Hans-Jürgen Wenz

Quality of life in oral cancer patients--effects of mandible resection and socio-cultural aspects.

INTRODUCTION The aim of this study was to assess the postoperative quality of life in oral cancer patients depending on different mandible resection types and to collect information about their socio-cultural situation. MATERIAL AND METHODS In this cross-sectional study, patients with primary oral cancer treated with different types of mandibular resection in the Clinic of Oral and Maxillofacial Surgery at the University of Kiel between 1997 and 2007 were included. Quality of life was assessed by means of the EORTC QLQ-C30 and H&N 35 questionnaires. Furthermore, a questionnaire about the socio-cultural background of the patients was applied. To be included, at least one year had to be passed after tumour resection. RESULTS 111 of 235 questionnaires were returned (47%). Significant differences in quality of life were found between patients with soft tissue resections and bone resections. There were significant worse values for continuity resections compared to only partial resections. Sixty-seven patients (60.4%) had a graduation of an elementary school as the highest school graduation, four patients (3%) had no school graduation. CONCLUSIONS The postoperative quality of life in our patients was significantly influenced by the extent of bone resection. This should be considered for surgical planning. The socio-cultural data showed a rather low education level for the majority of the patients.

Public awareness about prevention and early detection of oral cancer: A population-based study in Northern Germany

INTRODUCTION This study investigated the knowledge about oral cancer in a representative population sample of the state of Schleswig-Holstein, Germany. MATERIAL AND METHODS A representative survey (n=1000) was carried out by means of computer-aided phone interviews among the population of Schleswig-Holstein. Descriptive statistics of demographic variables and responses to the questionnaires were reported by means of counts and percentages. Knowledge about diagnostic items and risk factors was further analysed for socioeconomic factors. RESULTS 66% of the sample was aware that oral cancer lesions are most often diagnosed at an advanced stage. Only 20-40% knew the two most common sites. More than 70% identified tobacco consumption and a prior oral cancer lesion as risk factors, consumption of alcohol and older age were identified by about 50%. The detailed analysis showed a relationship between a low level of knowledge and certain socioeconomic factors, e.g. older age, low level of education and employment. CONCLUSIONS This survey highlighted a general lack of public awareness about signs and symptoms of oral cancer and its risk factors. A low level of knowledge was associated with a low level of certain socioeconomic factors. These results should have implications for the design of a state-wide public awareness campaign.

Baseline data of oral and pharyngeal cancer before introducing an oral cancer prevention campaign in Germany

OBJECTIVES Oral and pharyngeal cancer is still a serious health problem with an annual incidence of about 13,000 in Germany. This study aimed at describing trends of incidence and mortality in Germany by age, sex, and sub-site as a baseline for an oral cancer prevention campaign. METHODS Using data from the National Association of Population-based Cancer Registries, incidence rates for oral and pharyngeal cancer (ICD-10, C00-C14) from 2003 to 2011 and mortality rates from 1990 to 2012 were analysed by age, sex, and sub-site (C00-C06, C07-C08, C09-C14). Trends were described by annual percentage changes. RESULTS Men are 2.5-times more likely than women to be diagnosed and 3-times more likely to die from this tumour. Incidence and mortality in women increased slightly during the last decade, while incidence and mortality in men remained stable at a high level. While a decline was observed for younger age groups, an increase was seen in the elderly. For some sub-sites a deviation from this overall pattern was observed. CONCLUSIONS The decrease in this tumour in younger age groups is pleasing and may be attributed to public efforts in non-smoker protection in recent years. Further efforts are needed to counteract the increasing burden of disease in older age groups and in men.

Exploratory Research Focusing on Oral Cancer Prevention: Challenges of Dealing With Informational and Cognitive Barriers

Oral cancer is a considerable public health problem, and a low level of awareness and knowledge about this tumor and its risk factors is prevalent. To gain a profound understanding of risks groups and to identify suitable communication strategies for a prevention campaign in Northern Germany, an exploratory research was realized. In semistructured face-to-face interviews, the participants of the study (n = 28) described their individual oral cancer-related perceptions and information-seeking behaviors. A computer-assisted qualitative data analysis showed a vague but also deterring picture of cancer combined with restricted attitudes toward the topic and an inactive or even avoiding information behavior. Four underlying cognitive patterns of self-distancing were identified: (a) optimistic bias, (b) fatalism, (c) hedonism, and (d) pragmatism. The main challenge of oral cancer prevention is to deal with the target groups’ informational and cognitive barriers.