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In AugustCDC convened a national conference to develop strategies for preventing and controlling oral and pharyngeal cancer in the United States. The conference, catalanotto and oral and pharyngeal cancer, which was cosponsored by the National Institute of Dental Research of the National Institutes of Health and the American Dental Association, included experts in oral and pharyngeal cancer prevention, treatment, and research; both the private and public sectors were represented. Participants at the conference developed recommendations concerning advocacy, collaboration, and coalition building; public health policy; public education; professional education and practice; and data collection, catalanotto and oral and pharyngeal cancer, evaluation, and research.
A follow-up meeting consisting of selected participants of the conference was held in September During this meeting, changes that had occurred in the political and scientific arenas since the conference were considered, and 10 recommended strategies from the conference were selected for priority implementation. CDC will use these recommended strategies to develop programs to reduce the burden of oral and pharyngeal cancer in the United States.
Through the Oral Cancer Roundtable, a group of conference and meeting participants, CDC will communicate to interested agencies, organizations, and state health departments ways in which they can implement elements of the national plan. The Roundtable will help CDC track the efforts and progress of these groups. During the past decade, federal health agencies have focused on reducing the incidence of oral and pharyngeal cancer and increasing the 5-year survival rate from these cancers in the United States.
Beginning with a consortium of health agencies in and including a strategic planning conference in and a follow-up meeting inCDC has been involved in concerted efforts to establish a national plan for preventing and controlling these cancers.
This report presents recommended strategies for action from the conference and a list of priority recommendations from the meeting. These recommendations will enable CDC to develop a coordinated national plan to reduce morbidity and mortality from oral and pharyngeal cancer in the United States. Inthis diagnosis will be made in an estimated 30, Americans; approximately 8, deaths 5, catalanotto and oral and pharyngeal cancer and 2, females are expected in allergy and asthma jenkintown year 2.
Ninety-five percent of cases of oral cancer occur among persons aged greater than 40 years, and the average age at diagnosis is 60 years 3.
Inthe male-to-female ratio of oral cancer incidence was approximately 6: The changing ratio is likely the result of the increase in smoking among women in the past three decades 3.
Duringthe annual incidence rate among black males in the United States was 1. Despite agressive combinations of surgery, radiation therapy, and chemotherapy, the 5-year survival rate for oral cancer is poor blacks: The use of tobacco in other forms i. Persons who have oral cancer often develop multiple primary lesions i.
Persons having primary oral cancer are more likely to develop a second primary cancer of the aerodigestive tract i. The initally diagnosed disease accounts for one half of the deaths caused by oral cancer; one fourth of these deaths are due to a second primary cancer, and the remaining one fourth are attributable to other illnesses Diagnosing cancers at an early stage is crucial to improving survival rate and reducing morbidity.
During the past decade, at diagnosis stage has not changed significantly 3. The Oral Cancer Work Group, which was formed as part of this initiative, subsequently developed short-term and long-term goals for preventing and controlling oral cancer. A list of these goals was disseminated to interested organizations and individuals in One of the recommendations of the Oral Cancer Work Group was to summarize the state of the science regarding oral cancer.
In response, CDC commissioned nine background papers regarding the prevention, control, and treatment of the disease and addressing current knowledge, emerging trends, opportunities, and barriers to further progress. The authors, representing several specialties and expertise, drew on current literature reviews, in-depth critiques, and personal experience. The Oral Cancer Work Group also suggested that CDC convene a conference to develop national strategies to help make oral cancer prevention and control a higher public health priority.
The planning group, along with a larger cadre of oral cancer experts, developed a draft set of strategies. This draft catalanotto and oral and pharyngeal cancer the nine background papers were distributed to invited participants before the conference.
Participants included invited experts in oral cancer prevention, treatment, and research; both the private and public sectors were represented. Following brief welcoming remarks by ADA, CDC, and NIDR representatives, nationally recognized experts made presentations on the etiology of oral cancer, its epidemiology, ongoing and cancer and aquarius research, and clinical experience with five other cancers i.
A survivor of oral cancer described the human impact of the disease. Conference participants broke into five work groups: The work groups made revisions, including comments raised during the general erectile dysfunction and heart problems. After the conference, the recommended strategies were disseminated to all participants for final review and comments.
These last comments were incorporated to produce the finalized recommended strategies to reduce oral cancer morbidity and mortality in the United States. The work group on advocacy, collaboration, and coalition building e. Establish an ongoing, institutionalized mechanism to implement and monitor progress made regarding the recommended strategies developed during the conference. Urge professionals in oral health and other health disciplines to become more actively involved in community health concerns, especially in preventing tobacco and heavy alcohol use, by.
Promote the publication and dissemination of the U. This document, mandated by the Comprehensive Smoking Education Act of 14 and the Comprehensive Smokeless Tobacco Health Education Act of 15should review completely the health effects of and trends in tobacco use.
It should also serve as a tool to update policymakers, the media, and the public on smokeless tobacco use and oral health. Increase excise taxes on tobacco and alcohol products to provide targeted funding for oral cancer prevention programs.
Food and Drug Administration regulatory authority over tobacco, because nicotine is an addictive drug. Prohibit all advertising and promotional activities by the tobacco industry and conduct a well-funded counteradvertising campaign that focuses on cigarettes, cigars, pipe tobacco, and spit tobacco.
Deny federal health and medical research funding to organizations that accept health research funding from the tobacco industry or its research institutes. Increase excise taxes on spit tobacco to an amount equal to or greater than the taxes on cigarettes.
Encourage professional sports teams to ban the use of tobacco products among team members during practices and games. Add catalanotto and oral and pharyngeal cancer statements cats and amoxicillin tobacco and alcohol warning labels about the risk of oral catalanotto and oral and pharyngeal cancer. Model warnings after those used in Australia and Canada.
Require instruction in preventing and controlling tobacco and alcohol use, including tobacco cessation, at all levels of training in dental, medical, nursing, and related health-care disciplines. Ensure that clinicians learn procedures to detect oral cancer that are appropriate to their professional practice. Urge all health professionals to routinely assess tobacco and alcohol intake by their patients. Encourage health-care agencies and professionals cytomegalovirus and valtrex side effects recommend that all clinicians who deliver primary health care routinely examine their patients for oral cancer.
Encourage Medicaid, Medicare, traditional insurance plans, and managed-care entities to make oral cancer examinations an integral part of comprehensive physical and oral examinations.
Base reimbursement for oral cancer examinations on the service provided rather than the academic degree of the provider. Designate federal funding for a national program of oral cancer prevention, early detection, and control that includes support for outcomes assessment and policy-based research.
Develop and disseminate guidelines and lists of resources to assist communities e. This effort could include an inventory of available guidelines, literature, processes, catalanotto and oral and pharyngeal cancer, and educational models. Develop, implement, and evaluate statewide models to educate all relevant groups. These models should be tailored to local needs, practical, culturally appropriate, and user friendly and should include the following content areas:.
Develop and conduct a national campaign to raise public awareness of oral cancer and its link to tobacco use and heavy alcohol consumption. The campaign might include a mascot or antihistamine and astelin, sports figures or other distinguished persons as spokespersons, or a national oral cancer awareness week.
Ensure that behavioral and educational research in oral cancer is included in the budget of organizations that sponsor such research e. Increase the representation of educators, behavioral scientists, and oral cancer specialists on the grant review committees of cancer and dental research institutions.
Develop health-care curricula that require competency in prevention, diagnosis, catalanotto and oral and pharyngeal cancer, and multidisciplinary management of oral cancer, including the prevention and cessation of tobacco use and alcohol abuse.
Promote soft tissue examination for oral cancer as a standard part of a complete patient examination. Develop, promote, and maintain a database of all professional education materials related to oral cancer.
Define, identify, develop, and promote centers of excellence in oral cancer management. Sponsor and promote continuing education for health-care professionals on the multidisciplinary management of all phases of oral cancer and its sequelae. In addition, the work group identified seven initiatives that would facilitate achievement of their recommended strategies: These recommended strategies would facilitate research regarding the etiology, prevention, and treatment of oral cancer and would translate research findings into effective public health action.
Increase funding or target existing funding to initiate and sustain research concerning oral cancer. Improve the capacity of individual health practitioners and small medical centers to participate in research regarding prevention strategies and therapeutic approaches.
Develop curricula for basic preparation and continuing education for health professionals that will improve their knowledge of the nature, value, implementation, and importance of well-designed and well-conducted research studies. Develop valid and reliable patient-oriented indices of health, quality of life, and functioning.
Obtain input from affected groups e, catalanotto and oral and pharyngeal cancer. Conduct focus groups and gather other information to refine research questions and formulate effective ways to obtain responses, cooperation, and compliance from research colon cancer and katie couric. Create multidisciplinary groups to facilitate movement of findings in two directions -- from basic research to applied research and from research in the clinical sciences, epidemiology, and health-services delivery to basic science -- thus helping to focus basic research efforts.
Such strategies may include the following:. Strengthen organizational approaches to reducing oral cancer by developing cooperative and collaborative arrangements, funding formal centers, and involving commercial firms. The following means are suggested:. The Oral Cancer Working Group, a multidisciplinary group who attended the Oral Cancer Strategic Planning Conference, met September, to identify 10 strategies from the meeting recommendations to receive immediate attention and implementation by the agencies they represented.
The Oral Cancer Working Group considered political and scientific changes that had occurred after the conference e. Food and Drug Administration had been given regulatory authority over tobacco, legal cases involving tobacco had been settled in several states, national tobacco legislation had been proposed, and catalanotto and oral and pharyngeal cancer comprehensive oral cancer research centers had been funded by NIDR and selected strategies the group could effect as opposed to strategies already under way as a result of the leadership and support of other groups.
The 10 priority strategies are catalanotto and oral and pharyngeal cancer follows. Establish a mechanism to implement and monitor progress made regarding the recommended strategies developed during the national conference. Urge oral health professionals to become more actively involved in community health concerns.
Require instruction in preventing and controlling tobacco and alcohol use at all levels of training in dental, medical, nursing, and related health-care disciplines. Designate federal funding for a national program of oral cancer prevention, catalanotto and oral and pharyngeal cancer, early detection, and control.
After assessing local needs, develop, implement, and evaluate statewide models to educate all relevant groups. Develop health-care curricula that require competency in prevention, diagnosis, and multidisciplinary management of oral cancer.
Members of the Roundtable will communicate among themselves to discuss implemention of the priority recommendations and the recommendations from the conference and to share information on progress made, catalanotto and oral and pharyngeal cancer.