Abstract
Medical practitioners’ (MP) role is pivotal in primary prevention, early diagnosis,
prompt referral and effective management of oral and oropharyngeal carcinomas (OC/OPC),
which raises the importance of their effective OC/OPC education at all levels of medical
education. The purpose of this systematic review was to summarise the available scientific
evidence about their educational competence in dealing with OC/OPC. We made a systematic
search of papers in the English language in MEDLINE, Scopus, Cochrane Library CENTRAL
and CINAHL databases from their inception until December 2018. Overall, 23 cross-sectional
and three interventional studies have been selected for the systematic review and
18 of these were included in the meta-analyses. Excluding tobacco use (synthesised
estimate of 95% of respondents identified tobacco as an OC/OPC risk factor, 95% CI
of synthesised estimate 92% to 97%) and alcohol consumption (65%, 95%CI 52% to 77%),
less than half of MP (approximately) were knowledgeable about important OC/OPC risk
factors including human papilloma virus (42%, 95% CI 30% to 54%), poor diet (34%,
95% CI 17% to 54%), and advancing age (45%, 95% CI 21% to 70%). There was a low to
moderate level of awareness among MP regarding common precancerous oral lesions involving
leukoplakia (56%, 95% CI 32% to 79%), erythroplakia (30%, 95% CI 8% to 58%), and oral
lichen planus (13%, 95% CI 0 to 41%). Moderate knowledge was also recorded about frequent
sites of OC development involving the tongue (48%, 95% CI 33% to 64%) and floor of
the mouth (37%, 95% CI 19% to 57%). Most MP enquired about tobacco use (86%, 95% CI
74% to 96%), and alcohol consumption (73%, 95% CI 47% to 94%) during history taking,
and expressed willingness to be given supplementary OC/OPC education (78%, 95% CI
54% to 96%), as well. With regard to the incidence of intraoral screening, 27% of
MP (95% CI 12% to 46%) make an intraoral examination as a routine. Interestingly,
studies from each continent yielded significantly different outcomes to some research
questions in the review. From the MP’s perspective, clinical time restrictions and
deficiencies in organised training were recognised as the main barriers towards their
OC/OPC educational competence. The findings of this systematic review indicated the
existence of deficiencies in knowledge and misconceptions, neglected preventive responsibilities,
and associated barriers towards OC/OPC. A need for improved OC/OPC training at all
levels of medical education is required to increase competence worldwide.
Keywords
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Article info
Publication history
Published online: November 27, 2019
Accepted:
August 12,
2019
Received:
July 10,
2019
Identification
Copyright
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
