Dental patients’ knowledge, attitudes, and behaviors related to oral cancer: the need of a nation-wide oral cancer prevention program

Aim: The aim of the present study was to evaluate the oral cancer (OC) knowledge, including risk factors and clinical symptoms, among patients attending Dental Departments within large Italian University hospitals. Methods: 2200 questionnaires were sent to four hospitals in order to assess patients’ knowledge regarding epidemiological and clinical features of oral cancer; oral cancer knowledge was assessed overall and stratified by oral cancer family history. Associations between exposures of interest such as positive family history, hospital, education level, oral hygiene and our outcomes (oral cancer knowledge and oral cancer education) were evaluated by the use of logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs).Results: Patients frequently identified cigarette smoking as a risk factor for oral cancer (87.8%), knew the clinical signs of oral cancer (65 to 79% depending on the specific symptoms) and reported that early detection was related to better prognosis of oral cancer (94%). Participants with a positive family history for oral cancer were significantly more likely to identify risk factors for oral cancer correctly yet family history of oral cancer did not affect smoking status. Less than 15% of patients reported having received OC counseling by a primary care physician or dentist.Conclusion: Most of patients are aware of the clinical signs and risk factors of oral cancer. However they do not change their risky behaviours. Finally, oral health care providers infrequently talk about OC to their patients. As such, accurate knowledge of the risk factors and patients’ education are essential for improving oral cancer prevention and early detection efforts in Italy.