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Head and Neck Surgery

(352) Oral Cancer Incidence Is Associated with Access to Dental Care

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Henrique Ochoa Scussiatto, MD

    Research Fellow
    Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center
    Chicago, Illinois, United States

    • Co-Author(s)

  • MK

    Marynia A. Kolak, PhD

    University of Chicago Center for Spatial Data Science, University of Chicago, USA

  • CN

    Cheryl C. Nocon, MD

    Clinical Assistant Professor
    Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, NorthShore University Health System
    Chicago, Illinois, USA

  • JP

    Jayant M. Pinto, MD

    Professor and Dean of Faculty Affairs
    Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences Division
    Chicago, Illinois, USA

    • Senior Author(s)

  • MB

    Mihir K. Bhayani, MD

    Associate Professor
    Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, USA

Disclosure(s):
Henrique Ochoa Scussiatto, MD: No relevant relationships to disclose.


Introduction: There is limited data available about how disparities in dental care screening services may affect oral cavity squamous cell carcinoma incidence (OSCC). We tested whether incidence of OSCC is higher in regions with less dental care services access in Chicago and across the state of Illinois.

Methods: We extracted 5-year averages of county and city level OSCC incidence from 2015 to 2019 from the Illinois Department of Public Health (IDPH) (public dataset). Dental care access information was also collected for each county in Illinois for the same period, as well as percentage of people that had ≥1 dentist visit in the previous year in Chicago. We dichotomized county and city OSCC incidence (high and low) by the average incidence for comparison. Multivariate logistic regression was used to investigate the relationship between county level access to dental care (or city level dentist visits) and OSCC incidence, controlling for potential confounders. To visually compare data in Illinois and Chicago, we mapped the OSCC 5-year incidence, dental care access rate and percentage of people with ≥1 dentist visit in the previous year (the latter just for Chicago), using previously validated geostatistical methods (Inverse Density Weighting).

Results: Higher 5-year incidence of OSCC was significantly associated with low access to dental care in Illinois counties (OR=0.51, 95% CI 0.28, 0.92). Geographically, the southern and southwestern counties had higher incidence rates of OSCC (15.5 to 28.4%) and the lowest rates of access to dental care (47.5 to 69.2%) when compared to the northern counties (10.3 to 15% and 55.4 to 80.6%, respectively). In Chicago, people with no dentist visits in the previous year had an increased chance of developing OSCC (OR=1.11, 95% CI 1.01, 1.19).

Conclusions: Increased OSCC incidence is closely associated with poor local dental healthcare access in a major state and large, diverse urban city. Understanding geographic distribution of cancers and treatment access may allow targeted oral screening programs that result in improved cancer outcomes.