Increasing Oral Cancer Screening by Dentists:Qualitative Research on Practitioner

波多黎各（PR）的口腔癌（OC）发病率和死亡率（世界）是 是西半球最高的口腔癌的早期诊断可降低发病率和死亡率 这种疾病及其治疗。《2010年健康人》的目标是增加 口腔癌和咽癌（I期，局部）在最早期检测到的百分比提高到50%。 不幸的是，波多黎各联邦似乎在早期癌症检测方面存在缺陷， 我们已经报道了浸润性癌与原位癌呈倒三角形， 癌和癌前口腔癌病变，即，口腔疾病的病理学签出诊断显著增加， 癌症比其他类型的病变。因此，在临床实践中常规地包括口腔癌检查将 检测更多的癌前病变和早期口腔癌，从而降低发病率， 波多黎各的死亡率。本项目的长期目标是加强口腔癌的二级预防 通过增加牙科诊所中的头颈部检查的做法， 筛查的人数，B）筛查的频率（初始检查、回忆检查），以及c）筛查的质量。 具体目的是：1）确定改变波多黎各牙医OC筛查实践行为的方法 波多黎各，2）确定将增加波多黎各从业者筛查的新兴技术，3）确定 新兴的社会趋势和活动，将增加从业者筛选在波多黎各，和4）基于 具体目标#1-3中的调查结果，为增加从业者确定了一个务实的实施战略 在波多黎各进行口腔癌筛查。为了实现具体目标，定性调查方法 (i.e.,专家焦点小组和关键知情人访谈），以获取必要的数据， 具体目标#1-3，以实现具体目标#4。因此，文化上/专业上可接受的方法， 可以开发目标群体（牙医）认可的技术和活动 在增加口腔癌筛查的频率方面是可接受的，也是有效的。这些目标将 由经验丰富的多学科研究团队完成。意义：通过关注公共卫生 和专业活动，传播和实施高度可接受的口腔癌筛查 根据该项目的研究结果，口腔癌的发病率和死亡率将降低 在波多黎各。

Age-adjusted (world) oral cancer (OC) incidence and mortality rates for Puerto Rico (PR) are among the highest in the Western Hemisphere. Early diagnosis of oral cancer will decrease the morbidity and mortality resultant from this disease and its treatment. The objective of Healthy People 2010 is to increase the percentage of oral and pharyngeal cancers (stage I, localized) detected at the earliest stage to 50%. Unfortunately, the Commonwealth of Puerto Rico appears to have a deficit in early cancer detection that is strikingly worse than the mainland U.S. We have reported an ¿inverse triangle¿ of invasive carcinomas to in situ carcinomas and premalignant oral cancer lesions, i.e., significantly more pathology sign-out diagnoses for oral cancer than the other lesion types. Thus, routinely including oral cancer examinations in clinical practice will detect both more pre-malignant and earlier oral cancers with the result of decreasing the morbidity and mortality in Puerto Rico. The long-term goal of this project is to strengthen secondary prevention of oral cancer by increasing the practice of head and neck examinations in dental practices in terms of the a) proportion of persons screened, b) the frequency of screenings (initial, recall exams), and c) the quality of the screenings. The Specific Aims are: 1) identify methods to change OC screening practice behaviors by dentists in Puerto Rico, 2) identify emerging technologies that will increase practitioner screening in Puerto Rico, 3) identify emerging social trends and activities that will increase practitioner screening in Puerto Rico , and 4) based on the findings from Specific Aims #1-3, define a pragmatic implementation strategy for increasing practitioner screening for oral cancer in Puerto Rico. To accomplish the Specific Aims, qualitative investigative methods (i.e., expert focus groups and key informant interviews) will be conducted to obtain the necessary data from Specific Aims #1-3 to allow accomplishing Specific Aim #4. Thus, culturally/professionally acceptable methods, technologies and activities can be developed that are recognized by the targeted group (dentists) as being acceptable as well as productive in increasing the frequency of oral cancer screenings. These objectives will be accomplished by an experienced multi-disciplinary research team. Significance: By focusing public health and professional activities on highly acceptable oral cancer screening dissemination and implementation operations that are based on the findings of this project, oral cancer morbidity and mortality will be decreased in Puerto Rico.