous cell carcinoma: role of primary care physicians. Can Fam Physician 54:870–875

    PubMed  Google Scholar 

  36. LeHew CW, Epstein JB, Koerber A, Kaste LM (2009) Pilot study of the impact of oral cancer prevention and early detection training on medical clinicians’ perceptions and intentions. Ear Nose Throat 88(1):748–753

    Google Scholar 

  37. Daley E, Debate R, Dodd V, Smith S, Helmy H, Dyer K, Fuhrmann H (2011) Exploring awareness, attitudes and perceived roles among oral health providers regarding HPV-related oral cancers. J Pub Health Dent 71(2):136–142

    Article  Google Scholar 

  38. McAvoy BR, Kaner EFS, Lock CA, Heather N, Gilvarry E (1999) Our Healthier Nation: are general practitioners willing and able to deliver? A survey of attitudes to and involvement in health promotion and lifestyle counseling. Br J Gen Pract 49:187–190

    PubMed  CAS  Google Scholar 

  39. Laws RA, Kemp LA, Harris MF, Davies GP, Williams AM, Eames-Brown R (2009) An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study. Implement Sci [On-line] 4:66

    Article  Google Scholar 

  40. Jepson RG, Harris FM, Platt S, Tannahill C (2010) The effectiveness of interventions to change six health behaviours: a review of reviews. BMC Pub Health [On-line] 10:538

    Article  Google Scholar 

  41. Brocklehurst P, Kujan O, Glenny AM, Oliver R, Loan P, Ogedn G, Shepherd S (2010) Screening programmes for the early detection and prevention of oral cancer. Cochrane Database of Systematic Reviews, Issue 11. Art. No.: CD004150. doi: 10.1002/14651858.CD004150.pub3

  42. Miller A (2010) Early diagnosis and screening in cancer control. In: Elwood JM, Sutliffe SB (eds) Cancer control. Oxford University Press, New York, pp 63–77

    Google Scholar 

  43. Rethman MP, Carpenter W, Cohen EEW, Epstein J et al (2010) Evidence-based clinical recommendations regarding screening for oral squamous cell carcinomas. J Am Dent Assoc 141:509–520

    PubMed  Google Scholar 

  44. Lingen MW (2008) Critical evaluation of diagnostic aids for the detection of oral cancer. Oral Oncol 44(1):10–22

    Article  PubMed  Google Scholar 

  45. Attner P, Du J, Nasman A et al (2009) The role of human papillomavirus in the increased incidence of base of tongue cancer. Int J Cancer 126:2879–2884

    Google Scholar 

  46. Auluck A, Hislop G, Bajdik C et al (2010) Trends in oropharyngeal and oral cavity cancer incidence of human papillomavirus (HPV)-related and HPV-unrelated sites in a multicultural population: the British Columbia experience. Cancer 116:2635–2644

    PubMed  Google Scholar 

  47. Ernster JA, Sciotto CG, O’Brien MM et al (2007) Rising incidence of oropharyngeal cancer and the role of oncogenic human papilloma virus. Laryngoscope 117:2115–2128

    Article  PubMed  Google Scholar 

  48. Nasman A, Attner P, Hammarstedt L et al (2009) Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: an epidemic of viral-induced carcinoma? Int J Cancer 125:362–366

    Article  PubMed  Google Scholar 

  49. Chaturvedi AK, Engels EA, Anderson WF et al (2008) Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 26:612–619

    Article  PubMed  Google Scholar 

  50. Sturgis EM, Cinciripini PM (2007) Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer 110:1429–1435

    Article  PubMed  Google Scholar 

  51. Brown LM, Check DP, Devesa SS (2011) Oropharyngeal cancer incidence trends: diminishing racial disparities. Cancer Causes Control 22:753–763

    Article  PubMed  Google Scholar 

  52. Yu GP, Mehta V, Branovan D et al (2012) Improved survival among patients with base of tongue and tonsil cancer in the United States. Cancer Causes Control 23:153–164

    Article  PubMed  Google Scholar 

  53. Ang KK, Harris J, Wheeler R et al (2010) Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 363:24–35

    Article  PubMed  CAS  Google Scholar 

  54. Fakhry C, Westra WH, Li S et al (2008) Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 100:261–269

    Article  PubMed  CAS  Google Scholar 

  55. Putnam RD, Feldstein LM (2003) Better together: restoring the American community. Simon & Schuster, New York

    Google Scholar 

  56. Sarason SB, Lorentz EM (1998) Crossing boundaries: collaboration, coordination, and the redefinition of resources. Jossey-Bass Publishers, San Francisco

    Google Scholar 

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Authors and Affiliations

  1. College of Dentistry, Cancer Center, and Institute for Health Research and Policy, University of Illinois, 1747 W. Roosevelt Road, Room 558, Chicago, IL, 60608, USA

    Charles W. LeHew

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  1. Charles W. LeHew
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Correspondence to Charles W. LeHew .

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  1. S Paulina St 801, Chicago, 60612, USA

    James A. Radosevich

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LeHew, C.W. (2013). Challenges in Community-Based Head and Neck Cancer Prevention Programs. In: Radosevich, J. (eds) Head & Neck Cancer: Current Perspectives, Advances, and Challenges. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5827-8_4

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