Katrin Hertrampf

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.

Dentists' perspectives on oral cancer: a survey in Northern Germany and a comparison with international data.

The objective of this study was to assess the knowledge on diagnostic procedures and risk factors for oral cancer among dentists in Northern Germany by means of a standardized questionnaire. A self-administered questionnaire was mailed to all dentists in Schleswig-Holstein, Germany, which was composed of 41 items focusing on knowledge about diagnostic procedures for oral cancer and its main risk factors. Three hundred and six of 2233 questionnaires were returned and analysed. Most dentists correctly agreed that early detection of oral cancer improves 5-year survival. Knowledge of the facts that oral cancer is mostly diagnosed at an advanced stage and that the floor of the mouth is a common site to be affected was higher compared with international data. In contrast, knowledge was lower on the appearance of oral cancer and its symptoms in the early stages. Dentists were less certain about the role of nonrisk factors (e.g. family history) than that of risk factors. Continuous education on oral cancer within the past year was the only background factor that significantly contributed to a better knowledge onrisk-related and diagnostic factors. Profound knowledge about diagnostic procedures and risk factors for oral cancer is essential for dentists. This survey was informative with regard to areas of high versus low knowledge and will help design appropriate continuing education programmes.

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.

The Fifth German Oral Health Study (Fünfte Deutsche Mundgesundheitsstudie, DMS V) – rationale, design, and methods

BackgroundOral diseases rank among the most prevalent non-communicable diseases in modern societies. In Germany, oral epidemiological data show that both dental caries and periodontal diseases are highly prevalent, though significant improvements in oral health has been taking in the population within the last decades, particularly in children. It is, therefore, the aim of the Fifth German Oral Health Study (DMS V) to actualize the data on current oral health status and to gather information on oral health behavior and risk factors. In addition to current oral health monitoring, the study will also permit conclusions about trends in the development of oral health in Germany between 1989 and 2014.Methods/DesignDMS V is a cross-sectional, multi-center, nationwide representative, socio-epidemiological study to investigate the oral health status und behavior of the German resident population in four age cohorts. Study participants are children (12-year-olds), adults (35- to 44-year-olds), young olds (65- to 74-year-olds), and old olds (75- to 100-year-olds) who are drawn from local residents’ registration offices. Social-science investigation parameters concern subjective perceptions and attitudes regarding oral health and nutrition, sense of coherence, and socio-demographic data. Clinical oral parameters are tooth loss, caries and periodontitis, prosthodontic status, further developmental and acquired dental hard tissue and mucosal lesions. To ensure reproducibility, the dental investigators are trained and calibrated by experts and multiple reliability checks are performed throughout the field phase. Statistical analyses are calculated according to a detailed statistical analysis plan.DiscussionThe DMS studies first performed in 1989, 1992 and repeated in 1997 and 2005 are the only cross-sectional oral health studies conducted in Germany on a population-based national representative level. Updated prevalence and trend analyses of key oral diseases are, therefore, of major epidemiological and health services research interest.Trial registrationGerman Health Services Research Data Bank VfD_DMSV_13_002152

Knowledge of diagnostic and risk factors in oral cancer: Results from a large-scale survey among non-dental healthcare providers in Northern Germany

INTRODUCTION A survey was conducted to assess the level of knowledge on oral cancer among different medical fields, in particular about diagnostic items and risk factors. MATERIAL AND METHODS A self-administered questionnaire was mailed to physicians from various fields, such as otorhinolaryngology, general practice, internal medicine, and dermatology. RESULTS 388 of the 2,952 questionnaires were returned (13.1%), subdivided into otorhinolaryngology (n = 33), internal medicine (n = 135), dermatology (n = 28), and general practice (n = 192). The average knowledge of risk factors was similar in the specialisations, ranging from 68% for internal medicine to 76% for otorhinolaryngology and 77% for dermatology. The three main risk factors: tobacco (93%-100%), alcohol (79%-100%), and prior oral cancer lesions (91%-100%) were the most commonly known. Regarding the diagnostic items, the average percentage of correct answers ranged from 69% for internal and general medicine to 77% for dermatologists. Continuous courses of education and the year of graduation were the only two variables that significantly related to a better level of knowledge of risk factors and diagnostic items. CONCLUSIONS The average knowledge among the different medical fields was satisfying. These results demonstrated a robust base for all healthcare providers to continue working together to improve the early detection of oral cancer.

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.