British Journal of Oral and Maxillofacial Surgery 58 (2020) 3–24 Available online at www.sciencedirect.com ScienceDirect Review Medical practitioners’ educational competence about oral and oropharyngeal carcinoma: a systematic review and meta-analysis S. Papadiochou a,∗ , I. Papadiochos b , C. Perisanidis c , N. Papadogeorgakis d a Health Center of Spata, Spata Attikis 19004, Greece b Eacmfs Clinical Fellow, Chirurgie Maxillo-faciale et Stomatologie, CHU Amiens-Picardie, 1 Rue du Professeur Christian Cabrol, 80000 Amiens, France c Oral & Maxillofacial Surgery Department, Evaggelismos General Hospital of Athens, National and Kapodistrian University of Athens, Greece d Oral and Maxillofacial Surgery, National and Kapodistrian University of Athens, Greece Accepted 12 August 2019 Available online 27 November 2019 Abstract Medical practitioners’ (MP) role is pivotal in primary prevention, early diagnosis, prompt referral and effective management of oral and oropharyngeal carcinomas (OC/OPC), which raises the importance of their effective OC/OPC education at all levels of medical education. The purpose of this systematic review was to summarise the available scientific evidence about their educational competence in dealing with OC/OPC. We made a systematic search of papers in the English language in MEDLINE, Scopus, Cochrane Library CENTRAL and CINAHL databases from their inception until December 2018. Overall, 23 cross-sectional and three interventional studies have been selected for the systematic review and 18 of these were included in the meta-analyses. Excluding tobacco use (synthesised estimate of 95% of respondents identified tobacco as an OC/OPC risk factor, 95% CI of synthesised estimate 92% to 97%) and alcohol consumption (65%, 95%CI 52% to 77%), less than half of MP (approximately) were knowledgeable about important OC/OPC risk factors including human papilloma virus (42%, 95% CI 30% to 54%), poor diet (34%, 95% CI 17% to 54%), and advancing age (45%, 95% CI 21% to 70%). There was a low to moderate level of awareness among MP regarding common precancerous oral lesions involving leukoplakia (56%, 95% CI 32% to 79%), erythroplakia (30%, 95% CI 8% to 58%), and oral lichen planus (13%, 95% CI 0 to 41%). Moderate knowledge was also recorded about frequent sites of OC development involving the tongue (48%, 95% CI 33% to 64%) and floor of the mouth (37%, 95% CI 19% to 57%). Most MP enquired about tobacco use (86%, 95% CI 74% to 96%), and alcohol consumption (73%, 95% CI 47% to 94%) during history taking, and expressed willingness to be given supplementary OC/OPC education (78%, 95% CI 54% to 96%), as well. With regard to the incidence of intraoral screening, 27% of MP (95% CI 12% to 46%) make an intraoral examination as a routine. Interestingly, studies from each continent yielded significantly different outcomes to some research questions in the review. From the MP’s perspective, clinical time restrictions and deficiencies in organised training were recognised as the main barriers towards their OC/OPC educational competence. The findings of this systematic review indicated the existence of deficiencies in knowledge and misconceptions, neglected preventive responsibilities, and associated barriers towards OC/OPC. A need for improved OC/OPC training at all levels of medical education is required to increase competence worldwide. © 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Keywords: knowledge; attitudes; practices; medical practitioners; oral cancer; oropharyngeal cancer ∗ Corresponding author. E-mail addresses: sofiapapadiochou@gmail.com (S. Papadiochou), ioannispapadiochos@gmail.com (I. Papadiochos), cperis@dent.uoa.gr (C. Perisanidis), papavr@yahoo.com (N. Papadogeorgakis). Introduction According to the official report of Global Cancer Statistics (GLOBOCAN) about the incidence and mortality estimates for 2018, the incidence of lip, oral, and oropharyngeal car- https://doi.org/10.1016/j.bjoms.2019.08.007 0266-4356/© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.