Fury Over Churchill Cancer Gaffe Amid Calls For Apology
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- Published: Monday, 21 June 2021 08:07
- Written by Chris Tapper
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Jo Churchill drew wide criticism on social media from dental professionals at the weekend after making what appeared to be an ill-informed statement on the role of dentists in detecting oral cancer.
The Parliamentary Under-Secretary of State for Health and Social Care was answering a question asked by Peter Dowd, Labour Member of Parliament for Bootle.
Mr Dowd asked the Secretary of State Matt Hancock “Whether his department has plans to increase patients’ understanding of the merits of regular dental check-ups in helping to ensure the early diagnosis of oral cancer.”
Ms Churchill replied on behalf of Mr Hancock.
She said “No assessment has been made. Whilst dentists can play an ad hoc role in detecting potential oral cancers as a by-product of dental check-ups, oral cancer is primarily detected through the medical system.”
“The Department currently has no plans to promote dentists appointments for the specific purpose of oral cancer diagnosis. Patients with concerns should seek advice from their general practitioner and not wait for their next dental appointment.”
Ms Churchill appeared to misunderstand the role of clinical dental practitioners in detecting the early signs of oral cancer, during routine and regular dental examinations, when patients aren’t necessarily aware of problems in their mouths.
Social media users felt that the minister or her advisors had misinterpreted statistics, pointing out that definitive diagnosis IS usually performed by medically-based hospital practitioners, but only after primary care dental and medical practitioners have referred so that a final diagnosis can be made.
Dr Eddie Crouch, Chair of the British Dental Association wrote on Twitter “Think my colleagues will be disappointed with comments that we play an “ad hoc” role in oral cancer detection.”
In reply to Dr Crouch’s tweet, Sam Shah wrote “Not sure who provides you (Jo Churchill) with clinical advice, but to suggest it’s an ad hoc role is an insult to the profession. It’s views like this that really demonstrate how out of touch you and your department really are. Very disappointing.”
Ms Churchill’s statement appeared to ignore the fact that many dental-based organisations are behind promotions to raise the awareness of the signs of oral malignancy amongst the public. Each year during November, the Oral Health Foundation runs the Mouth Cancer Action Month.
But some dental professionals on Facebook and Twitter felt that health minister’s response was an attempt to downplay the role of dentistry in oral cancer detection.
Dr Judith Husband wrote on Twitter “This could be read as a cynical attempt to downgrade oral healthcare – avoid free access at the point of need (still a claim of the NHS), and enable the extension of recall periods beyond what is reasonable to screen for mouth cancers.”
GDPUK has found a number of large-scale studies have revealed no significant delay in referrals between dentists and medical practitioners for suspected oral cancers, although some studies have concluded that dentists refer patients at an earlier stage than physicians do.
A study carried out in the US in 2003 found that patients referred from dental surgeries were of a significantly lower stage in the course of the disease than those referred from general medical practices.
The study also found that as many as 72% of patients referred by physicians and ENT specialists were at advanced stages of the diseases, where only 21% of the patients referred by dentists and dental hygienists were at stages considered to be advanced.
The General Dental Council’s prescribed scope of practice for dental therapists and dental hygienists expects registrants to perform screening for oral cancer.
Replying to Dr Crouch, Debbie Hemington, Chair of the British Association of Dental Therapists wrote “I was speechless Eddie! Hygienists and therapists are also trained to recognise and refer and many of my colleagues have done... appalling statement from Jo Churchill.”
Dr Peter Crooks, Northern Ireland representative and current Deputy Chair of the BDA Principal Executive Committee wrote he disagreed with Jo Churchill.
“Recent figures from the Belfast Trust show 43% of oral cancer referrals from GDP’s, the rest are from GMP’s and other departments like haematology and dermatology. Dentists provide more than an ad hoc service.”
Some of the biggest criticism of the health minister came as it was revealed that she had written an article
in Harpers Bazaar on June 19th on “the importance of cervical cancer screening.”
Writing of her own past personal experiences with thyroid cancer and breast cancer, Jo Churchill said “Going to my GP and asking for help the minute I noticed a change in my body arguably saved my life. It meant my cancer was caught quickly before it had time to spread and I was able to get the help I needed to be diagnosed quickly and start treatment.”
Promoting the article through her Twitter feed, the minister said “Catching my cancers early helped give me a positive outcome. I explain in @harpersbazaarus why screening is important to early diagnosis. If you’ve been invited for screening please attend.”
Dr Richard Hellen wrote in response to Jo Churchill’s tweet “Your response to Peter Dowds question re the role of dentists in early cancer diagnosis is appallingly wide of the mark. You have been misinformed and I recommend that you spend some time in a dental practice.”
“In my time as a GDP I’ve detected and referred 4 squamous cell carcinomas. Sadly two patients died, but the other two were successfully treated.”
“This is because dentists as part of their undergraduate course are taught how to examine for cancer and many other conditions. I have palpated, and examined every single patient that I’ve ever examined, for cancer.”
“So it takes about one minute for a dentist to do a head neck and mouth cancer exam. We ask patients about risk factors and advise on them.”
“You will never find a more cost effective, community-based way of screening for mouth cancer. I am very disappointed at your lack of knowledge of this. But perhaps I’m not all that surprised?”
Replying to Dr Hellen, dental therapist Dave Bridges wrote “I would point out that dental hygienists and dental therapists are also trained to examine soft tissues and to refer appropriately.”
“It’s in our scope of practice. I have referred many patients: Amongst them - 1 SCC, 1 oesophageal tear and 1 Barrett’s syndrome.”
The British Association of Private Dentistry also strongly criticised Jo Churchill. They wrote "We are writing to protest in the strongest terms at your alarming mischaracterisation of dentistry in your response to the written questions from Peter Dowd."
"Studies show that dental professionals provide an essential core role in identifying, appropriately referring, and diagnosing, both symptomatic and pre symptomatic oral cancer cases, with evidence that detection by the dental team is at an earlier stage in the disease process, than that from medical colleagues. https://pubmed.ncbi.nlm.nih.gov/32591210/"
"As with all cancers, early diagnosis is associated with improved patient survival and reduced morbidity. We are appalled therefore that you, as Parliamentary Under Secretary for Health and Social Care, with responsibility for Dentistry, and accountability for improvements in health outcomes, are not in possession of these essential facts. Instead, you state: " Whilst dentists can play an ad hoc role in detecting potential oral cancers as a by-product of dental check-ups, oral cancer is primarily detected through the medical system."
"Contrary to your opinion, it is accepted by the profession worldwide, that oral cancer screening is an essential part of routine oral health screening. https://www.ada.org/en/publications/ada-news/2019-archive/september/ada-expands-poli cy-on-oral-cancer-detection-to-include-oropharyngeal-cancer http://www.cda-adc.ca/en/oral_health/complications/diseases/oral_cancer.asp https://bda.org/news-centre/blog/vigilance-is-essential-for-oral-cancer-detection https://www.cancerresearchuk.org/about-cancer/mouth-cancer/getting-diagnosed/screening."
"For all the above reasons, the promotion of improved access to dental care should be central to your approach to this burgeoning health care crisis. Instead, a massive opportunity to improve patient outcomes is being missed. This misrepresentation of the dental profession by the minister with responsibility for said profession is completely unacceptable, and we believe you owe the profession and the public an explanation and an apology."
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