The Pharmaceutical Journal
Vol 270 No 7240 p367
15 March 2003

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  OFT report
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Letters to the Editor

Oral health

A role for pharmacists in cancer detection

From Dr I. Macleod, and others

Oral cancer is one of the most serious disorders to affect the mouth and in the United Kingdom there are about 3,800 new cases each year and around 1,700 deaths. This unfortunately high mortality is often a result of late presentation, since, frequently, patients will put off attending their dental or medical practitioner, preferring instead to self-treat until the problem becomes unmanageable.

We instigated a survey, whose aim was to look at ways of facilitating referral at an earlier stage when the disease would be more amenable to successful treatment. We decided to contact community pharmacists, because they are probably the most accessible members of the primary health care team for the general public. A postal survey of all community pharmacists in Edinburgh was undertaken over a four-week period between September and October 2002 to assess the sorts of oral problems pharmacists are being asked about. The results of our survey revealed that each pharmacist over the trial period was being asked at least once a week about an oral-related problem. In 83 per cent of cases patients asked advice for themselves and in 13 per cent of cases, for a relative. Of significance, 47 per cent of the queries related to mouth ulcers or persistent oral soreness; clearly, among this group, there might well be patients with oral cancer or a premalignant condition. In nearly all cases the pharmacist had been the only health care professional from whom advice had been sought. This confirmed our original impression of what was occurring.

To help facilitate referral directly from a pharmacy, we produced a patient information sheet and a credit card sized version that could be taken away. These included a helpline telephone number. In addition, we provided educational material for pharmacists. There is an ongoing audit to monitor how effective this approach has been. We would be pleased to supply copies of our information leaflets to anyone requesting them.

Ian Macleod
Consultant in Oral Medicine/Radiology
Edinburgh Dental Institute
Lauriston Place
Edinburgh EH3 9YW

Graham Bell
Consultant in Dental Public Health
Fife, Lothians and Borders

Anne Lorimer
Community Pharmacist
Edinburgh

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