PROSTHODONTICS - American College of Prosthodontists
PROSTHODONTICS - American College of Prosthodontists
PROSTHODONTICS - American College of Prosthodontists
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Whatisthestatus<strong>of</strong>communityscreening?RecommendationsandpolicypositionsANationalStrategicPlanningConferenceheldin1996publishedstrategiesdesignedtopreventandcontroloralandpharyngealcancerintheUnitedStates.Amongstthe10strategieswereonethatincludedencouragingMedicaid,Medicare,traditionalinsuranceplans,andmanaged‐careprogramstoconsideroralcancerexaminationsasintegralparts<strong>of</strong>comprehensivephysicalandoralexaminationsandonetodesignatefederalfundingforanationalprogram<strong>of</strong>oralcancerprevention,earlydetection,andcontrol(MMWRAugust28,1998/47(RR14)(http://www.cdc.gov/mmwr/preview/mmwrhtml/0054567.htm)In2003,aNationalScreeningCommitteeintheUnitedKingdomrecommendedthatopportunisticscreeningbyallhealthcarepr<strong>of</strong>essionalsshouldbeencouraged.Theyneedtobeaware<strong>of</strong>thesignsandsymptoms<strong>of</strong>oralcancerandstandardreferralpathwaysshouldbedevelopedtominimizedelays(Improvingoutcomesfororalcancer,workshopsconvenedundertheauspices<strong>of</strong>theNationalScreeningCommittee,JJversion216/6/03).ThecurrentUnitedKingdomNationalScreeningpolicyposition(www.library.nhs.uk/screening/viewResource.aspx?searchText=Oral+Cancer&resID=61087)isthatscreeningprogramsshouldnotbe<strong>of</strong>feredbuthealthpr<strong>of</strong>essionalsshouldbeencouragedtoperformscreenings(Richards,Evidence‐BasedDentistry2007;8:21).TheCanadianTaskForceonPreventiveHealthCareindicatedtheusefulness<strong>of</strong>oralcancerscreeningislimitedbythelowprevalenceandincidence<strong>of</strong>oralcancerinCanada,thepotentialforfalsepositivediagnoses,andpoorcompliancewithscreeningandreferral.Therefore,itwasdeterminedthereisnoevidencethatscreeningthegeneralpublicorhighriskindividualsleadstoareductioninmortalityormorbidityfromoralcancer(Hawkins,JCanDentAssoc1999;65:617‐627).OralHealthinAmerica:areport<strong>of</strong>theSurgeonGeneralindicatedthereisnodefinitiveevidencesupportingtheoralcancerscreeningexaminationbutalsostatedpractitionersshouldregularlyperformoralcancerexaminationsonhigh‐riskindividuals(USDepartment<strong>of</strong>HealthandHumanServices.OralHealthinAmerica:areport<strong>of</strong>theSurgeonGeneral.Rockville,MD:Department<strong>of</strong>HealthandHumanServices,NationalInstitute<strong>of</strong>DentalandCrani<strong>of</strong>acialResearch,NationalInstitutes<strong>of</strong>Health,2000).In2004,theU.S.PreventiveServicesTaskForceissuedarecommendationstatementregardingscreeningfororalcancer.Theyfoundnonewgoodqualityevidencethatoralcancerscreeningimprovedthehealthoutcomes<strong>of</strong>eitheraverageorhigh‐riskindividuals.Theyalsostateditisunlikelycontrolledtrialswilleverbecompletedinthegeneralpopulationbecause<strong>of</strong>thelowincidence<strong>of</strong>oralcancerintheU.S.andthereisnoevidence<strong>of</strong>harmsproducedfromscreening.Theyindicatedcliniciansshouldbealerttothepossibility<strong>of</strong>oralcancerwhentreatingpatientswhousetobaccooralcohol(AgencyforHealthcareResearchandQuality–AHRQPub.No.05‐0564‐A,November2004).(Acopymaybeobtainedbycalling1‐800‐358‐9295ore‐mailahrqpub@ahrq.gov).TherecommendationisalsopostedontheWebsite<strong>of</strong>theNationalGuidelineClearinghouse(www.guideline.gov). 112010 CDEL Re-recognition <strong>of</strong> the Specialty Report 195 <strong>of</strong> 279
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