Maria Teresa Canto

Oral cavity and pharynx cancer incidence rates in the United States, 1975-1998 §

To identify subgroups of oral cavity and pharynx (OCP) cancers that may be etiologically distinct, we evaluated age-adjusted incidence rates by histologic type, anatomical site, race, and sex using cases diagnosed during 1975-1998 in nine US Surveillance, Epidemiology, and End Results (SEER) program registries. Male/female rate ratios were about one for adenocarcinoma (AC), three or more for squamous cell carcinoma (SCC), and undetermined for Kaposis sarcoma (KS). Among males, black/white rate ratios exceeded two for cancers of the palate, tonsil, oropharynx, and pyriform sinus, and were less than one only for lip and salivary gland cancers. Among females, rates by race were similar for all oral sites except lip, but rates for each of the pharynx subsites were higher among blacks. Findings suggest that OCP cancers may be separated into SCC of the lip, SCC of the oral cavity, SCC of the pharynx, AC, and KS.

Annual cancer incidence rates for hispanics in the United States

The expansion of the Surveillance, Epidemiology, and End Results (SEER) program and the determination of annual population estimates by county level for different racial/ethnic groups since 1990 allow the calculation of annual cancer incidence rates for Hispanics.

Maryland Dentists' Knowledge of Oral Cancer Risk Factors and Diagnostic Procedures

A questionnaire was mailed to 800 Maryland general practice dentists to assess their knowledge of risk factors and diagnostic procedures for oral cancer. Two indices were created based on 14 questions on knowledge of oral cancer risk factors and 9 questions on oral cancer diagnostic procedures. Data were analyzed statistically and evaluated with an alpha level of 0.05. Nearly all respondents identified use of tobacco, prior oral cancer lesions, and use of alcohol as risk factors. However, only 36% correctly identified that poor-fitting dentures are not a risk factor and 58% that poor oral hygiene is not a risk factor. Nearly 87% knew how to examine the tongue and surrounding areas, and 32% identified erythroplakia and leukoplakia as conditions associated with oral cancer. Appropriate knowledge about risk factors and diagnostic procedures is essential for dentists to counsel their patients and perform appropriate oral cancer examinations.

Geographic variation in breast cancer mortality for white and black women: 1986-1995.

Breast cancer mortality rates have decreased during the last 20 years in the United States overall. However, declines in breast cancer mortality rates differ among individual states. This analysis ranked states from the highest to the lowest percentage change in mortality between 1986 to 1990 and 1991 to 1995. Data on white and black females were analyzed separately. Among white women, the 10 states showing the greatest percentage change in mortality during those two periods had the greatest baseline mortality in the 1986‐to‐1990 period. Similarly, the 10 states with the lowest percentage change in mortality had the lowest mortality rate in 1986 to 1990. In contrast, among black women, the top 10 states ranked by percentage change in mortality included either a decline or an increase. The disparities in mortality rates by state likely depend on the stage of disease at diagnoses, socioeconomic status, access to care, and adequacy of medical care.

Use of skin and oral cancer examinations in the United States, 1998

BACKGROUND Findings from previous surveys suggest low utilization of oral cancer examinations, even though this examination is noninvasive. The purpose of this analysis is to compare the use of an oral cancer examination (OCE) and a skin cancer examination (SCE) in the past 12 months within the United States. Both exams are noninvasive and include a visual component. METHODS Weighted data from the Adult Prevention Supplement of the 1998 National Health Interview Survey (NHIS) for adults 40 years of age or older were analyzed using SAS and SUDAAN. A ratio compared the percentage reporting an OCE (%OCE) with the percentage reporting a SCE (%SCE). RESULTS The percentage having an OCE in the past year (13.8%) was very similar to the percentage having a SCE (13.5%) during that same period. With increasing age group, the %OCE/%SCE ratio varied inversely from 1.60 (C.I. 1.42-1.78) among persons 40-49 years to 0.62 (C.I. 0.55-0.69) among persons 70+ years. The ratio was similar in whites and blacks, males and females, and Hispanics and non-Hispanics. There was a positive gradient in the ratio by education and family income. CONCLUSIONS Overall, less than 15% of the population is receiving either of these examinations, although the American Cancer Society recommends both of them on an annual basis for individuals 40 years of age and older. To increase detection of these cancers at early stages, extensive educational and media campaigns for the public and providers identifying risk factors and the availability of and the need for these examinations are required.

Oral Cancer Examinations among U.S. Hispanics in 1998

BACKGROUND An oral cancer examination (OCE) is crucial for early detection of oral and pharyngeal cancers. The objectives of this study were: 1) to estimate the percentages of Hispanics and Hispanic subgroups who reported having an OCE in the past 12 months; 2) to compare these groups with various Non-Hispanics; and 3) to evaluate the extents to which having an OCE might be explained by age, gender, education, family income, a recent visit to a dentist, and edentulism. METHODS Descriptive and logistic regression analyses using data from the 1998 National Health Interview Survey. RESULTS 6.4% of Hispanics and 14.5% of non-Hispanics had had an OCE in the past 12 months. After adjusting for age, gender, education, income, a dental visit, and edentulism, Hispanics were 1.7 times less likely than non-Hispanics to have had an OCE in the past 12 months. CONCLUSIONS Fewer Hispanics are receiving OCEs relative to Non-Hispanics.