title: A survey of National Cancer Institute-designated comprehensive cancer centers' oral health supportive care practices and resources in the USA.
abstract: BACKGROUND
  The oral complications and morbidity resulting from overall cancer therapy utilizing radiation, chemotherapy, and/or stem cell transplantation can have significant impact on a patient's health, quality of life, cost of care, and cancer management. There has been minimal health services research focusing on the status of medically necessary, oral supportive services at US cancer centers.
  
  
  METHODS
  A pre-tested, survey questionnaire was distributed to the directors of National Cancer Institute (NCI)-designated comprehensive cancer centers to assess each institution's resource availability and clinical practices, as it relates to the prevention and management of oral complications during cancer treatment.
  
  
  RESULTS
  Sixteen of the 39 comprehensive cancer centers responded to the survey. Of the respondents, 56% of the centers did not have a dental department. The sites of delivery of oral supportive care services range from the provision of in-house dental care to community-based, private practice sites. No standard protocols were in place for either oral preventive care or for supportive services for oral complications during or after cancer therapy. Fifty percent of the responding comprehensive cancer centers reported orally focused research and/or clinical trial activities.
  
  
  CONCLUSIONS
  Comprehensive cancer care must include an oral care component, particularly for those cancer patients who are at high risk for oral complications. This requires a functional team of oral care providers collaborating closely within the oncology team. Considering the number of cancer patients receiving aggressive oncologic treatment that may result in oral toxicity, the impact of oral conditions on a compromised host, and the potential lack of appropriate resources and healthcare personnel to manage these complications, future research efforts are needed to identify the strengths and weaknesses of present oral supportive care delivery systems at both NCI-designated cancer centers and community-based oncology practices.
authors.affiliation: Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois, MC-838, 801 S. Paulina Street, Chicago, IL, 60612, USA. jepstein@uic.edu
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.forename: Ira R
authors.initials: IR
authors.lastname: Parker
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Epstein
authors.forename: Anurag
authors.initials: A
authors.lastname: Gupta
authors.forename: Susan
authors.initials: S
authors.lastname: Kutis
authors.forename: Daniela M
authors.initials: DM
authors.lastname: Witkowski
mesh_terms: D002173:Cancer Care Facilities; D003752:Dental Health Services; D019538:Health Care Surveys; D006295:Health Resources; D006801:Humans; D009059:Mouth Diseases; D009316:National Institutes of Health (U.S.); D009369:Neoplasms; D009909:Oral Health; D010346:Patient Care Management; D011795:Surveys and Questionnaires; D014481:United States