A Community Survey on Association of Sociodemographic Characteristics with Risk Perception and Awareness about Oral Cancer in Lagos, Nigeria

Afolabi Oyapero; Olufemi Erinoso; Olubukola Olatosi

Authors

Afolabi Oyapero
Olufemi Erinoso
Olubukola Olatosi

Keywords:

Alcohols, Awareness, Oropharyngeal Neoplasms, Risk Factors, Tobacco

Abstract

Objective: To assess the level of oral cancer awareness and risk factors perception and the relationship between this awareness and the sociodemographic and behavioral characteristics. Material and Methods: This descriptive study was conducted among rural and urban residents in Lagos State, Nigeria. A multi-stage random sampling method was utilized. The sociodemographic and behavioral characteristics of respondents, as well as their knowledge about oral cancer risk factors, were assessed with a validated questionnaire. The bivariate association was done using an independent t-test and one-way ANOVA. Multivariate regression was used to determine the association between predictor variables and oral cancer knowledge scores. The statistical significance level is set at p<0.05. Results: 590 participants between 18 and 82 years (mean age 34.5 ±13.7) completed the survey. The prevalence of cigarette smoking was 25.7%, of which 16 (1.5%) were heavy smokers (20+ cigarettes per day). The prevalence of alcohol consumption was 66.1%, with 57 (9.7%) being heavy drinkers, consuming drinks for 5-7 days of the week. A high proportion of the respondents (>60%) exhibited gaps in their knowledge of oral cancer. Uneducated participants had lower oral cancer knowledge than those with >12 years of formal education (aOR = 5.347; 95% CI: 4.987-6.240). Participants who were smokers had lower oral cancer knowledge compared with non-smokers (aOR = 3.341; 95% CI: 2.147-4.783); Participants who consumed alcohol had more deficient oral cancer knowledge compared with non-drinkers (aOR = 1.699; 95% CI: 1.087-2.655); While heavy smokers aOR = 4.023; 95% CI: 3.615-4.825) and heavy drinkers aOR = 4.331; 95% CI: 3.158-5.939) had lower oral cancer knowledge compared with those who did not abuse both substances. Conclusion: A high proportion of the respondents exhibited gaps in their knowledge of oral cancer in their responses. Delayed diagnosis of oral cancer can be reduced by increasing the awareness and knowledge of the populace about risk factors and also in the recognition of its signs and symptoms.

References

World Health Organization. ICD-10: International Statistical Classification of Diseases and Related Health Problems: tenth revision. 2nd ed. 2004. Available from: https://apps.who.int/iris/handle/10665/42980. [Accessed on April 6, 2023].

National Cancer Institute. Definition: oral cancer. Available from: https://www.cancer.gov/publications/dictionaries/cancerterms/ def/oral-cancer. [Accessed on April 6, 2023].

American Society of Clinical Oncology. Oral and oropharyngeal cancer: Introduction. 2022. Available from: https://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/introduction. [Accessed on February 5, 2023].

Ahluwalia KP. Assessing the oral cancer risk of South-Asian immigrants in New York City. Cancer 2005; 104(12 Suppl):2959-2961. https://doi.org/10.1002/cncr.21502

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6):394-424. https://doi.org/10.3322/caac.21492

Ghantous Y, Abu Elnaaj I. [Global incidence and risk factors of oral cancer]. Harefuah 2017; 156(10):645-649. [In Hebrew].

Rivera C. Essentials of oral cancer. Int J Clin Exp Pathol 2015; 8(9):11884-11894.

Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer 2001; 94(2):153-156. https://doi.org/10.1002/ijc.1440

Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55(2):74-108. https://doi.org/10.3322/canjclin.55.2.74

Osazuwa-Peters N, Wang DD, Namin A, John VM, O'Neill M, Patel PV, et al. Sexual behavior, HPV knowledge, and association with head and neck cancer among a high-risk group. Oral Oncol 2015; 51(5):452-456. https://doi.org/10.1016/j.oraloncology.2015.01.011

Elrefaey S, Massaro MA, Chiocca S, Chiesa F, Ansarin M. HPV in oropharyngeal cancer: the basics to know in clinical practice. Acta Otorhinolaryngol Ital 2014; 34(5):299-309.

Akinkugbe AA, Garcia DT, Brickhouse TH, Mosavel M. Lifestyle risk factor related disparities in oral cancer examination in the US: a population-based cross-sectional study. BMC Public Health 2020; 20(1):153. https://doi.org/10.1186/s12889-020-8247-2

Joseph BK. Oral cancer: prevention and detection. Med Princ Pract 2002; 11(Suppl 1):32-35. https://doi.org/10.1159/000057776

Riley JL, Pomery EA, Dodd VJ, Muller KE, Guo Y, Logan HL. Disparities in knowledge of mouth or throat cancer among rural Floridians. J Rural Health 2013; 29(3):294-303. https://doi.org/10.1111/jrh.12003

Shepperd JA, Howell JL, Logan H. A survey of barriers to screening for oral cancer among rural Black Americans. Psychooncology 2014; 23(3):276-282. https://doi.org/10.1002/pon.3415

Hvidberg L, Pedersen AF, Wulff CN, Vedsted P. Cancer awareness and socioeconomic position: Results from a population-based study in Denmark. BMC Cancer 2014; 14:581. https://doi.org/10.1186/1471-2407-14-581

Richards MA. The national awareness and early diagnosis initiative in England: Assembling the evidence. Br J Cancer 2009;101 Suppl 2(Suppl 2):S1-4. https://doi.org/10.1038/sj.bjc.6605382

Bhatia S, Landier W, Paskett ED, Peters KB, Merrill JK, Phillips J, et al. Rural-urban disparities in cancer outcomes: Opportunities for future research. J Natl Cancer Inst 2022; 114(7):940-952. https://doi.org/10.1093/jnci/djac030

Howell JL, Shepperd JA, Logan H. Barriers to oral cancer screening: A focus group study of rural Black American adults. Psychooncology 2013; 22(6):1306-1311. https://doi.org/10.1002/pon.3137

Shepperd JA, Howell JL, Logan H. A survey of barriers to screening for oral cancer among rural Black Americans. Psychooncology 2014; 23(3):276-282. https://doi.org/10.1002/pon.3415

Vineis P, Wild CP. Global cancer patterns: Causes and prevention. Lancet 2014; 383(9916):549-557. https://doi.org/10.1016/S0140-6736(13)62224-2

Zhou XH, Huang Y, Yuan C, Zheng SG, Zhang JG, Lv XM, et al. A survey of the awareness and knowledge of oral cancer among residents in Beijing. BMC Oral Health 2022; 22(1):367. https://doi.org/10.1186/s12903-022-02398-6

Cannick GF, Horowitz AM, Drury TF, Reed SG, Day TA. Assessing oral cancer knowledge among dental students in South Carolina. J Am Dent Assoc 2005; 136(3):373-378. https://doi.org/10.14219/jada.archive.2005.0180

Reed SG, Duffy NG, Walters KC, Day TA. Oral cancer knowledge and experience: A survey of South Carolina medical students in 2002. J Cancer Educ 2005; 20(3):136-142. https://doi.org/10.1207/s15430154jce2003_6

Carter LM, Ogden GR. Oral cancer awareness of undergraduate medical and dental students. BMC Med Educ 2007; 7:44. https://doi.org/10.1186/1472-6920-7-44

World Health Organization. Cancer fact sheets - Global Cancer Observatory. Available from: https://gco.iarc.fr/today/fact-sheets-cancers. [Accessed on February 5, 2023].

Gupta N, Gupta R, Acharya AK, Patthi B, Goud V, Reddy S, et al. Changing trends in oral cancer - A global scenario. Nepal J Epidemiol 2016; 6(4):613-619. https://doi.org/10.3126/nje.v6i4.17255

Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin 2002; 52(1):23-47. https://doi.org/10.3322/canjclin.52.1.23 Erratum in: CA Cancer J Clin 2002; 52(2):119. Erratum in: CA Cancer J Clin 2002; 52(3):181-182.

Rogers SN, Hunter R, Lowe D. Awareness of oral cancer in the Mersey region. Br J Oral Maxillofac Surg 2011; 49(3):176-181. https://doi.org/10.1016/j.bjoms.2010.04.004

Tadbir AA, Ebrahimi H, Pourshahidi S, Zeraatkar M. Evaluation of levels of knowledge about etiology and symptoms of oral cancer in southern Iran. Asian Pac J Cancer Prev 2013; 14(4):2217-2220. https://doi.org/10.7314/apjcp.2013.14.4.2217

West R, Alkhatib MN, McNeil A, Bedi R. Awareness of mouth cancer in Great Britain. Br Dent J 2006; 200(3):167-169. https://doi.org/10.1038/sj.bdj.4813197

Rogers SN, Hunter R, Lowe D. Awareness of oral cancer in the Mersey region. Br J Oral Maxillofac Surg 2011; 49(3):176-181. https://doi.org/10.1016/j.bjoms.2010.04.004

Falk DE, Yi HY, Hiller-Sturmhöfel S. An epidemiologic analysis of co-occurring alcohol and tobacco use and disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Res Health 2006; 29(3):162-171.

Hashibe M, Brennan P, Chuang SC, Boccia S, Castellsague X, Chen C, et. al. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev 2009; 18(2):541-550. https://doi.org/10.1158/1055-9965.EPI-08-0347

Kreimer AR, Clifford GM, Boyle P, Franceschi S. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiol Biomarkers Prev 2005; 14(2):467-475. https://doi.org/10.1158/1055-9965.EPI-04-0551

Chrystala C, Georgios P, Athanasios N Mamas T. Knowledge and perceptions of cypriots about oral cancer. Balk J Dent Med 2014; 18(2):78-84. https://doi.org/10.1515/bjdm-2015-0012

Monteiro LS, Salazar F, Pacheco J, Warnakulasuriya S. Oral cancer awareness and knowledge in the city of Valongo, Portugal. Int J Dent 2012; 2012:376838. https://doi.org/10.1155/2012/376838

Adeoye J, Chu CS, Choi SW, Thomson P. Oral cancer awareness and individuals' inclination to its screening and risk prediction in Hong Kong. J Cancer Educ 2022; 37(2):439-448. https://doi.org/10.1007/s13187-020-01834-x

Morse DE, Psoter WJ, Cleveland D, Cohen D, Mohit-Tabatabai M, Kosis DL, et al. Smoking and drinking in relation to oral cancer and oral epithelial dysplasia. Cancer Causes Control 2007; 18(9):919-929. https://doi.org/10.1007/s10552-007-9026-4

Elrefaey S, Massaro MA, Chiocca S, Chiesa F, Ansarin M. HPV in oropharyngeal cancer: the basics to know in clinical practice. Acta Otorhinolaryngol Ital 2014; 34(5):299-309.

Olson CM, Burda BU, Beil T, Whitlock EP. Screening for oral cancer: A targeted evidence update for the US preventive services task force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013. Report No.: 13-05186-EF-1.

Asthana S, Labani S, Kailash U, Sinha DN, Mehrotra R. Association of smokeless tobacco use and oral cancer: A systematic global review and meta-analysis. Nicotine Tob Res 2019; 21(9):1162-1171. https://doi.org/10.1093/ntr/nty074

Mayne ST, Morse DE, Winn DM. Cancers of the oral cavity and pharynx. In: Schottenfeld D, Fraumeni JF. Cancer epidemiology and prevention. 3rd ed. New York: 2006; Oxford Academic; 2009. https://doi.org/10.1093/acprof:oso/9780195149616.003.0035

Chaturvedi P, Singh A, Chien CY, Warnakulasuriya S. Tobacco related oral cancer. BMJ 2019; 365:l2142. https://doi.org/10.1136/bmj.l2142

Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer 2015; 112(3):580-593. https://doi.org/10.1038/bjc.2014.579.46

Quaife SL, Winstanley K, Robb KA, Simon AE, Ramirez AJ, Forbes LJL, et al. Socioeconomic inequalities in attitudes towards cancer. Eur J Cancer Prev 2015; 24(3):253-260. https://doi.org/10.1097/CEJ.0000000000000140

Hvidberg L, Wulff CN, Pedersen AF, Vedsted P. Barriers to healthcare seeking, beliefs about cancer and the role of socioeconomic position. A Danish population-based study. Prev Med 2015; 71:107-113. https://doi.org/10.1016/j.ypmed.2014.12.007

Niksic M, Rachet B, Warburton FG, Wardle J, Ramirez AJ, Forbes LJ. Cancer symptom awareness and barriers to symptomatic presentation in England--are we clear on cancer? Br J Cancer 2015; 113(3):533-542. https://doi.org/10.1038/bjc.2015.164

Park JH, Slack-Smith L, Smith A, Frydrych AM, O'Ferrall I, Bulsara M. Knowledge and perceptions regarding oral and pharyngeal carcinoma among adult dental patients. Aust Dent J 2011; 56(3):284-289. https://doi.org/10.1111/j.1834-7819.2011.01342.x

Grossman M. The relationship between health and schooling. East Econ J 2008; 34(3):281-292. https://doi.org/10.1057/eej.2008.13

Razavi SM, Tahani B, Nouri S, Khazaei A. Oral cancer knowledge and practice among dental patients and their attitude towards tobacco cessation in Iran. Asian Pac J Cancer Prev 2015; 16(13):5439-5444. https://doi.org/10.7314/apjcp.2015.16.13.5439

Petersen PE. Oral cancer prevention and control--the approach of the World Health Organization. Oral Oncol 2009; 45(4-5):454-460. https://doi.org/10.1016/j.oraloncology.2008.05.023

Messadi DV. Diagnostic aids for detection of oral precancerous conditions. Int J Oral Sci 2013; 5(2):59-65. https://doi.org/10.1038/ijos.2013.24

Huber MA, Tantiwongkosi B. Oral and oropharyngeal cancer. Med Clin North Am 2014; 98(6):1299-1321. https://doi.org/10.1016/j.mcna.2014.08.005

Paudyal P, Flohr FD, Llewellyn CD. A systematic review of patient acceptance of screening for oral cancer outside of dental care settings. Oral Oncol 2014; 50(10):956-962. https://doi.org/10.1016/j.oraloncology.2014.07.007