Oral Cancer Awareness And Practice Of Risk Habits And Mouth Self-Examination In High Risk Indigenous Community In Sarawak, Malaysia

Introduction: This study was to obtain baseline information and its associated factors on oral cancer awareness, practice of risk habits and mouth self-examination (MSE) among selected highrisk indigenous community in Sarawak. Materials and Methods: Cross-sectional survey using faceto-face interview was conducted on consented Malaysian, aged ≥15 years old who attended a one day Ministry of Health annual oral cancer screening programme at Bisaya villages in Limbang, Sarawak. Data were analysed using chi-square and multiple logistic regression. Significance level was set at p<0.05. Results: 75.1% of respondents were aware of oral cancer. Smoking was the most recognised risk habits (85.1%). About three-quarter of respondents recognised non-healing ulcer (74.7%) and red/white spot (72.1%) in the mouth as possible early cancer signs. Men had higher prevalence of smoking (85.7%) and drinking (70.8%)(p<0.01), whereas, women had higher percentage of betel quid chewing (62.5%). Low income was significantly associated with smoking and alcohol habits, whereas older age group and lower education level were significantly associated with betel quid chewing. Although 94.8% of respondents agreed that early detection may improve treatment outcome, only 33.8% had heard about MSE. Respondents who ever heard of MSE were 57 times more likely to practice MSE. Conclusion(s): Majority of selected high-risk indigenous community were aware of oral cancer, however awareness of MSE are still lacking. Gender, age, education level and income were significantly associated with health-risk behaviours. Future health promotion agenda should focus in addressing socio-environment gaps, and develop health education intervention based on specific health behaviour theory.

Download Full-text

The Impact of in Intervention Program on Oral Cancer Awareness and Practice of Preventive Behaviors in High-Risk Indigenous Community in Sarawak, Malaysia

Journal of Global Oncology ◽

10.1200/jgo.18.44600 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 10s-10s ◽

Cited By ~ 1

Author(s):

T.H. Maling ◽

J.G. Doss ◽

W.Y. Low

Keyword(s):

High Risk ◽

Oral Cancer ◽

Cancer Education ◽

Intervention Group ◽

Indigenous Community ◽

Betel Quid ◽

Control Group ◽

Cancer Awareness ◽

Betel Quid Chewing ◽

The Impact

Background: Oral cancer is highly prevalent among indigenous people in Sarawak as this population lacks awareness and is known to practice high-risk habits. Aim: This study aimed to develop and evaluate the impact of an educational intervention to improve oral cancer awareness and practice of preventive behavior among high-risk indigenous communities in Sarawak, Malaysia. Methods: A quasi-experimental study was undertaken involving adults in a Bisaya community (with high risk habits) in Limbang, Sarawak. The intervention group received a structured, Health Beliefs Model (HBM) theory-based oral cancer education module, while the control group was exposed to the conventional oral cancer education method during Ministry of Health's community oral cancer and precancer screening program. Face-to-face interviews using a validated structured questionnaire were conducted to obtain baseline information prior to intervention and after one and three months. Descriptive and multivariate statistics were used for analyzing the data using SPSS software. Results: The overall response rate was 99.5%. The final sample comprised of 204 respondents (89 in the control group and 115 in the intervention group). At baseline, 75.1% of respondents had heard about oral cancer, however their in-depth knowledge on risk factors, signs and symptoms and prevention were lacking. The control group had better awareness than the intervention group. Smoking and alcohol drinking were more prevalent in the intervention group, whereas betel quid chewing and practice of mouth self-examination (MSE) were more evident in the control group. At 1-month and 3-month follow-up, there were significantly higher mean scores in all aspects of oral cancer awareness among respondents in the intervention group and these improved levels of awareness were maintained over a period of 1- and 3-months. There were higher proportion of smokers, alcohol drinkers and betel quid chewers in the intervention group who reported quitting their habits or reducing the number of cigarettes smoked per day, frequency of alcohol drinking and betel quid chewing than the control group. The respondents in the intervention group also had significant increase in uptake of MSE and higher proportions who performed it once a month. Conclusion: The structured HBM-based oral cancer health education intervention was shown to have significant impacts on oral cancer knowledge and awareness, cessation and reduction of risk habits and increased the uptake of MSE among respondents in the intervention group of this indigenous community. Therefore, the introduced structured health education intervention is recommended for other communities in Malaysia that practice the same oral cancer risk habits. Considering this indigenous community is of lower socioeconomic status (SES), the introduced intervention could also be extended to other lower SES groups in Malaysia.

Download Full-text

Combined Genetic Biomarkers and Betel Quid Chewing for Identifying High-Risk Group for Oral Cancer Occurrence

Cancer Prevention Research ◽

10.1158/1940-6207.capr-16-0259 ◽

2017 ◽

Vol 10 (6) ◽

pp. 355-362 ◽

Cited By ~ 5

Author(s):

Chia-Min Chung ◽

Chien-Hung Lee ◽

Mu-Kuan Chen ◽

Ka-Wo Lee ◽

Cheng-Che E. Lan ◽

...

Keyword(s):

High Risk ◽

Oral Cancer ◽

Risk Group ◽

High Risk Group ◽

Betel Quid ◽

Genetic Biomarkers ◽

Cancer Occurrence ◽

Betel Quid Chewing

Download Full-text

Mouth self-examination to improve oral cancer awareness and early detection in a high-risk population

Oral Oncology ◽

10.1016/j.oraloncology.2011.05.001 ◽

2011 ◽

Vol 47 (7) ◽

pp. 620-624 ◽

Cited By ~ 49

Author(s):

Kalavathy Jayapal Elango ◽

Nitin Anandkrishnan ◽

Amritha Suresh ◽

Subramania K. Iyer ◽

Sundaram Karimassery RamaIyer ◽

...

Keyword(s):

High Risk ◽

Oral Cancer ◽

Early Detection ◽

High Risk Population ◽

Cancer Awareness ◽

Risk Population ◽

Self Examination

Download Full-text

Mouth Self-Examination (MSE) As a Screening Tool for Oral Potentially Malignant Disorders Among a High-Risk Indigenous Population With a Low Socioeconomic Status

Journal of Global Oncology ◽

10.1200/jgo.18.37700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 48s-48s

Author(s):

I.A. Razak ◽

W.M.N. Ghani ◽

J.G. Doss ◽

A. Ramanathan ◽

Z. Tahir ◽

...

Keyword(s):

High Risk ◽

Oral Cancer ◽

Screening Tool ◽

Oral Potentially Malignant Disorders ◽

Betel Quid Chewing ◽

Oral Mucosal Lesions ◽

Potentially Malignant Disorders ◽

Potentially Malignant ◽

Mucosal Lesions ◽

Self Examination

Background: Oral cancer can be preceded by a group of conditions termed oral potentially malignant disorders (OPMDs). Oral cancers are associated with a 5-year survival of less than 50%, largely attributed to diagnoses at advanced stages. As pain associated with oral cancer manifests only at late stages, delay in detection often occurs. Screening has been found to aid in detection at an early stage, however it is only feasible if targeted toward high risk individuals. Mouth self-examination (MSE) is a relatively quick, inexpensive and simple to perform method of screening. Aim: To evaluate the efficacy of MSE as a screening tool for detection of oral mucosal lesions and OPMDs in a high risk indigenous population with a high prevalence of tobacco and betel quid chewing habit. Methods: Two villages were selected as the sampling frame based on prevalence of tobacco and betel quid chewing habit. Respondents were asked to check their mouth for presence of lesion or abnormalities. Education on oral cancer, including MSE was provided. Subsequently, respondents were asked to perform MSE. Finally, a comprehensive oral examination (COE) was done by a specialist and the presence of oral mucosal lesions was recorded. Results: Almost 64.5% of respondents exhibited high levels of difficulty and low mucosal visualization and retracting ability, whereas 3.0% demonstrated high attention level when performing MSE. Prevalence of oral mucosal lesions was 59.0%, whereas the prevalence of oral potentially malignant disorders (OPMDs) was 9.0%. Detection of oral lesions by respondents using MSE was lower than detection by the gold standard. Sensitivity and specificity of MSE for detection of all types of lesions were 8.6% and 95.0% respectively. When analyzing each lesion type separately, MSE was found to be most sensitive in detection of swellings (10.0%), and most specific in identifying red lesions (100.0%). For detection of OPMDs, MSE yielded a high specificity of 98.9%, with an accuracy rate of 91.8%. Conclusion: MSE is a potentially good screening tool for OPMDs and oral cancer; however, awareness level of the public on oral cancer and its associated signs and symptoms needs to be improved.

Download Full-text

Impact of HOTAIR Gene Polymorphism and Environmental Risk on Oral Cancer

Journal of Dental Research ◽

10.1177/0022034517749451 ◽

2018 ◽

Vol 97 (6) ◽

pp. 717-724 ◽

Cited By ~ 23

Author(s):

S.C. Su ◽

M.J. Hsieh ◽

C.W. Lin ◽

C.Y. Chuang ◽

Y.F. Liu ◽

...

Keyword(s):

Oral Cancer ◽

Odds Ratio ◽

Gene Polymorphisms ◽

Clinical Stage ◽

Interactive Effect ◽

Clinical Status ◽

Betel Quid ◽

Nucleotide Polymorphisms ◽

Advanced Clinical Stage ◽

Betel Quid Chewing

Genetic and acquired factors are thought to be interrelated and imperative to estimate the risk and prognosis of oral squamous cell carcinoma (OSCC). HOX transcript antisense intergenic RNA ( HOTAIR) plays crucial roles in gene regulation and is regulated in a variety of cancers. Polymorphisms in HOTAIR have been recently linked to the predisposition to diverse malignancies. In the present study, we aimed to evaluate the influences of HOTAIR gene polymorphisms, combined with environmental triggers, on the susceptibility to oral tumorigenesis. Four single-nucleotide polymorphisms of the HOTAIR gene— rs920778, rs1899663, rs4759314, and rs12427129—were tested in 1,200 control participants and 907 patients with OSCC. We detected a significant association of rs1899663 with the risk of OSCC (adjusted odds ratio, 2.227; 95% confidence interval [95% CI], 1.197 to 4.146; P = 0.012) after adjustment for 3 potential confounders: smoking, betel quid chewing, and alcohol consumption. In further analyses where habitual exposure to each of 3 environmental factors was excluded, we found that, in addition to rs1899663, non–betel quid users who carried the polymorphic allele of rs920778 were more prone to develop OSCC than were those homozygous for wild-type allele (TC: odds ratio [OR], 1.472; 95% CI, 1.069 to 2.029; P = 0.018; TC+CC: OR, 1.448; 95% CI, 1.060 to 1.977; P = 0.020). Moreover, in exploring the relationship between HOTAIR gene polymorphisms and the clinical status of only patients with OSCC who were non–betel quid chewers (excluding the advanced clinical stage), we found that rs920778 and rs4759314 were correlated with the development of large-size tumors (OR, 1.891; 95% CI, 1.027 to 3.484; P = 0.04) and increased lymph node metastasis (OR, 4.140; 95% CI, 1.785 to 9.602; P = 0.001), respectively. Further functional assessments link rs920778 to the regulation of HOTAIR expression and epigenetic status. Our results reveal an interactive effect of HOTAIR gene polymorphisms and betel quid chewing on the development and progression of oral cancer.

Download Full-text