Clin Oral Invest (2003) 7:46–51 DOI 10.1007/s00784-002-0181-4 Abstract The ability to diagnose oral cancer depends in part on the knowledge, attitudes, and practices of the health professional. On the other hand, the patients’ choice of health professional depends on their percep- tions of the ability of such professionals to diagnose and treat what they believe their health problem is. In this study, we investigated the clinical profiles of patients with oral cancer (n=354) when first seen by dentists (n=129) or physicians (n=225) in a teaching hospital. The charts of patients with oral squamous cell carcinoma were analyzed for the following variables: age, sex, race, signs and symptoms by the time of presentation to the health professional, size and site of the tumor since first manifestation, and clinical stage of the disease. Our re- sults demonstrate that dentists and physicians assessed patients comparably regarding age, sex, and race. Pa- tients complaining of dysphagia and odynophagia were seen more often by physicians than dentists (45/225 vs 9/129 [20.0% vs 7.0%] and 30/225 vs 4/129 [13.3% vs 3.1%], respectively), whereas those with local pain and burning preferentially sought dentists (77/129 vs 56/225 [59.7% vs 24.9%] and 4/129 [3.1%] vs 0/225, respec- tively). Physicians diagnosed oropharyngeal (45/208 vs 9/116 [21.6% vs 7.8%]) and lip lesions (71/208 vs 7/116 [34.1% vs 6.0%]) more often, whereas dentists saw more cases of cancer of the alveolar ridge (42/116 vs 7/208 [36.2% vs 3.4%]) and floor of the mouth (19/116 vs 10/208 [16.4% vs 4.8%]). Our findings suggest that pa- tients have different perceptions of the roles of dentists and physicians regarding the ability to diagnose and treat oral lesions. Signs, symptoms, and location of the cancer lesions appear to be the most important variables associ- ated with the choice of health professional. Keywords Oral cancer · Squamous cell carcinoma · Diagnosis · Health care Introduction Incidence and mortality rates of oral cancer are very high in Brazil, with figures in the magnitude of those found in India, Pakistan, Singapore, the United States, Canada, and France [9, 18, 24, 26, 28, 37]. The Brazilian Nation- al Institute of Cancer estimates that 11,255 new cases of oral cancer will be diagnosed in 2002, with age-adjusted incidence and mortality rates around 9.69/100,000 and 4.48/100,000, respectively, for males, and 3.25/100,000 and 1.16/100,000, respectively, for females [19]. An in- creasing incidence of oral cancer has been noted in the last decades, apparently associated with the widespread use of alcohol and tobacco [24, 26, 27, 28]. The diagno- sis of oral cancer is often made in advanced stages of the disease [9, 11]. Delay in oral cancer diagnosis has been linked to pa- tients, clinicians, or both [21, 39]. Patient delay, defined as the time when a “change” was first noticed in the mouth to the first visit to a health professional, has been associated to unawareness of the population regarding cancer’s early signs and symptoms. On the other hand, professional delay, the time interval between the first visit to a health professional and the definitive diagnosis, is related to inadequate training of health providers for making diagnoses [10]. The issue of training is of inter- est in oral cancer, since at least three types of health pro- fessionals can potentially detect this disease in its early stages: physicians, dentists, and dental hygienists [17]. Differences between dentists and physicians have been P. R. de Faria · S. V. Cardoso · A. M. Loyola ( ✉ ) Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia School of Dentistry, Av. Pará 1720, bloco 2 N, 38 405–900 Uberlândia (MG), Brazil e-mail: passaro@ufu.br Fax: +55-34-32182333 S. de A. Nishioka · S. J. Silva Departments of Internal Medicine and Surgery, Federal University of Uberlândia School of Medicine, Uberlândia (MG), Brazil ORIGINAL ARTICLE Paulo Rogério de Faria · Sérgio Vitorino Cardoso Sérgio de A. Nishioka · Sindeval José Silva Adriano Mota Loyola Clinical presentation of patients with oral squamous cell carcinoma when first seen by dentists or physicians in a teaching hospital in Brazil Received: 6 March 2002 / Accepted: 1 October 2002 / Published online: 23 January 2003 © Springer-Verlag 2003