Barriers to early detection and management of oral cancer in the Asia Pacific region.

OBJECTIVE: Oral cancer is amenable to early detection but remains a prominent cause of mortality in the Asia Pacific region. This study aimed to identify barriers to early detection and management of oral cancer in the Asia Pacific region. METHODS: A mixed-methods approach was employed triangulating findings from a survey and focus groups. The survey was conducted among seven representative members of the Asia Pacific Oral Cancer Network (APOCNET) across six countries. Focus groups were conducted to gain deeper insights into the findings of the survey. RESULTS: The identified barriers were a lack of national cancer control strategies and cancer registries and the limited availability of trained health care professionals. Overcoming these challenges in the Asia Pacific region where resources are scarce will require collaborative partnerships in data collection and novel approaches for continuous professional training including eLearning. Further, to overcome the lack of trained health care professionals, innovative approaches to the management of oral potentially malignant lesions and oral cancer including telemedicine were suggested. CONCLUSION: The findings of this study should be taken into account when charting national cancer control plans for oral cancer and will form the basis for future collaborative studies in evaluating effective measures to improve oral cancer detection and management in low- and middle-income countries.

Associations of alcohol use with mental health and alcohol exposure among school-going students in Cambodia.

The aim of this study was to examine the associations of alcohol use with sociodemographic factors, mental health and alcohol exposure among school-going adolescents in Cambodia. The analysis included 3,806 school children, mean age 15.7 years (SD=1.8), from Cambodia who participated in the "Global School-based Student Health Survey" (GSHS) in 2013. The results indicate that overall, 10.0% of the students reported current alcohol use, 10.8% lifetime drunkenness, and 2.8% problem drinking. In multivariate logistic regression analysis, sociodemographic factors (older age and being male), mental health and other variables (bullying victimization, OR (odds ratio) = 1.99; 95% Confidence Interval (CI) [1.50, 2.65] and OR = 2.15; 95% CI [1.58, 3.21], respectively; having attempted suicide, OR = 2.04; 95% CI [1.35, 3.08] and OR = 2.06; 95% CI [1.29, 3.28], respectively and illicit drug use, OR = 4.97; 95% CI [2.41, 10.24] OR = 5.05; 95% CI [2.14, 11.98], respectively) and alcohol exposure variables (peer influence on drinking alcohol, OR = 6.68; 95% CI [4.75, 9.39] and OR = 7.83; 95% CI [5.73, 10.66], respectively and daily or almost daily to alcohol advertising in the past 30 days OR = 1.61; 95% CI [1.03, 2.51] and OR = 2.30; 95% CI [1.40, 3.77], respectively) were significantly positively associated with current alcohol use and drunkenness. Moreover, older age, being male, bullying victimization, having close friends, suicide attempt, drug use, father or male guardian drinks alcohol and peer influence were associated with problem drinking. There is a need to implement public health interventions with a special focus on the determinants of alcohol consumption, including exposure to alcohol advertising, in this age group.

Prevalence and correlates of perceived teeth health status and oral health behavior among school-going adolescents in Cambodia.

The purpose of the study was to investigate perceived teeth health status and oral health behavior, as well as their correlates, among adolescents in Cambodia. The analysis included 3806 Cambodian school children (mean age 15.7 years, SD=1.8 years) who took part in the "Global School-based Student Health Survey" (GSHS) in 2013. Overall, 7.8% of the students reported poor perceived teeth status, 18.0% had missed school in the past year because of a toothache, 26.7% engaged in combined oral health behavior (brushing teeth twice daily or more often = 79.8%, using fluoride toothpaste = 59.9%, and drinking soft drinks less than once a day = 53.6%), and 59.9% had never visited a dentist for a routine examination or other dental work. In the multivariate logistic regression analysis, older age, being female, missing school because of a toothache, having a toothache in the past 12 months, poor oral health behavior and sedentary leisure time were associated with poor perceived teeth status. Older age, good perceived teeth status, having had a dental check-up, washing hands before eating and after toilet use, and not eating fast food were associated with a positive oral health behavior (brushing teeth twice daily or more often, using fluoride toothpaste, and drinking soft drinks less than once a day). Significant proportions of poor perceived teeth status and poor oral health behavior were found among school children in Cambodia. Various risk factors (sociodemographic, dental variables, general health risk behaviors) for perceived poor teeth status, oral health behavior and never having had a dental check-up were identified, which can be utilized for intervention programs.