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Br Dent J 2016:221: 247–250 http://dx.doi.org/10.1038/sj.bdj.2016.643

It is often pointed out that even those patients who visit a dentist for a check-up in the time-honoured if not evidence-based frequency of every six-months only spend part of two days a year with an oral health professional compared with 363 when they don't. If that is true for one-to-one care, treatment and advice it is also true for sources of information on oral health matters.

The research reported in this paper provides a very valuable analysis of how oral cancer is portrayed in UK newspaper print media achieved by scanning story content for over three years in ten UK national newspapers with the greatest print circulation. Specifically the authors studied how signs and symptoms of oral cancer were covered, signposting to care and emotive language used in stories.

What has emerged is that the subject matter is quite widely reported with a total of 279 articles identified and, following exclusions of duplicates and so forth, 239 analysed with 78 from broadsheet and 161 tabloid newspapers. Perhaps not surprisingly these were written along what might be described as journalistic lines of recent research, health information, celebrity linkage, survivor stories, legal issues and cancer as an 'other' issue in stories. Within these, topics of smoking and alcohol, signposting to health services, risk factors, negative emotional language and signs and symptoms predominated.

Proportion of news articles covering aspects of oral cancer and advice found in the study

However, unlike specific health education material, the pieces hardly ever included information on signs and symptoms, advice to seek early professional help or indeed where to go to seek help, for example, from the dentist or GP. One has to remember that journalists are writing for a different reason than oral cancer prevention, they are scribing to sell newspapers. Nevertheless, one cannot help feeling that the addition of a few salient facts about what readers might look for in their own mouths or those of family members could be very valuable additions in the campaign to prompt early recognition and consultation. Saliently, we must all have journalists as patients; maybe we should have quiet words in ears for the two days that they might spend with us each year?

Author Q&A with Ilona Johnson University of Cardiff

What is the impact of your results?

Oral cancer awareness and prevention are critical. Cancer UK statistics show incidence rates have increased by over 90% since the late 70s, and survival has not improved. Older people and those from deprived backgrounds are at greatest risk of developing oral cancer, but they are also the least likely to visit the dentist. Early identification is key to survival, and we need to use every possible opportunity to prevent oral cancer.

Our study found that oral cancer does feature in newspaper articles, but opportunities to raise awareness of oral cancer to a wider audience highlighting signs and symptoms, using proper evidence and signposting people to help are often missed. We have recommended some simple changes to news reporting of oral cancer to address this, which could save many lives.

What do you feel the dental profession can do to influence the media?

On a local level, we should be talking about oral cancer with patients and the public. News stories can provide an excellent opportunity to engage with people. When doing this, we need to be clear and consistent about our messages highlighting proper sources of information and the evidence. In addition, as a profession, we should be encouraging and facilitating responsible health journalism.

Do you have plans for further research in this field?

We are particularly interested in improving oral health among older adults, and are working to improve awareness of signs and symptoms of oral cancer amongst older people and those working with older people. We are looking to extend our work to examine ways to make the information that we give, effective. We need to ensure the messages work and that they are in the right place at the right time.

Expert view By Nigel Carter OBE CEO Oral Health Foundation — organiser of Mouth Cancer Action Month

This worthwhile piece of research aims to pinpoint how effectively the public are getting messages about oral cancer through the press and media.

By focusing on the method by which the media report on oral cancer the researchers have effectively identified the ways in which dental professionals can adjust their messaging to the media and public alike.

It is no surprise to hear that many articles are not evidence based and fail to contain the accurate information on risk factors and signs and symptoms which would be most useful.

After 40 years of dealing with the media and seeing the inaccurate reporting that often arises even when high quality information has been provided to the journalist it will be a hard battle to try and implement the authors' proposed media guidance for responsible reporting.

The number of journalists directly employed by newspapers has greatly decreased and editorial input into articles submitted by freelancers can be extremely limited.

Playing on fear through 'shock' reporting can be a risky strategy. While some may choose to actively avoid the messaging through uneasiness, for others it has been proven to be a highly effective way of communication.

It is clear that whilst celebrity stories quite possibly gain some of the greatest coverage the 'celebrity' aspect of the story tends to dominate to the exclusion of health education messages. The breadth of this coverage though has been shown to lead to more members of the public presenting for opportunistic screening.

It is pleasing to hear that it is the health information stories that perhaps give the most balanced and useful coverage since it is this type of material that Mouth Cancer Action Month aims to get published.

Survivor stories whilst useful can be seen by the newspapers as an opportunity for sensationalism or criticising professionals and very often the chance for good health messaging is lost.

A barrier that will remain is the media's goal of 'selling newspapers', which may continue to inhibit important messages getting to patients as they are traded off for a 'good story'.