Socioeconomic indicators and economic investments influence oral cancer mortality in Latin America

Mortality and disease burden of oral cancer in China: a time-trend analysis on the China Death Surveillance Database from 2006 to 2021

BACKGROUND

Oral cancer is one of the most common cancers in China and seriously threaten life and health of Chinese people. We analysed the trends and disparities of oral cancer mortality rates and the disease burden of oral cancer in China from 2006 to 2021 to provide a reference for its prevention and control.

METHODS

Annual death data for oral cancer was gleaned from the China Death Surveillance Database. The age-standardized mortality rate (ASMR), annual percentage change (APC), and average APC (AAPC) were used to analyze the trend of mortality. Loss of life expectancy (LLE) and years of life lost (YLL) were adopted to assess disease burden.

RESULTS

From 2006 to 2021, the overall ASMR of oral cancer lightly declined (AAPC: - 0.97%; 95% CI: - 1.89%, - 0.04%), and the similar trend was observed among females (AAPC: - 1.22%; 95% CI: - 1.89%, - 0.55%). The ASMR of males was 2.31-3.16 times higher than that of females per year. The median of LLE for overall, males and females caused by oral cancer from 2006 to 2021 were 0.05, 0.06 and 0.03 years, respectively. There was a decrease of standardized YLL rate from 2006 to 2021 for overall (AAPC: - 1.31%, 95% CI: - 2.24% ~  - 0.37%) and for female (AAPC: - 1.63%, 95% CI: - 2.30% ~  - 0.95%). ASMR in urban areas was 1.02-1.28 times higher than that in rural areas from 2006 to2011, but 0.85-0.97 times lower in urban areas than that in rural areas from 2018 to 2021. The disease burden was higher in urban areas than in rural areas in 2006, whereas the reverse was observed in 2021.

CONCLUSIONS

There are severe health gaps and disparities in trends between sexes and different areas in China. Males and rural populations need to be focused on targeted interventions for the main influencing factors.

Genetic and epigenetic landscape of early-onset oral squamous cell carcinoma: Insights of genomic underserved and underrepresented populations

Oral squamous cell carcinoma (OSCC) has a poor prognosis and the treatment employed generates significant physical deformity in patients. In recent years, an increase in the incidence of cases of OSCC has been observed in adult patients up to 45 years old in several genetic underrepresented and underserved countries. The increase in OSCC cases in young people is very relevant because it shows that OSCC does not make exceptions and hereditarily must play an important role. This fact has not been associated with an evident biological basis, and a large majority of these patients do not present the classic principal risk factors association. OSCC is the result of accumulation of genetic and epigenetic alterations and this information is still fragmented in the literature, mainly in the young group. Conducting studies with a comprehensive analysis of genetic and epigenetic data is crucial, to provide greater understanding of the underlying biology of OSCC, because this information can be decisive to determine targets for therapeutic treatment. We review the main germline and somatic aspects of genetic and genomic variation in OSCC considering the absence of genomic data from developing countries such as Chile and the rest of Hispano-America.

Oral cancer screening outcomes in the Latin American region with special relevance to Brazil and Cuba: a systematic review

BACKGROUND

 The Latin American region represents a hotspot for oral cancer incidence and mortality. To reduce oral cancer mortality rates, screening for early detection of subjects with suspicious or innocuous oral lesions has been promoted. A systematic review was performed to assess the outcomes of oral cancer screening in the Latin American region.

MATERIAL AND METHODS

 An electronic search was conducted in eight databases and grey literature. The eligibility criteria included screening where adult participants underwent any screening test during an organized screening program. Screening programs were assessed to understand trends in oral cancer diagnosis. Rates of oral cancers diagnosed in screening programs were classified as increase, decrease, or stable based on each year assessed.

RESULTS

 Following our searches, twelve studies conducted in Brazil and Cuba were included. The screening tests reported were visual oral examination (VOE) and in one study in addition light-based fluorescence testing. 13,277,608 individuals were screened and a total of 1,516 oral cancers were detected (0.01%). Only two studies aimed to screen high-risk individuals (smokers and drinkers). Oral cancer cases diagnosed during screening programs were proportionately stable over the years 1997 to 2009 but increased from 2010 to 2021. The fluorescence-associated VOE test demonstrated a sensitivity of 100% and a specificity of 90%. Similarly, the VOE test alone exhibited a sensitivity of 100%, with specificity ranging from 75% to 90%.

CONCLUSIONS

 Screening studies conducted in Latin American countries had serious limitations both in methodology (lack of examiner training) and in reporting data (lack of description of clinical categories of screen positives). Capacitation of health workers to perform VOE in well-designed screening programs should be implemented.

Oral cancer mortality and factors associated in the state of Ceara, Brazil, 2009-2019: a spatial analysis

The study aimed to analyze the spatial distribution and factors associated with oral cancer mortality in the 2009-2019 period in the municipalities of Ceará, Brazil. This ecological study of oral cancer deaths used distribution analysis, autocorrelation, and spatial regression. The oral cancer mortality rate has spatial autocorrelation. In the geographically weighted regression analysis, a negative relationship was observed between mortality and the number of households with access to the sewage system (β = -0.001) and the mean number of people per household (β = -5.947). We observed a positive relationship between mortality and percentage of oral health coverage in Primary Health Care (β = 0.021), number of people living in the rural area of ​​the municipality (β = 0.0001), Municipal Human Development Index (β = 40.417), and aging rate (β = 1.169). We can conclude that the influence on the mortality risk showed spatial clusters that require priority in public policies that impact oral cancer morbimortality.

Burden of oral disorders, 1990-2019: estimates from the Global Burden of Disease Study 2019

INTRODUCTION

The aim of this study was to understand the global incidence and disability-adjusted life years (DALY) of oral disorders by age, gender, region, and Sociodemographic Index (SDI) from 1990 to 2019.

MATERIAL AND METHODS

The estimated annual percentage change (EAPC) and 95% confidence intervals (CIs) were used to assess the trends in age-standardized incidence and DALY rates from 1990 to 2019.

RESULTS

The global age-standardized incidence rate (EAPC = 0.01) of oral disorders increased slightly from 1990 to 2019. From 1990 to 2019, the age-standardized DALY rate decreased in high-SDI (EAPC = -0.43) and high-middle-SDI (EAPC = -0.14) regions, but it showed increasing trends in low-SDI (EAPC = 0.22), low-middle-SDI (EAPC = 0.36), and middle-SDI (EAPC = 0.17) regions. The EAPC in the age-standardized DALY rate was negatively correlated with the regional SDI value (ρ = -0.402, p = 0.001). From 1990 to 2019, the region with the largest increase in age-standardized DALY rate was South Asia (EAPC = 0.67), while the country with the greatest increase in age-standardized DALY rate was India (EAPC = 0.82).

CONCLUSIONS

From 1990 to 2019, the global age-standardized incidence rate of oral disorders showed a slight increasing trend. It is necessary to control the increase in DALY and the disease burden associated with oral disorders in low-, low-middle-, and middle-SDI regions, such as South Asia, particularly in India.

Bolsa Família Program and deaths from oral cancer in Brazil: an ecological study

Objective

To assess the effect of coverage of the Bolsa Família Program (BFP) on oral cancer mortality rates in Brazil between 2005 and 2017, adjusting for health care coverage and socioeconomic characteristics of the Brazilian federative units.

Methods

This is an ecological study using annual data (2005-2017) from all the Brazilian federative units. The dependent variable for this study was the oral cancer mortality rate, standardized by gender and age using the direct standardization technique. BFP coverage was the main independent variable, calculated as the ratio of the number of BFP beneficiaries to those families that should potentially be entitled to this conditional cash transfer. Socioeconomic background and health care coverage were covariables. Choropleth maps were drawn, and space-time cube analysis was used to assess changes in the spatiotemporal distribution of BFP and oral cancer mortality rates. Mixed-effects linear regression analysis estimated the coefficients (β) and 95% confidence intervals (CI) for the association between BFP coverage and oral cancer mortality rates.

Results

BFP coverage trends increased and oral cancer mortality rate trends stabilized in Brazilian federative units, except for Maranhão, Goiás, and Minas Gerais, where the oral cancer mortality rates have increased. In the adjusted model, greater BFP coverage was associated with lower oral cancer mortality rates (β -2.10; 95% CI [-3.291, -0.919]).

Conclusions

Egalitarian strategies such as BFP can reduce the oral cancer mortality rate. We recommend the follow-up of families benefiting from conditional cash transfer program by oral health teams to reduce the oral cancer mortality rate.

Bibliometrics Evaluation of Scientific Journals and Country Research Output of Dental Research in Latin America Using Scimago Journal and Country Rank

Innovations in dental sciences are potentially disruptive; however, the language barrier in the case of Latin America and the Caribbean (LAC) limits access to scientific studies. There is a necessity to measure the development of dental research across the LAC region, where economic power and postgraduate education access vary significantly. This article aims to analyze documents, citations, and journals and compare the SJR, H-Index, citation rates, and Co-occurrence Networks (Keywords) between dental journals published in LAC and the rest of the world, according to the report of Scimago Journal and Country Rank, between the years 1996 and 2020. Results show that Brazil leads dental research in the LAC, scoring the highest number of published documents, citations, and SJR metrics. The mean H-index and SJR of LAC dentistry journals are significantly lower than those of other regions (p < 0.03); however, there are no significant differences in the mean total citations in the last 3 years between LAC and other regions (p > 0.15). This suggests that the articles published in dentistry journals from LAC are being cited in similar proportions to the journals of other regions, but a large portion of these citations came from publications with low scientific impact.