Case record analysis: biopsied lesions in a high-risk white and African American Community

The purpose of this secondary data analysis was to characterize biopsied intraoral lesions documented from neighborhood health center records in a lower socioeconomic biracial community over an eight year period, (1982-1989.)

A thorough intraoral examination, which included radiographs, was completed by either a general dentist or an oral surgeon. Questionable lesions were referred to and biopsied in the Department of Pathology at Johns Hopkins Medical Center. Biopsied lesions were classified into three groups for analysis: benign, malignant/premalignant, and dental-related.

Of 13,317 recorded dental visits, 10,819 (81.2%) visits were made by African Americans. There were 341 lesions biopsied, representing 69 different histologic diagnoses. Of identified lesions, 76.5% were in African Americans; 41.6% were in males, ranging in age from 41 to 94 years old (a mean age of 73 +/- 7 years). Approximately 50% of identified lesions in African American and Whites were benign. Among African Americans, 11.9% of the lesions were malignant premalignant, while 16.3% were among Whites. Within the malignant/premalignant category, squamous cell carcinoma was the most frequently identified malignant lesion. Hyperkeratosis was the most common premalignant lesion type.

Neighborhood health centers can provide a valuable screening service identifying intraoral lesions in vulnerable communities. Future research should explore how socioeconomic factors affect differences in the prevalence of intraoral pathologies among White and African American subgroups as well as other subpopulations.