Oral Cancer: Social Determinants in Australia

Many risk factors or social determinants have been identified, but who will be at greater risk of oral cancer is the question. Not everyone who has a risk factor will experience oral cancer and not everyone who has little to no risk will be in the clear, so what makes the difference in early diagnosis? It is through regular oral health assessments and screening undertaken by a general medical practitioner or general dentist that early detection and risk status can be determined³. High-risk factors are seen as⁶:

• Long Term Smoking

• Heavy Alcohol Consumption

• Age of 40+

• History of Human Papilloma Virus (HPV)

• Family History of Cancer

• Poor Nutrition

• Stress

• Ultraviolet (UV) Exposure 

• Patient Delay in Self-Detection of Signs & Symptoms

Additionally, many as yet unproven determinants/behaviours have been identified as potential risks for OSCC. Such as vaping, ill-fitting dentures and poor oral hygiene⁶. With a lack of evidence to suggest direct links, it may still be helpful to address factors with the potential for modification and positive health outcomes. 

Improved public knowledge is shown to greatly decrease an individual’s risk, seeing as greater knowledge allows for greater understanding of consequences. Evidence suggests a trending decline in OSCC incidence in the Australian population as a result of lifestyle changes¹. This is supported via oral health promotion and campaigns such as graphic health warnings on cigarette packaging¹. Oral cancer has vast potential to be successfully treated when an early diagnosis is made, and it is by understanding one’s risk and maintaining oral cancer screenings that this can be better achieved³. In support of early identification, the following signs and symptoms in and around the mouth should never be overlooked⁴. 

• Non-healing Ulcer

• Red/White Patches

• Continuous Bleeding Gums 

• Difficulty moving Tongue

• Reduced Opening

• Pain on Swallowing 

• Loss of Taste

• Altered Sensations 

It is with modification of lifestyle factors and early detection via thorough oral cancer screenings, that greater prevention of OSCC is achievable⁵. Trained professionals should encourage safe alcohol consumption and endorse smoking cessation to those at high risk. By promoting healthier choices and regular dental checks, together this  can positively improve an individual’s outcome and quality of life⁴.

Ramamurthy, D, Sharma, D & Thomson, P, 2022, ‘Oral cancer awareness in patients attending university dental clinics: A scoping review of Australian studies’, Australian Dental Journal, vol. 67, issue. 1, pp. 5-11, https://onlinelibrary.wiley.com/doi/epdf/10.1111/adj.12877

Bosetti, C, Carioli, G, Santucci, C, Bertuccio, P, Gallus, S Garavello, W, Negri, E & La Vecchia, C, 2020, ‘Global trends in oral and pharyngeal cancer incidence and mortality’, Internal Journal of Cancer, vol. 147, issue. 4, pp. 1040-1049, https://pubmed.ncbi.nlm.nih.gov/31953840/

Webster, JD, Batsone, M & Farah, CS, 2019, ‘Missed opportunities for oral cancer screening in Australia’, Journal of Oral Pathology & Medicine, vol. 48, issue. 7, pp.. 595-603, https://pubmed.ncbi.nlm.nih.gov/31188491/

Yang, LC, Yang, A, Chen, LN, Firth, N, Prabhu, SR & Zachar, J, 2022, ‘Knowledge of Oral Cancer Amongst Dental Patients Attending Public Clinics in South East Queensland, Australia’, Journal of Cancer Education, vol 37, issue. 4, pp. 924-931, https://pubmed.ncbi.nlm.nih.gov/33068265/

Wolfer, S, Kunzler, A, Foos, T, Ernst, C, Leha, A & Schultze-Mosgau, S, 2022, ‘Gender and risk-taking behaviours influence the clinical presentation of oral squamous cell carcinoma’, Clinical and Experimental Dental Research, vol. 8, issue. 1, pp. 141-151, https://pubmed.ncbi.nlm.nih.gov/34989151/

American Cancer Society 2024, Can Oral Cavity and Oropharyngeal Cancers Be Prevented?, https://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/prevention.html

Latisha Sykora is a fourth-year student pursuing a Bachelor of Dental Surgery at the University of Adelaide. As a proud Mudburra-Jingili woman, she possesses great desire and commitment to elevate Indigenous oral health outcomes by promoting leadership and preventive measures. Latisha's journey in dentistry began in 2012, completing a school-based traineeship in dental assisting, an experience that fuelled her interest in oral disease, particularly in rural and remote communities. Her determination led to becoming a graduate Oral Health Therapist in 2019. Currently, she serves as a supporting clinician at the Indigenous Oral Health Unit (IOHU) at the University of Adelaide, while also devoting time to work in private practice. For Latisha, early intervention and education hold the key to achieving excellence in oral health. She actively demonstrates this belief by mentoring Indigenous students and serving as a Director of the Indigenous Dental Association Australia (IDAA). In 2022, she was awarded the Student Leadership Award for Indigenous Allied Health Australia (IAHA). Through her inspiring work and leadership, Latisha joins the Colgate Advocates for Oral Health: Content Community ready to embody a lasting impact on Indigenous oral health and create a brighter, healthier future for her community.