Maryland Oral Cancer Prevention, Education and Training Initiative 2003 Maryland State Council on Ca

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Maryland Oral Cancer Prevention, Education and
Training Initiative2003 Maryland State Council
on Cancer ControlNovember 12, 2003

• Ilise D. Marrazzo,MPH
• Acting Director, Office of Oral Health
• Family Health Administration
• Maryland Department of Health Mental Hygiene

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Oral Cancer in Maryland

• Maryland ranks 8th in mortality among all states
• 6th highest mortality rate in the US for African
  American men
• 5-year survival rate in Maryland for African
  Americans is 33 (whites - 55)
• Nearly a 15 higher death rate from oral cancer
  in Maryland than the US
• Ries et. al. SEER Cancer Statistics review,
  1973-1996

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2002 Telephone Survey

• Survey of Maryland Adults Knowledge of Oral
  Cancer 2002 1,127 randomly selected Maryland
  adults by telephone interview.
• 42 reported ever having had an oral cancer exam
• 73 had never heard of a test or exam for oral
  cancer
• 77 of those surveyed who had ever had an oral
  cancer exam had their exam performed by a
  dentist
• 97 said smoking increased the risk for oral
  cancer only 46 said that alcohol increased the
  risk for oral cancer.

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Risk Factors for Oral Cancer

• Tobacco
• Cigarettes
• Cigars
• Snuff
• Spit tobacco
• Pipes
• Alcohol
• Sunlight lip cancer
• Lack of fruits and vegetables
• Viruses e.g., Human papilloma virus

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The Problem
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History

• 2000
• Reduce Oral Cancer Mortality legislation
  (SB791)
• Educate public and increase awareness
• Train healthcare providers to screen and refer
  patients
• Promote smoking cessation programs.
• Cigarette Restitution Fund (CRF)
• Oral cancer included as one of the 7 targeted
  cancers
• Local health departments choose to include oral
  cancer in screening and treatment programs.

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History

• 2001 2003
• OOH awarded 2-year grants to local health
  departments for oral cancer prevention and
  education.
• Maryland Oral Cancer Awareness week proclaimed
  by the Governor.
• 2004
• 9 counties conducting screenings with CRF funding
• 19 counties education prevention activities
  with OOH funding
• OOH funds education and prevention activities
  including public education and provider education

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Initiative Highlights

• FY 2003 both CRF OOH
• Website www.Maryland-OralCancer.org
• Over 6,500 screened (1case of oral cancer)
• Over 350 healthcare providers educated
• Over 6,500 individuals attended oral cancer ed.
• Print ads, t.v. and radio PSAs, and editorials .
• Best Practices
• Eastern Shore Oral Cancer Coalition
• Linkages with county smoking cessation services
• Outreach to firefighters, road workers,
  watermen, farmers, barber shops.

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Oral Cancer LiteracyWhat Everyone Needs To Know

• Risk assessment and risk reduction
• Risk factors
• Signs and symptoms
• Behavior modification
• Public to request oral cancer examination
• Providers to incorporate adequate oral cancer
  examination into standard of care
• Adequacy of oral cancer examination
• Frequency of oral cancer examination

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Oral Cancer Prevention, Early Detection, and
Treatment Model
Educational interventions, such as
Schools/agencies, Workplace, Hospitals,
Faith-based institutions, Service organizations,
Sports and recreation, Website Government,
Providers
Public
Use and provide appropriate screening, referral,
follow-up, and treatment
Oral Cancer Literacy
Curriculum Change
Provider
Provider Education
PCP
CME/CEUs
Dental Professionals
Curriculum Change
CME/CEUs
Media
Awareness

• What everyone needs to know
• Risk assessment and risk reduction
• Risk factors
• Signs and symptoms
• Oral cancer exam- steps
• Frequency of oral cancer exam

Policy Makers

• Funding for Research
• Covering of medically necessary dental
  procedures
• Uniform adult dental coverage that includes
  preventive services as well as emergency care
• Management/incorporation uninsured and
  undocumented populations
• CME/CEU
• Medical Dental Board Licensure and
  Re-licensure
• Oral Cancer Competency Module on Licensure Exams

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Disparities

• Main issues
• Lack of access
• Lack of oral health literacy
• Ultimate Goal
• Reduce disparities in oral cancer mortality and
  morbidity

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Current and Future Plans

• RO1 Application State Models for Oral Cancer
  Prevention and Early Detection
• Implementation of the Comprehensive Cancer
  Control Plan
• Identifying models that could be replicated in
  other areas of the State