Impact of the Presenting Symptom on Time Intervals and Diagnostic Routes of Patients with Symptomatic Oral Cancer.

This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-sectional, ambispective study was designed to investigate symptomatic incident cases. The Aarhus statement was used as a conceptual framework. Strategies for minimizing potential recall biases were implemented. A sample of 181 patients was recruited (power: 99.5%; α = 0.05). The patient interval reached 58.2 days (95% CI, 40.3-76.2), which accounted for 74% of the whole prereferral interval and for more than one third of the total time interval. The presenting symptom (trigger for consultation) influenced both the number of primary care consultations and the length of time to diagnosis. General dental practitioners generated longer intervals to diagnosis (p < 0.005) and needed more consultations before referring a patient (RR = 0.76; 95% CI, 0.61-0.93), than general medical practitioners. The current study identifies the patient as the main target for interventions to improve awareness and reinforces the need for increased alertness amongst healthcare professionals about presenting symptoms of oral cancer and to diminish the number of prereferral consultations in order to optimize the primary care interval.

Role of Artificial Intelligence in the Early Diagnosis of Oral Cancer. A Scoping Review.

The early diagnosis of cancer can facilitate subsequent clinical patient management. Artificial intelligence (AI) has been found to be promising for improving the diagnostic process. The aim of the present study is to increase the evidence on the application of AI to the early diagnosis of oral cancer through a scoping review. A search was performed in the PubMed, Web of Science, Embase and Google Scholar databases during the period from January 2000 to December 2020, referring to the early non-invasive diagnosis of oral cancer based on AI applied to screening. Only accessible full-text articles were considered. Thirty-six studies were included on the early detection of oral cancer based on images (photographs (optical imaging and enhancement technology) and cytology) with the application of AI models. These studies were characterized by their heterogeneous nature. Each publication involved a different algorithm with potential training data bias and few comparative data for AI interpretation. Artificial intelligence may play an important role in precisely predicting the development of oral cancer, though several methodological issues need to be addressed in parallel to the advances in AI techniques, in order to allow large-scale transfer of the latter to population-based detection protocols.

Study of factors influencing preoperative detection of alveolar antral artery by CBCT in sinus floor elevation.

This study aimed at assessing the prevalence of alveolar antral artery (AAA) detection by CBCT, its related variables, and at describing explanatory models useful in surgical planning, by retrospective evaluation of CBCT explorations. The modelling of the probability for detecting AAA was undertaken using logistic generalized additive models (GAM). The capacity for discriminating detection/no detection was assessed by receiver operating characteristic curves. A total of 466 sinuses were studied. Univariate models showed detection probability was linked to sinus width and thickness of the lateral bony wall, together with the shape and height of the osseous crest. AAA detection probability increased steadily until the thickness of the bony wall reached 6 mm. Multivariate models resulted good discriminators for AAA detection, particularly for females, showing an area under the curve (AUC) of 0.85. Models considering patients altogether, and those including only males offered slightly lower values (AUC = 0.79). The probability of AAA detection by CBCT was influenced by gender (higher in males and for narrow sinuses) and increases with the thickness of the sinus lateral bony wall and the height of the residual alveolar ridge. Besides, and particularly for women, the thickness of the ridge at the basal level seems to improve the explanatory model for AAA detection.

Riesgo de cáncer oral atribuible al consumo de alcohol y tabaco en la Zona de Salud de Burela (Lugo) / Risk of oral cancer attributable to alcohol and tobacco consumption in the Burela Health Zone (Lugo)

Fundamento: La literatura muestra muy dispares prevalencias de cáncer oral que podrían reflejar distinto consumo de alcohol y tabaco. Por ello, el objetivo de este estudio ha sido determinar el riesgo de padecer cáncer oral atribuible al consumo de alcohol y tabaco en una zona básica de salud. Material y método: Estudio de casos y controles, donde los casos fueron los tratados en el Centro Oncológico de Galicia durante los años 1996-2000 y los controles fueron obtenidos entre los pacientes asignados al Centro de Salud de Burela (Lugo) mediante un muestreo consecutivo no probabilístico, realizado en marzo de 2000. Resultados: Fumadores entre los casos: 83,8% (n=62), por 26,4% (n=32) entre controles (p=0,000). Cigarrillos consumidos por día (37,43±25,99 por 17,67±13) p=0,000. El riesgo de cáncer oral fue 5,90 veces mayor en fumadores. De cada 100 cánceres orales en fumadores, 83 se explicarían por el hábito tabáquico. El riesgo de cáncer oral atribuible al consumo de alcohol, fue de 0,23 con un riesgo relativo de 2,04 y una fracción etiológica de riesgo del 0,51. Conclusión: A la vista de los resultados, nuestra responsabilidad en la información, consejo y ayuda a los pacientes con prácticas de riesgo no puede ser obviada

Background: Wide differences in oral cancer prevalence have been reported that may account for disparities in alcohol and tobacco consumption. Thus, the aim of this study was to ascertain the risk of oral cancer attributable to alcohol and tobacco consumption in a primary health zone. Methods and materials: A case-control study of oral cancer patients treated at the Galician Cancer Centre from 1996 to 2000. Controls: primary care patients, selected by a non-random, consecutive method, from those treated at the Burela Primary Care Clinics in March 2000. Results: The number of case smokers was: 83.8% (n=62), vs. 26.4% (n=32) in the controls (p=0,000). The number of cigarettes consumed per day was (37.43±25.99 vs. 17.67±13) p=0.000. The risk of oral cancer was 5.90 fold among smokers. Out of every 100 oral cancers in smokers, 83 could be attributed to smoking tobacco. The risk of oral cancer attributable to alcohol was 0.23 with a relative risk of 2.04 and the etiological risk fraction was 0.51. Conclusion: The dentist plays a key role in providing information, counselling and help to those patients with risk habits

Riesgo de cáncer oral atribuible al consumo de alcohol y tabaco en la Zona de Salud de Burela (Lugo) / Risk of oral cancer attributable to alcohol and tobacco consumption in the Burela Health Zone (Lugo)

Fundamento: La literatura muestra muy dispares prevalencias de cáncer oral que podrían reflejar distinto consumo de alcohol y tabaco. Por ello, el objetivo de este estudio ha sido determinar el riesgo de padecer cáncer oral atribuible al consumo de alcohol y tabaco en una zona básica de salud. Material y método: Estudio de casos y controles, donde los casos fueron los tratados en el Centro Oncológico de Galicia durante los años 1996-2000 y los controles fueron obtenidos entre los pacientes asignados al Centro de Salud de Burela (Lugo) mediante un muestreo consecutivo no probabilístico, realizado en marzo de 2000. Resultados: Fumadores entre los casos: 83,8% (n=62), por 26,4% (n=32) entre controles (p=0,000). Cigarrillos consumidos por día (37,43±25,99 por 17,67±13) p=0,000. El riesgo de cáncer oral fue 5,90 veces mayor en fumadores. De cada 100 cánceres orales en fumadores, 83 se explicarían por el hábito tabáquico. El riesgo de cáncer oral atribuible al consumo de alcohol, fue de 0,23 con un riesgo relativo de 2,04 y una fracción etiológica de riesgo del 0,51. Conclusión: A la vista de los resultados, nuestra responsabilidad en la información, consejo y ayuda a los pacientes con prácticas de riesgo no puede ser obviada (AU)

Background: Wide differences in oral cancer prevalence have been reported that may account for disparities in alcohol and tobacco consumption. Thus, the aim of this study was to ascertain the risk of oral cancer attributable to alcohol and tobacco consumption in a primary health zone. Methods and materials: A case-control study of oral cancer patients treated at the Galician Cancer Centre from 1996 to 2000. Controls: primary care patients, selected by a non-random, consecutive method, from those treated at the Burela Primary Care Clinics in March 2000. Results: The number of case smokers was: 83.8% (n=62), vs. 26.4% (n=32) in the controls (p=0,000). The number of cigarettes consumed per day was (37.43±25.99 vs. 17.67±13) p=0.000. The risk of oral cancer was 5.90 fold among smokers. Out of every 100 oral cancers in smokers, 83 could be attributed to smoking tobacco. The risk of oral cancer attributable to alcohol was 0.23 with a relative risk of 2.04 and the etiological risk fraction was 0.51. Conclusion: The dentist plays a key role in providing information, counselling and help to those patients with risk habits (AU)