On-line Self-diagnosis of Oral Cancer - The Path of Least Resistance?

November 27, 2015

On-Line Self-diagnosis of Oral Cancer - The Path of Least Resistance?

 Image courtesy of Stuart Miles from Freedigitalphotos.net 

I have just been reading a news item at mouthcancer.org called 'Calling Dr Internet - Could Self-diagnosis be Costing Lives?'.  This is a very thought-provoking article particularly at a time when oral cancer rates are escalating across the UK. Research carried out on behalf of the British Dental Health Foundation found that 'Four in ten people questioned by the charity say they prefer turning to the internet to investigate their symptoms, while less than one in three (31 per cent) would see their doctor or dentist first'. It does rather beg the question as to why this is happening and why people are trusting information from a 'virtual doctor' rather than a real-life version. Are people frightened of visiting the dentist/doctor or simply fearful of the truth? Or is it that they just can't get an appointment without a wrestling match with a receptionist or waiting a week or two?

I think the truth of the matter is very complex, politically based and fraught by bureaucracy like many things in our world. Humans are known to take the path of least resistance and in this case the resistance presents itself in terms of fear, lack of knowledge, problematic access to medical services and poor public awareness of this hidden killer. If you find an unusual lesion or a lump or bump, you want to find out what it is quickly and the internet provides the path that seemingly overcomes the resistance instantly. However, the path of least resistance can be a hazardous route to take. Many on-line diagnostic websites only give an overview of what to look for. Some sites relate symptoms to a diagnosis eg red patch = erythroplakia, but do not relay the need to see a doctor or dentist quickly to the patient. This is particularly worrying as a lesion may well have been there for a while before being detected by the patient. In many cases, lesions that are visible in the mouth have already developed into a carcinoma in situ and need immediate attention and I can't find one self-diagnostic website that gives me this information. Very worrying indeed!

The message is very clear. As dental and medical professionals, we need to be shouting from the rooftops about the importance of regular oral cancer screening with a dentist. Regular screening is key to early detection and can increase survival rates from just 50% up to 90%. Hugely significant! Teach patients to self-screen properly and furnish them with the correct information about how to act in the event of finding something out of the ordinary. They can then make an informed decision to reattend before a given recall interval and be checked out by a real live dentist. If we don't educate and speak to patients and the public about oral cancer, I can only see the situation getting worse. More and more people will continue to rely on self-screening websites and virtual doctors without understanding the risks of doing so. New cases of oral cancer may end up being seen by a professional very late and survival rates could fall rather than improve. 

As we near the end of Mouth Cancer Action Month, I would urge everyone to engage with the campaign not just for November but all year round!