Oral cancer in Australia 1982-2008: a growing need for opportunistic screening and prevention.

BACKGROUND: Globally, a decline in the incidence of oral cancer has been noted, while the mortality rates have remained relatively stable. The aim of this study was to provide an update on the incidence and mortality of oral cancer in Australia on a national and state level. METHODS: Data regarding new cases and deaths associated with cancer of the lip, oral cavity and oropharynx were obtained from the Australian Institute of Health and Welfare for the period 1982-2008. Crude- and age-standardized incidence and mortality rates were calculated for all of Australia and for each state and territory. RESULTS: A total of 60 826 cases of lip, oral cavity and oropharyngeal cancer were diagnosed in Australia. Between 1992 and 2008, a decline in the annual percentage change of age-standardized incidence was noted. The lip, followed by the tongue, continue to represent the most common sites of new oral cancer cases. There was no significant change in the rates of mortality for oral cancer over the time period. CONCLUSIONS: These findings show that the oral cancer mortality rate remains high despite a decline in incidence over the past three decades, highlighting a greater need for dental practitioners to undertake preventive strategies and opportunistic screening for patients.

Scope of practice, referral patterns and lesion occurrence of an oral medicine service in Australia.

AIM: The purpose of this study was to examine the scope of practice, lesion occurrence and utilisation of referral-based hospital and private practice oral medicine and oral pathology (OMP) services in Australia. MATERIALS AND METHODS: Clinical records of patients referred to a hospital (n=500) and private (nbequals;1104) OMP clinic were audited. For each patient, the following parameters were recorded: age, gender, source of referral, reason for referral, site of lesion/condition if applicable, medical and drug history, diagnostic services utilised, clinical and histopathological diagnoses rendered, medications prescribed and further treatment required. RESULTS: A majority of the referrals were generated by general dental practitioners. The most commonly seen problems were epithelial hyperplasia/hyperkeratosis, oral candidosis, oral lichen planus, xerostomia, recurrent aphthous ulcers and burning mouth syndrome. OMP specialists requested diagnostic imaging for 13% of hospital and 9.42% of private patients, diagnostic biopsies were required for 18.4% of hospital and 19.3% of private patients, blood tests were ordered for 14.4% of hospital and 12.13% of private patients, while medications were prescribed for approximately 36% of hospital and 51% of private patients. CONCLUSIONS: This study is the first to detail the scope of practice, lesion occurrence and utilisation of services offered by OMP specialists in Australia. The demand for OMP services is strong.