Objective: To investigate the likelihood of smoking and betel quid chewing behavior changes, as well as the associated factors, among subjects in a nationwide oral cancer screening program in Taiwan, where oral cancer is the fourth leading malignancy in men. Methods: The Taiwanese Oral Cancer Screening Program targets smokers and betel quid chewers over the age of 30. Between 2010 and 2021, 2,578,245 individuals participated in the program at least twice. During each visit, the central data monitoring center collected information on gender, age, education level, smoking and betel quid chewing habits, the quantities consumed, and diagnoses of oral potentially malignant disorders (OPMDs) and oral cancer. A three-state Markov chain exponential regression model was employed to assess the probabilities of behavior change—deterioration, maintenance, or improvement—and the factors influencing these changes. Results: The largest proportion of both smokers and betel quid chewers remained unchanged in the repeated attendees. The smoking cessation transition result was less than 10%, whereas the reduction in dosage exceeded 20%. However, the discontinuation of betel quid chewing was observed in more than 20% of individuals in the low-dose group, and there was also a reduction in dosage of more than 20%. The positive OPMDs caused the progression of the Net Force Progression (NFP) from an initial stage of none, as well as the NFP between low and high doses of both smoking and betel quid chewing. Higher levels of education, residing in urban areas, and receiving screenings in large hospitals help to avoid the progressive NFP between low and high doses of smoking. Additionally, these factors also help to prevent the development of the NFP from an initial stage of none, as well as the progressive NFP between low and high doses of betel quid chewing. Conclusions: Participation in an oral cancer screening program can effectively enhance hazardous oral behaviors, including smoking and betel quid chewing. Although it may not have a substantial effect on smoking cessation, it can decrease the daily consumption of cigarettes. This approach demonstrates encouraging outcomes in encouraging individuals to quit betel quid chewing and decrease their daily consumption. Higher levels of education, urban residency, and receiving screenings at large hospitals all have a good impact on reducing dangerous oral cancer behaviors.
目的：在台湾，口腔癌是男性第四大恶性肿瘤。本研究旨在探讨参与全国口腔癌筛查项目的受试者吸烟与嚼槟榔行为改变的可能性及其相关因素。方法：台湾口腔癌筛查项目针对30岁以上的吸烟者和嚼槟榔者。2010年至2021年间，共有2,578,245人至少参与该项目两次。每次筛查时，中央数据监测中心收集了参与者的性别、年龄、教育水平、吸烟与嚼槟榔习惯、消费量以及口腔潜在恶性病变（OPMDs）和口腔癌的诊断信息。采用三状态马尔可夫链指数回归模型评估行为改变（恶化、维持或改善）的概率及其影响因素。结果：在重复参与者中，吸烟者和嚼槟榔者中行为保持不变的比例最大。戒烟转变率低于10%，而减少吸烟量的比例超过20%。然而，在低剂量嚼槟榔组中，超过20%的个体停止了嚼槟榔行为，且减少槟榔消费量的比例也超过20%。口腔潜在恶性病变（OPMDs）的存在促使净进展力（NFP）从初始的无病变阶段进展，同时也促使吸烟和嚼槟榔行为在低剂量与高剂量之间的NFP进展。较高的教育水平、居住在城市地区以及在大型医院接受筛查有助于避免吸烟行为在低剂量与高剂量之间的NFP进展。此外，这些因素也有助于防止嚼槟榔行为从初始的无病变阶段发展为NFP，以及避免其在低剂量与高剂量之间的NFP进展。结论：参与口腔癌筛查项目可有效改善吸烟和嚼槟榔等危险口腔行为。尽管对戒烟的影响可能有限，但能减少每日吸烟量。该方法在鼓励个体戒除嚼槟榔和减少每日槟榔消费量方面显示出积极效果。较高的教育水平、城市居住以及在大型医院接受筛查均对减少危险的口腔癌行为具有良好影响。
肿瘤(癌症)患者之家