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Awareness of mouth cancer in Great Britain R. West, M. N. Alkhatib, A. McNeill and R. Bedi Br Dent J 2006; 200: 167–169

Comment

There is a vast literature on the subject of mouth cancer.1 It is a growing problem in the UK, with high relative mortality and increasing incidence. UK mortality in 2003 from cases of mouth cancer was higher than that for cervical cancer and similar to that for melanoma skin cancer. While members of the public can generally identify the more common symptoms such as persistent sores or ulcers and red or white patches, there is a much lower level of recognition of other symptoms such as new, persistent pains in the tongue or ear.

This paper offers the most current information on mouth cancer awareness in Great Britain's adult population and suggests that awareness of risk factors is lower in individuals at high risk because of their lifestyles. The data were collected from a large household survey of a probability sample of nearly 4,000 adults. Interviews were carried out face-to-face by trained interviewers who were instructed to make at least three attempts to interview a respondent from chosen addresses.

Four findings are especially important. While 96% of respondents had heard of mouth cancer, awareness of early signs was low except for persistent ulcers. Female respondents were more likely to be aware of early signs. Female respondents, younger respondents, respondents of a higher occupational status and non-smoking respondents were more likely to recognise the risk factors of tobacco use and drinking alcohol. Respondents of lower occupational status were less likely to recall being counselled about mouth cancer by either their general medical or dental practitioners.

While there is an improving awareness of mouth cancer, recognition of risk factors and early signs remains similar to earlier studies.2 It is suggested that this may be due to the developing media attention given to oral cancer awareness week rather than primary health care practitioner advice. Cancer Research UK has recently launched a three year national mouth cancer awareness campaign. Targeted at older members of the population of lower occupational status who are heavy smokers and drinkers, illustrated mouth cancer referral guidelines are also being made available for medical and dental practitioners and pharmacists. A website has been set up to provide current and accessible information for both the public and health professionals.3 These separate strands of activity should be closely monitored for their impact.

Addressing the disparities in mouth cancer awareness and information giving is complex. In addition to developing public awareness there are opportunities for both undergraduate and continuing professional development. Diagnostic delays should be addressed by clear referral protocols. Clear policy initiatives will reduce the prevalence of risk factors such as smoking and excess alcohol consumption.