Health care auxiliaries in the detection and prevention of oral cancer

Oral cancer is one among the few human cancers with a vast potential for prevention. One of the operational strategies considered to translate preventive measures into practice in developing countries has been the use of community health workers and other health auxiliaries of the primary health care system to disseminate anti-tobacco health education messages and to provide mouth examinations in high-risk individuals during their routine home visits and community meetings. Studies conducted in India and Sri Lanka to address the role of the above approach indicate that it is feasible to train community health workers and other health auxiliaries in primary prevention and early detection of oral cancer and precancerous lesions. However, no evidence of the efficacy of such an approach in reducing the incidence and mortality from oral cancer is yet available. Sufficient evidence in terms of efficacy and cost effectiveness is needed to justifiably convince health administrators for the inclusion of non-communicable disease control in general and oral cancer screening in particular as part of the primary health care delivery by community health workers and other health auxiliaries, especially when considering the burden of already existing work responsibilities. The need for studies in this direction is very obvious. However, the opportunities for 'case-finding' and health education should be utilised when encountering high-risk subjects both in primary medical and health care. (C) 1997 Elsevier Science Ltd.