GPs’ role in early detection of oral cancer now easier

While management of oral issues commonly sits under the scope of dentists, GPs are most often the first point of contact for people seeking medical care, which can include mouth problems, and therefore have an important role in early detection of oral, or mouth, cancer.
 
However, Australian GPs have traditionally only had limited education and training resources available to assess for and manage such issues, including referrals for oral cancer. A recent study identified gaps in GPs’ related knowledge and clinical practices, and a lack of training to support them with oral cancer prevention and diagnosis.
 
To help address this gap, the RACGP has released a new gplearning online learning activity, ‘Oral cancer screening and prevention’, which is designed to provide optimal referral and treatment pathways for GPs when they identify a suspicious lesion, as well as the preventive actions they can discuss with patients to reduce their risk of oral cancer.
 
RACGP National Clinical Lead Dr Judith Culliver, who led development of the module, told newsGP it reiterates the importance of early detection and the GP’s role.
 
‘As with other cancers, early detection leads to better outcomes and this module is to help raise the awareness and confidence of GPs in managing oral and oropharyngeal cancer,’ she said.
 
‘This module looks at the types of oral and oropharyngeal lesions that can occur, the risk factors for cancer, how to screen and when and how to refer.
 
‘Referral and treatment pathways are discussed in the module with links about how to access these.’
 
The module, available to GPs nationally, forms part of the Victorian Oral Cancer Screening and Prevention Program, developed in collaboration with Dental Health Services Victoria (DHSV) under the Victorian Government’s 2016–20 Cancer Plan.
 
In Australia, more than 4000 new cases of head, neck and lip cancers are diagnosed each year – the majority of which are oral cancers. It is estimated more than 700 people will be diagnosed with oral cancer in 2023 – a figures that is expected to rise in coming years.
 
On a global scale, the World Dental Federation has urged the World Health Organization to consider new strategies to support GPs for oral cancer screening, while the RACGP also recently called for the removal of existing barriers to care.
 
According to Dr Culliver, GPs play an important role in screening for oral cancer and timely referral for suspicious lesions to manage at the early stages.
 
‘Detecting oral and oropharyngeal cancer at an early stage can reduce morbidity and mortality rates and improve long-term survival and quality of life,’ she said.
 
‘The five-year survival rate has not increased significantly over time; not uncommonly oral cancer is diagnosed in advanced stages.’
 
Oral cancer carries low survival rates due to delayed presentation or diagnosis, often resulting in poor prognosis. Previous studies have shown routine risk assessments, preventive counselling and oral cavity examination by GPs could considerably reduce the morbidity associated with the cancer.
 
The module, a CPD Accredited Provider Activity (Category 2 points) explores the risk factors for oral cancer and how to screen patients, including conducting a visual and tactile examination of the head and neck (including oral cavity) for early detection. Signs of oral cancer typically include lesions, swelling, lumps in the neck, and teeth issues.
 
In addition to HPV infection and lifestyle factors such as tobacco and alcohol use, oral cancers are more prevalent among people in low socioeconomic areas, regional and remote locations and Aboriginal and Torres Strait Islander people.
 
Dr Culliver said GPs are well placed to start the discussion with patients around screening and prevention of oral cancer.
 
‘GPs can raise the issue and talk to patients about their risk factors which include, amongst other things, smoking, alcohol or HPV infection,’ she said.
 
‘They can also screen for risk factors and perform a simple examination, especially on patients at particular risk.
 
‘Even brief interventions can be effective in talking to patients about reducing their risk factors.’
 
The new CPD Accredited Activity, under the Oral Cancer Screening and Prevention Program, is funded by the Victorian Department of Health and led by DHSV, in partnership with the RACGP, University of Melbourne, Cancer Council Victoria, and Victorian Comprehensive Cancer Centre.
 
For more information and to access the activity, RACGP members can login to myCPD.
 
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CPD dental health early detection mouth cancer oral cancer oropharyngeal lesion