Assessing the need for an educational intervention for primary care practitioners on HPV-related oropharyngeal cancer

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Cori Rebecca Atlin


Primary Care, ENT, Oncology, Surveys, HPV


Background and Objectives:
Human papillomavirus (HPV) is causing an epidemic of oropharyngeal squamous cell carcinoma (OPSCC). Patients presenting with HPV-related OPSCC tend to be younger and lacking the traditional risk factors of smoking and alcohol use. The objective of the present study was to assess whether knowledge of the demographic shift in the patient population affected by OPSCC has been disseminated to primary care practitioners.

Using an original questionnaire, we performed a quantitative cross-sectional needs assessment of family physicians, family medicine residents and advanced practice registered nurses in Ontario, Canada to asses their general knowledge and recognition of OPSCC.

Fifty-four respondents out of 11000 (0.5% response rate); majority were CCFPs (n=29; 59.18%) or FCFPs (n=9; 18.37%). When a 45-year-old patient presents with a persistent sore throat and enlarged tonsil, the majority (98%; n=50) would not refer immediately. Of those who did not refer after first and second line management (n=33), the majority (n= 20; 60.6%) would wait 1-4 weeks before referring. When a 45-year-old non-drinking, non-smoking patient presents with a progressively worsening sore throat, enlarged tonsil and lymphadenopathy, sexual history was elicited always (64.7%; n=33), sometimes (31.37%; n=16) and never (3.92%; n=2), but smoking and alcohol history was almost always elicited (90.2%; n=46 and 62.8%; n=32, respectively). Two true/false questions regarding prevalence and prognosis were answered incorrectly by a majority of respondents (69.4%; n=34 and 59.2%; n=29, respectively). Most participants (95.9%; n=47) wanted to learn more.

A knowledge gap exists regarding the demographic shift in OPSCC.