Perspectives, Challenges, and Oral Cancer Screening Practices of Primary Care Providers at Nebraska Medicine

Background High mortality and morbidity associated with oropharyngeal cancer (OPC) are due to delayed diagnosis. Early detection of OPC is possible by incorporating oral cancer screening (OCS) in the annual screening examination protocol of primary care providers (PCPs). The study was aimed to understand the perspectives and barriers of PCPs in screening their patients for OPC. Objectives 1) To understand challenges PCPs’ face in performing OCS, 2) To determine the factors that influence PCPs’ decision to complete OCS, and 3) To determine if PCPs who received education on OCS are more likely to perform the screening compared to PCPs who did not receive the education. Methods We used Sequential exploratory mixed methods for this research. Both qualitative and quantitative data from PCPs working at Nebraska Medicine were obtained. We conducted one-on-one in-depth interviews to identify PCPs perceptions and challenges in performing OCS. Themes identified in the qualitative study and the participant’s responses were used as a guide in the development of survey questionnaire. The survey was emailed to all the PCPs (N=100), whose information was available on the Nebraska Medicine public accessible website in 2017. Results The response rate was 34%. Approximately 60% of the participants mentioned that they currently perform OCS, but only 3.8% of the providers answered that they were performing comprehensive OCS hundred percent of the time. Forty-eight percent of the providers identified time as the biggest challenge in performing OCS during the annual comprehensive examination. Over 35.3% of the providers answered that they perform screenings for patients with a history of tobacco (i.e., smoking) or alcohol use. The providers who received education about the benefits of OCS in comparison to those who did not receive education during their medical training were equally performing the screening. Conclusion PCPs have an opportunity to detect OPC at a localized stage. However, PCPs mentioned that the time they have was insufficient and very few providers were performing comprehensive OCS during patients annual examination visit. Keywords: oral cancer screening, primary care providers, oropharyngeal cance