British Columbia Oral Cancer Prevention Program (BC OCPP)

Categories

Categories associated with best practice:

  • Organization
  • PP-icon1
  • Adult (ages 25-64) icon
  • Canada
  • Cancer Icon 1
  • Education and literacy
  • English
  • Health Care Setting
  • Health Literacy
  • Oral Health
  • Oral Health
  • Oral Health

Determinants of Health: Biology and genetic endowment, Education, literacy and life-long learning, Other

Overview

The British Columbia Oral Cancer Prevention Program (BC OCPP) is a multifaceted initiative that aims to reduce the incidence, morbidity and mortality of oral cancer through the development, validation, and adoption of new techniques for early detection, risk assessment, and management of premalignant oral diseases and cancer. An integrated management structure was implemented to facilitate a step-wise referral pathway that guides community health professionals (a clinical infrastructure links community dental practices and referral centres) and improves access to experts in diagnosis for a better management of oral cancer from early dysplasia to frank malignancy.

Since the BC OCPP initiation, partnerships between scientists and clinicians have stimulated the development of new technologies aimed at removing barriers to early diagnosis including:

  • Fluorescence Visualization
  • Toluidine Blue
  • Microsatellite Analysis
  • High-resolution computer Imaging systems
  • Salivary markers
  • Genomic profiling for patient management

The BC OCPP’s website was ranked among the top web-based, healthcare professionals-addressed resources on screening for oral cancer housing heterogeneous information with the potential to improve the existing educational gaps among healthcare professionals (Varela-Centelles et al., 2014).

The impact of the 2008 ‘Clinical Practice Guideline for the Early Detection of Oral Cancer in BC’ was evaluated in February 2010 using a telephone survey conducted with 100 general dentists. The survey showed an increase in oral cancer screening among dental practitioners that were aware of the guidelines: 84% of the dentists who had seen the guidelines had integrated screening as part of routine exams, compared to 65% among those not aware of the guidelines.

One of the BC OCPP key approach is centered on an opportunistic screening network of dentists and surgeons. This network is linked through a centralized BC Oral Biopsy Service (BC OBS) located in Vancouver BC that facilitates patient management and referrals. Change in usage in this service between 2007 (the year before the guideline’s release) and 2014 (last complete year of data) has been monitored and the following results were observed:

  • Total number of biopsies received via OBS increased by 31% between 2007 (4484) and 2014 (5866)
  • Number of ‘possible oral premalignant lesions’ (this includes all SCC, CIS, dysplasia, and hyperplasia / hyperkeratosis) increased by 4% between 2007 (828) and 2014 (862)
  • Number of diagnosed dysplasia, CIS and SCC via the BC OBS increased by 28% between 2007 (329) and 2014 (422)
  • Number of dental practitioners performing biopsies increased by 12% between 2007 (154) and 2014 (172)

Primary Source Document

MP Rosin, CF Poh, M Elwood, M Williams, R Gallagher, C MacAulay, WW Lam, A Auluck, L Zhang, and TG Hislop,, New hope for an oral cancer solution: Together we can make a difference J Can Dent Assoc. 2008 Apr; 74(3): 261–266.

Contact information of developer(s) and/or implementer(s)

N/A

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
To improve the early detection of local and regional recurrences.
  • Societal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
To achieve a greater cancer cure rate through more clinically effective treatment.
  • Societal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
To prevent the development of oral cancer, or to detect it at the earliest possible stage.
  • Societal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

  • Oral Health Promotion
  • Heathy Literacy
  • Oral HP Integration
  • Oral HP Surveillance

Risk Reduction

    Specific Activities of the Intervention

    • Advocacy for policy or policy changes
    • Create a community coalition
    • Educational health information offered
    • Media advocacy
    • Partnership development
    • Other

    Priority/Target Population for Intervention Delivery

    Life Stage

    • Adults (age 25-64 years)

    Settings

    Educational Settings

      Community Setting

      • Health care setting

      Outcomes

      Outcomes and Impact Chart
      Level of ImpactDescription of OutcomeEquity Focus
      Organizational LevelAmong dentists who had seen the ‘Clinical Practice Guideline for the Early Detection of Oral Cancer in BC, 84% had integrated screening as part of routine exams, compared to 65% among those who were not aware of the guideline.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.

      Adaptability

      Implementation History

      • Implemented once (could be a pilot) - The intervention has been implemented once and is theoretically replicable elsewhere.

      Expertise Required for Implementation within the Context of the Intervention

      • Specialized skills training provided as part of the Intervention - The intervention does not require individuals or groups with highly specialized training, but requires that individuals or groups be trained as part of the implementation of the intervention.

      Are there supports available for implementation

      Yes. funding

      Are there resources and/or products associated with the interventions

      Yes. website, guideline, clinical infrastructure