Suchergebnisse

PURPOSE: Oral cancer (OC) is the leading cancer in 25% of Indian cancer registries, and 80% of OCs are diagnosed in advanced stages. OC screening is a topic of debate. Studies from other countries have used a variety of study designs as OC screening strategies. There are not many studies from India on strategic screening, and there is a need to review the literature to provide insights and knowledge about screening programs. The purpose of this narrative review is to present broad epidemiologic evidence on the OC burden in India, to discuss and summarize the currently available evidence for OC screening strategies, and to highlight a feasible opportunistic screening strategy for addressing OC burden in India. METHODS: Medline and EMBASE were used to identify articles. Data from GLOBOCAN and government reports were obtained from websites. As many key concepts and divergent views cannot be addressed with a single research question, a narrative review was considered appropriate, but to ensure a comprehensive literature search, a systematic review search strategy was used. RESULTS: OC rates are rising more rapidly in India than projected. Wide variations in OC incidence within India reflect regional diversity of risk factors. Studies abroad have demonstrated the feasibility of opportunistic screening of oral potentially malignant disorders by dentists; however, although recommendations exist in India, no studies of opportunistic screening by dentists have been reported. CONCLUSION: The projected major increases in the OC burden necessitate an OC screening program; opportunistic screening of high-risk groups by dentists using oral visual examination is recommended as a cost-effective strategy. As a way forward, a pilot project to assess the feasibility of regional opportunistic screening is in progress.

The study described here examined whether knowledge gaps decrease when motivation to acquire information or the functionality of information is similar among more and less educated groups. Surveys at baseline and 12 months compared two groups with differing motivation to acquire cancer and diet information in a community that received a year-long health campaign. The more motivated group (higher on measures of salience, perceived cancer risk, and self-efficacy) was composed of those who self-selected to receive home-based learning, a campaign strategy. They were compared to general population samples. The study found that education-based differences in knowledge were evident even among members of the more motivated group. However, the effect of membership in this group raised knowledge levels higher than the general population irrespective of education level. The study suggested that group membership, information functionality, motivation, and education combined to affect knowledge, rather than motivation alone over-coming the effect of education.

<b>Objective:</b> Genetic testing for cancer risk will shortly enter medical practice. Our intent was to increase the understanding of the public's attitudes towards and potential demand for genetic testing. <b>Methods:</b> We conducted a random-digit-dial survey of 1,450 adults in Washington State to assess the public's attitudes toward genetic testing for cancer risk and to investigate correlates of intention to be tested for breast cancer risk (women) and prostate cancer risk (men). No specific genes were mentioned, as the intent of the survey was to understand the general interest in screening for genetic risks. The survey addressed familiarity with genetic testing, intention to be tested for breast or prostate cancer risk (when tests become available), benefits and risks associated with genetic tests, and who should have access to test results. <b>Results:</b> Most respondents expressed the intention to be tested for breast or prostate cancer risk (women 76%, men 83%). Most women (83%) and men (74%) would give the results to their primary care physician, but fewer believed that the test results should be available to their employer (women 5%, men 9%), their health insurer (women 32%, men 31%), or family members (women 42%, men 43%). Over 60% worried that discrimination could arise from genetic testing. Correlates of intention to be tested for breast cancer (women) included a family history of breast cancer, lower education, poor health, a history of mammography screening, and more physician visits in the past year. Among men, correlates of intention to test for prostate cancer included higher income, previous cancer diagnosis, a history of PSA screening, and more physician visits in the past year. Respondents who strongly believed in the benefits of genetic testing, who perceived themselves at greater risk for having a gene that increases risk, or who were less worried about discrimination expressed greater intent to be tested. <b>Conclusions:</b> Our survey suggests that the demand for genetic tests for cancer risk may be high, although confidentiality of test results is a major concern. Health care providers, genetic counselors, and research institutions should prepare strategies and policies for genetic testing and counseling as these tests enter general medical practice.