Oral cancer is associated with deprivation, with a higher incidence and mortality in the most disadvantaged groups. Scott et al. (2008) found that deprived patients were less likely to notice malignant lesions in their early stages and similar to Llewellyn et al. (2004), patients of a lower socioeconomic status were more likely to delay seeking health care utilisation. One reason for diagnostic delay is the patients’ inability to obtain service due to financial barriers. Patients delay following up on referrals due to cost leads to a delay in diagnosis. A disproportionate number of low-income populations, such as immigrants and the elderly have difficulty accessing oral health care.8 This is of particular concern in oral cancer as the average age at diagnosis is in the seventh decade and South Asian immigrants are at a higher risk for oral cancer. Diagnosis of oral cancer at an early stage (or as a premalignant lesion) is associated with better survival, and reduced morbidity and financial costs.
Currently in BC, the clinicians who would be the most likely to identify early oral cancer lesions are family dentists and/or dental hygienists. These patients would require either expertise evaluation by an oral medicine specialist or a biopsy to ascertain the exact diagnosis. In most cases, there is currently no MSP coverage, creating financial and service barriers that delay or preclude patients in BC with suspect oral dysplasia/neoplasia from benefitting from early diagnosis and early intervention. Without a mechanism to alleviate these barriers, these patients in BC face increasing mortality and morbidity.