부산대학교 도서관

Oral cavity cancer (OCC) is a public health problem, with approximately 355,000 new cases and over 177,000 deaths occurring globally per year. In comparison with many other cancers, 5-year survival rates for OCC are relatively poor and there has been limited improvement in these rates over the past few decades. Delay from first symptom to referral for diagnosis is a risk factor for advanced stage presentation and subsequent poorer survival. By contrast, the treatment of small, early-stage lesions is associated with reduced morbidity and mortality. The oral cavity has been described as a site which is relatively easy to examine, and it has therefore been proposed that improvement in outcomes should be possible through implementation of guidelines associated with the examination of the mouth and surrounding tissues for oral cancer and oral potentially malignant disorders (OPMDs), this process is described as a conventional oral examination (COE). An initial review of the literature showed that although there have been a number of systematic reviews and numerous clinical guidelines on the topic of the COE, there has been limited consistency and insufficient evidence available to support clear practice. Uncertainties remain around a number of factors associated with the examination process including: a) the method of conducting the COE, b) the target population, i.e. high risk or universal approach, c) the frequency of the oral cancer examination procedure, and d) the extent to which adjunct tools are used. Additionally, there is some ambiguity and limited information available on the clinical practice and views of oral health care professionals (OHCPs) and patients around these issues and the barriers and facilitators to implementing the COE in the primary dental care setting. This thesis describes three studies which were undertaken to try and address the identified gaps in the knowledge and evidence base. The first study was a systematic overview of systematic review