Citadel ideal site for oral cancer screening
by Dick PetersonPublic Relations
Not everybody there dips.
But “The Citadel is as unique a population of smokeless tobacco users as you can find anywhere,” said associate professor of oral medicine Mark Barry, DDS.
Barry is mentor to dental students Scott Kibler and Greg Millwood, who chose to determine the incidence of oral pre-cancerous lesions among smokeless tobacco users for this year’s College of Dental Medicine table clinic project. The Citadel appeared to be a place to screen for smokeless tobacco-related lesions.
Dr.
Mark Barry screens a cadet for pre-cancerous lesions.
It began with what Kibler, Millwood and Barry call “hall talk” with cadet friends and with MUSC colleagues who are Citadel graduates. From them came the tip that there’s a lot of dipping going on over there.
Permission was granted from Clay Robertson, M.D., the campus doctor, and from The Citadel’s assistant commandant Col. ‘Scoot’ Powers. At the Medical University, the project was submitted to the Institutional Review Board for approval to perform examinations. Posters and fliers called for volunteers, and on Feb. 21 with the assistance of Dr. Gerald Johnson, director of the college’s Mobile Dental Clinic, the team rolled onto campus.
“We saw 112 cadets, all volunteers, all males,” Barry said. Some had been using smokeless tobacco for up to eight years. He reports the cadets came mostly out of concern that a risky habit may be planting seeds for oral cancer in the future.
Of the 112 cadets examined, 81— that's 72.3 percent—had at least one precancerous lesion. Compare that to National Cancer Institute statistics that state 40 percent to 60 percent of smokeless tobacco users will develop lesions, and The Citadel numbers run high.
Classifying the lesions as grade one (less severe and superficial) to grade three (most severe and clinically destructive), Kibler, Millhouse and Barry found 61 cadets with grade one lesions, 37 with grade two, and 14 with grade three. By National Cancer Institute standards, all smokeless tobacco lesions are considered precancerous.
“There is good news,” Barry said. “If smokeless tobacco use is discontinued, the vast majority of lesions disappear. If they don’t disappear, then we biopsy for oral cancer.”
“You don’t smoke there,” Millwood said. Many of the cadets who dip snuff were formerly smokers who quit when faced with the athletic rigors of The Citadel.
Smoking is discouraged, cadets aren’t allowed to leave campus without a pass, and the study time requirement keeps cadets in their rooms and in the books until lights out. That and peer pressure, Kibler and Millwood report, are cultural preconditions that direct many to go smokeless.
“Smokeless tobacco products are readily available and at the rate of five cans a week that some of the cadets report using, the yearly cost to the user can run about $1,000,” Barry speculates.
Cadets who participated in the screening were given American Cancer
Society and National Cancer Institute brochures about the devastating effects
of oral cancer, were counseled on the dangers of smokeless tobacco and
on cessation techniques, and the results of each screening was forwarded
to the cadet’s personal dentist.