Oral squamous cell carcinoma (OSCC) remains a clinically important malignancy of the oral cavity with limited improvement in long-term survival. Early detection of visible oral lesions is a major determinant of prognosis, yet diagnostic delay persists. The authors designed this regional survey to assess public awareness of OSCC and its risk factors among adult customers of community pharmacies in Piedmont (North-West Italy), to identify demographic differences in knowledge, and to evaluate the perceived role of pharmacies as information and prevention sites.
A cross-sectional questionnaire-based study was carried out between 24 July 2023 and 28 June 2024 in community pharmacies across the Piedmont Region. Eligible participants were Italian-speaking adults (≥18 years) without evident cognitive impairment and without a personal history of OSCC. Recruitment was consecutive among pharmacy customers; 914 participants were included. The reported mean age of respondents was 54.1 ± 17.0 years.
The survey instrument comprised 15 items (two open-ended, one dichotomous, and twelve multiple-choice) organized into sociodemographic, knowledge/awareness, and perceptions sections. Items were adapted from previously validated instruments on OSCC and cancer awareness and refined by the research team. A pilot test with 20 pharmacy customers informed minor wording adjustments. Content validity was assessed by five university professors yielding a content validity index (CVI) of 0.92. The authors state that a full psychometric validation (construct or test–retest reliability) was not performed.
Face-to-face interviews were administered by trained researchers from the University of Turin to minimize interviewer-related bias. Key measured variables included prior awareness of OSCC (binary), sources of information, recognition of established and putative risk factors (e.g., tobacco, alcohol, sunlight exposure), knowledge of signs and symptoms, perceived appropriate healthcare professionals for suspicion, sociodemographic data (age, gender, education), dental check-up frequency, and smoking status.
Associations between awareness and participant characteristics were evaluated using chi-square tests and multivariable logistic regression analyses. The source reports that awareness was treated as a binary outcome (heard of OSCC vs not), and that multivariable models adjusted for relevant covariates; specific effect estimates and confidence intervals are provided in the full manuscript tables.
Overall, 70.4% of the 914 participants reported prior awareness of oral cancer (OSCC). Information most commonly came from family or friends (51.8%) and from the media (43.2%). The vast majority of respondents (92.2%) indicated they would welcome additional information on OSCC.
Respondents showed heterogeneous recognition of risk factors. Smoking was widely identified as a risk factor (97.9%). Fewer participants recognized alcohol consumption (63.9%) and even fewer identified sunlight exposure (18.6%) as risk factors. These findings underline variable public understanding of non-tobacco contributors to OSCC risk. Community pharmacies were identified by 67.3% of respondents as a preferred channel for receiving more information about OSCC.
Awareness of OSCC differed according to participant characteristics: gender, higher educational level, age, and smoking status significantly influenced awareness. The manuscript reports statistical testing using chi-square and multivariable logistic regression to quantify these associations; readers are referred to the source tables for specific adjusted estimates.
A strong majority (92.2%) desired further information about OSCC, and the most frequently indicated setting for receiving information was the community pharmacy (67.3%). The authors highlight community pharmacies’ accessibility, geographic distribution and extended opening hours as reasons they may serve effectively for targeted preventive interventions and awareness campaigns.
The study indicates that although awareness of OSCC is present in a majority of pharmacy customers in this regional sample, important knowledge gaps persist—particularly regarding non-tobacco risk factors and potentially early signs. Given that delayed diagnosis contributes to poorer survival and greater morbidity, the authors argue for regional awareness campaigns. Community pharmacies are proposed as pragmatic venues for education and outreach given participants’ preference for pharmacies as information sources.
The authors report that the questionnaire had strong content validity but acknowledge that a full psychometric validation was not performed. The study is cross-sectional and regionally focused (Piedmont), which limits generalizability beyond the surveyed setting. Despite these limitations, the data from 914 respondents support the need for targeted OSCC awareness efforts in North-Western Italy and suggest that community pharmacies could play a key role in delivering information and prevention activities.