Most oral and pharyngeal cancers (OPC are preventable, and many are curable when diagnosed at an early stage. North Carolina (NC) is the 11th most populous state and ranks 13th in age-adjusted mortality rate for OPCs. In NC, African Americans carry a disproportionate burden of this malignancy and are twice as likely to be diagnosed with regional or distant spread OPC as whites. Because tobacco and alcohol use are responsible for most oral cancers, and because the disease can be detected and treated at an early stage, it should be possible to develop and implement public health interventions that will impact this disease. However, since states may differ in the epidemiology of oral cancer, the public's exposure to risk factors and its awareness of the disease, health providers' knowledge, opinions, and practices regarding the disease, and the resources available for preventing and controlling the disease, state-specific plans are needed. In this project, NC OPC surveillance data will be used to characterize features of the state's OPC burden. Phone surveys of the general adult population will identify levels of public awareness about OPC risks, risk prevention, signs and symptoms, and access to care. Health care provider surveys and focus groups will identify how attitudes, knowledge and behavior regarding OPC prevention and early detection affect diagnosis stage. Patients newly diagnosed with OPC will be interviewed to document and characterize events leading to their diagnosis. An advisory committee will review research findings and guide development of statewide intervention. The hypothesis for this NC application is that by gaining state-specific information through needs assessments and by creating an organizational infrastructure responsible for developing, implementing, and evaluating a statewide plan for promoting the prevention and early detection of oral cancer, the incidence and mortality rates for OPC in NC, particularly among minorities, can be reduced.
