A population-based study of factors associated with early versus late stage oral cavity cancer diagnoses
A population-based study of factors associated with early versus late stage oral cavity cancer diagnoses
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DOI：
10.1016/j.oraloncology.2011.04.018
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发表时间：
2011-07-01
期刊：
影响因子：
4.8
通讯作者：
O'Sullivan, Brian
中科院分区：
文献类型：
--
作者：
Groome, Patti A.;Rohland, Susan L.;O'Sullivan, Brian
口腔癌可以早期发现，但许多口腔癌被诊断时已是晚期。我们在一项基于人群的研究中评估了晚期疾病的危险因素。研究人群为 1991 年至 2000 年间诊断出的所有安大略省患有前舌癌或口底癌的患者 (n = 2033)。数据来自回顾性图表审查。危险因素包括：人口特征、合并症、癌前病变、牙齿状况、吸烟、饮酒和社会边缘化。多变量回归分析评估独立关联，同时控制疾病等级和部位。百分之四十患有晚期疾病。 89% 的人出现症状，66% 的人由家庭医生转诊。舌头组的危险因素包括：年龄≥80岁（RR 1.47）、丧偶（RR 1.34）、社会边缘化（RR 1.69）、当前吸烟者（RR 1.26）或吸烟者重度饮酒者（RR 1.73）。口底组的危险因素为：年龄≥70岁（70-79岁：RR 1.24和≥80岁：RR 1.43）和社会边缘化（RR 1.22）。具有癌前病变（RR 0.44）或定期看牙医（RR 0.84）对口底组具有保护作用。患有共病的风险因素包括：年龄≥70岁（70-79岁：RR 1.28和≥80岁：RR 1.55）、分居/离婚（RR 1.26）、社会边缘化（RR 1.37）或吸烟者、酗酒者（RR 1.44）；而定期看牙医是有保护作用的（RR 0.83）。有针对性的教育，提醒那些有口腔癌危险的人注意口腔癌的警告信号，并进行更好的培训，再加上家庭医生的机会性口腔检查，可以减轻这种疾病的负担。 (C) 2011 Elsevier Ltd. 保留所有权利。
Oral cavity cancers can be detected early yet many are diagnosed with advanced disease. We assessed risk factors for advanced stage disease in a population-based study. Study population was all Ontario patients with anterior tongue or floor of mouth cancers diagnosed between 1991 and 2000 (n = 2033). Data are from a retrospective chart review. Risk factors included: demographic characteristics, co-morbidity, precancerous lesions, dental status, smoking, alcohol use, and social marginalization. Multivariate regression analyses assessed independent associations while controlling for disease grade and site. Forty percent had advanced disease. Eighty-nine percent presented with symptoms and 66% were referred by a family physician. Risk factors in the tongue group were being: age >= 80 (RR 1.47), widowed (RR 1.34), socially marginalized (RR 1.69), a current smoker (RR 1.26), or a smoker-heavy drinker (RR 1.73). Risk factors in the floor of mouth group were being: age >= 70 (70-79: RR 1.24 and >= 80: RR 1.43), and socially marginalized (RR 1.22). Having a pre-cancerous lesion (RR 0.44) or a regular dentist (RR 0.84) was protective in the floor of mouth group. Risk factors for those with co-morbid illnesses were being: age >= 70 (70-79: RR 1.28 and >= 80: RR 1.55), separated/divorced (RR 1.26), socially marginalized (RR 1.37), or a smoker-heavy drinker (RR 1.44); while having a regular dentist was protective (RR 0.83). Targeted education to alert those at risk about oral cancer warning signs and better training coupled with opportunistic oral cavity exams by family physicians could reduce the burden of this disease. (C) 2011 Elsevier Ltd. All rights reserved.