Assessing Oral Cancer Screening in US Adults: National Health and Nutrition Examination Surveys (NHANES) Data Analysis, 2011–2016

Introduction: Literature shows incidence of oropharyngeal squamous cell carcinoma (OPSCC) in US adults is higher in individuals infected with oral Human Papilloma Virus (HPV) and those with a history of tobacco and alcohol use. Our study analyzed factors that may contribute to lower oral cancer screening rates to address challenges in care equity and guide secondary prevention measures.

Methods: Our retrospective study utilized data from the National Health and Nutrition Examination Survey (NHANES) database. Participants surveyed about an oral cancer screening exam from the 2011-2012, 2013-2014, and 2015-2016 NHANES cycles were included in the study. Logistic regression models were used to evaluate the influence of oral HPV result, tobacco smoking, alcohol use, and demographic variables on the likelihood of undergoing an oral cancer exam.

Results: 28,709 participants met the inclusion criteria. A positive oral HPV result was associated with a 30% decreased likelihood of oral cancer screening (p < 0.05, 95% CI: 0.55 to 0.95). Smokers were 38% less likely to engage in screening compared to non-smokers (p < 0.001, 95% CI: 0.52 to 0.71). Alcohol consumption did not significantly affect screening practices (OR = 0.99, p = 0.36, 95% CI: 0.97 to 1.01).

Males were 23% less likely to undergo screening compared to females (p < 0.001, 95% CI: 0.69 to 0.86), and the likelihood of screening increased with age (p < 0.001, 95% CI: 1.02 to 1.04). Non-Hispanic White participants were significantly more likely to participate in screening compared to other racial and ethnic groups (OR = 6.21, p < 0.01, 95% CI: 5.53 to 7.01).

Conclusions: Our analysis shows smokers and those with oral HPV are less likely to undergo oral cancer screenings. Data on demographic disparities in screening rates underscores the need for targeted public health strategies. Implementing more inclusive oral cancer screening methods may increase equitable healthcare practices for earlier detection.