Patient knowledge, attitudes/beliefs and experiences with Oral Health Services in Puerto Rico as they relate to oral cancer risk awareness, prevention, detection, and care

Age-adjusted oral cancer incidence and mortality rates for Puerto Rico (PR) are among the highest in the Western Hemisphere. Most oral cancers are squamous cell carcinomas and preceded by precancerous lesions. It is generally agreed that oral lesions suspicious for precancer/cancer should be biopsied and evaluated histopathologically, yet oral precancers and early cancers are often asymptomatic and can go undetected in the absence of a careful oral examination. Previous analyses indicate significant disparity in the biopsying of a) potentially precancerous oral lesions and b) in situ oral cancers in PR relative to the United States. Findings suggest that PR residents with intraoral lesions suspicious for oral cancer/precancer are most likely to be biopsied only after developing an invasive cancer. To address the shortfall in the early detection of oral precancers and early-stage cancers in PR, it is critical that underlying causal factors first be identified and understood. The main objective of the ongoing project has been to gain insight into the knowledge, attitudes/beliefs and practices of people from populations identified within the cancer research literature as high risk for oral cancer, living in the main metropolitan area in PR. Males were the primary focus of the project given that they exhibit much higher risks of oral cancer than females. Methodological approach was focus groups, guided by semi-structured guide with questions related to Project objectives. Results include insights into the oral health service experiences of high risk patients and recommendations for further research and policy. Supported by NIDCR/NIH U54 DE14257.