Exploring a potential impact of a social marketing campaign on reducing oral cancer incidences in Michigan: an ecological study

OBJECTIVES/AIMS: The social marketing campaign was launched in 2005–2007 to address excess risk of oral cancer in Detroit tri-county area, Michigan. We assessed the extent to which the campaign might have contributed to decreasing risk of oral cancer using the modified interrupted time-series design. MATERIALS AND METHODS: Oral cancer incidence and mortality data came from Michigan Department of Community Health, and trends of age-adjusted rates during 1990–2009 were compared between intervention and comparison counties via joinpoint regression. RESULTS: Although mortality rates in both areas decreased in parallel manner, incidence rates decreased during and after the campaign only in the intervention counties. A similar trend was observed in the race-specific analysis. Alternative explanations, including population profiles, health-care access and pre-existing trends, were examined, and these characteristics were comparable between two areas in 1990s and 2000s. CONCLUSIONS: These results suggested that the campaign was more likely to be associated with the decreasing trend of oral cancer incidence in the intervention counties than alternative explanations. Although oral cancer is a deadly disease, its awareness has been relatively low. This study highlights a potential impact of concerted efforts to improve the oral cancer awareness in the high-risk communities.