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Cassol Spanemberg J, Velázquez Cayón R, Romanini J, Trevizani Martins MA, López-Jornet P, Carrard VC. Experiences, perceptions, and decision-making capacity towards oral biopsy among dental students and dentists. Sci Rep 2023; 13:22937. [PMID: 38129588 PMCID: PMC10739868 DOI: 10.1038/s41598-023-50323-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
The dentist plays a crucial role in identifying oral lesions as it is their responsibility to conduct the clinical examination for diagnosing diseases in this anatomical region. Dentists should be able to perform simple oral biopsies when this procedure is necessary. However, several studies point out that dentists lack experience and perceive themselves incapable of performing biopsies. This analytical cross-sectional study aimed to assess participants' experiences and perceptions regarding a continuing education activity focused on the biopsy procedure. The secondary aim was to evaluate their ability to determine when a biopsy is indicated. The sample consisted of 228 individuals: 143 dentists and 85 undergraduate dental students who completed questionnaires related to a lecture held in May/2021, as part of the continuing educational activities of the "Red May" Project. Participants completed two questionnaires: the first assessed their experience and self-confidence in performing oral biopsies, whereas the second evaluated their capacity to define when the biopsy is indicated by means the evaluation of 10 clinical cases. The results reveal no significant difference in the percentage of correct answers between dental students and dentists. Regarding the frequency of performing the biopsy procedure, most respondents (69.7%) reported doing so rarely or never. Furthermore, while 31.6% of the participants stated that they perform biopsies depending on the case, 68.4% prefer to refer patients to specialists, such as professionals in Stomatology/Oral Medicine. These findings highlight limitations in the educational preparation of the study population concerning biopsy procedures, oral lesions, and their management. They also indicate a concerning tendency to overestimate knowledge in this area. Thus, this study emphasizes the importance of continuing education and underscores the need to revise academic curricula and provide complementary education for all dental professionals.
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Affiliation(s)
- Juliana Cassol Spanemberg
- Department of Dentistry, Oral Medicine and Public Health, Faculty of Health Sciences, Universidad Fernando Pessoa Canarias, Gran Canaria, Spain
| | - Rocío Velázquez Cayón
- Department of Dentistry, Oral and Maxillofacial Surgery, Faculty of Health Sciences, Universidad Fernando Pessoa Canarias, Gran Canaria, Spain
| | - Juliana Romanini
- Dental Specialty/Oral Medicine Center, Porto Alegre City Hall, Porto Alegre, Brazil
| | | | - Pía López-Jornet
- Oral Medicine, Facultad de Odontología, Universidad de Murcia, Murcia, Spain
| | - Vinicius Coelho Carrard
- Oral Medicine, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
- School of Dentistry, TelessaúdeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2492/503, Porto Alegre, RS, 90035-003, Brazil.
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Costa EM, Magalhães Rodrigues ES, de Sousa FS, Pimentel FB, Sodré Lopes MB, Vissoci JRN, Thomaz EBAF. The Brazilian National Oral Health Policy and oral cancer mortality trends: An autoregressive integrated moving average (ARIMA) model. PLoS One 2023; 18:e0291609. [PMID: 37733703 PMCID: PMC10513197 DOI: 10.1371/journal.pone.0291609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/01/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE This study analyzes the effect of the Brazilian National Oral Health Policy (NOHP) on oral cancer mortality rates (OCMR). METHOD This is an ecological study with secondary oral cancer death data, using interrupted time series analysis (ARIMA, Autoregressive Integrated Moving Average). Annual death data were collected from the Mortality Information System (1996-2019). The outcome was the OCMR, standardized by gender and age We considered the NOHP, categorized as "0" (before its implementation), from 1996 to 2004, and "1 to 15", from 2005 to 2019. ARIMA modeling was carried out for temporal analysis, and regression coefficient estimation (RC). RESULTS The Brazilian NOHP implementation was associated with an increase in OCMR in the North region (CR = 0.16; p = 0.022) and with a decrease in the Southeast region (CR = -0.04; p<0.001), but did not affect the other macro-regions nor Brazil. The forecast models estimated an increase in OCMR for the North, and Northeast, a decrease for the Southeast, and stability for the South and Brazil. CONCLUSION The Brazilian NOHP is not being effective in reducing the OCMR. The trends behaved differently in the Brazilian territory, highlighting health inequities. We recommend that the NOHP strengthen the oral health care network, incorporating oral cancer as a notifiable disease, adopting strategies for prevention, screening, and providing opportunities for early treatment of the disease.
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Affiliation(s)
- Elisa Miranda Costa
- Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | | | - Felipe Bezerra Pimentel
- Department of Electrical Engineering, Federal University of Maranhão, São Luís, Maranhão, Brazil
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FOLETTO F, ARATANI N. Análise da cobertura de saúde bucal e práticas das equipes de saúde bucal na atenção primária em municípios sul-mato-grossenses. REVISTA DE ODONTOLOGIA DA UNESP 2022. [DOI: 10.1590/1807-2577.04222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Resumo Introdução Considerando a estimativa para o Brasil de 15.190 novos casos de câncer de boca e orofaringe para o triênio de 2020 a 2022, justifica-se a importância de o odontólogo na atenção primária estar capacitado para o diagnóstico precoce de câncer de boca e orofaringe, à biópsia e à regulação ao Centro de Especialidades Odontológicas. Objetivo Analisar a cobertura de saúde bucal e práticas das equipes de saúde bucal da atenção primária à saúde quanto ao cuidado ao câncer de boca e orofaringe em municípios de Mato Grosso do Sul. Material e método Estudo descritivo, transversal, quantitativo, em bases de dados secundários oficiais e públicos, referentes aos municípios do estado de Mato Grosso do Sul em que foram determinadas prevalência de câncer de boca e orofaringe, CID-10 C00 - C10, cobertura de saúde bucal e análise de dados de cuidado em saúde bucal do PMAQ-AB, 3º Ciclo. Resultado Houve divergência nas respostas entre as equipes de saúde bucal de alguns municípios no direcionamento do fluxo de referenciamento para biópsia e tratamento do câncer de boca e orofaringe, evidenciando desconhecimento das ofertas de serviços especializados. Conclusão Há fragilidades no processo de trabalho que podem influenciar no estadiamento do diagnóstico, tratamento, qualidade de vida e sobrevida do paciente com neoplasia maligna de boca e orofaringe. São importantes a capacitação e valorização das equipes de saúde bucal por meio de uma educação continuada e permanente, voltada ao diagnóstico precoce e à orientação dos fluxos assistenciais aos serviços especializados de referência, fortalecendo a coordenação do cuidado e ordenação na rede de atenção à saúde.
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Ferreira AK, Carvalho SH, Granville-Garcia AF, Sarmento DJ, Agripino GG, Abreu MH, Melo MC, Caldas AD, Godoy GP. Survival and prognostic factors in patients with oral squamous cell carcinoma. Med Oral Patol Oral Cir Bucal 2021; 26:e387-e392. [PMID: 33037796 PMCID: PMC8141315 DOI: 10.4317/medoral.24242] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/24/2020] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to evaluate sociodemographic and clinical factors influencing overall survival (OS) in patients with oral squamous cell carcinoma (OSCC).
Material and Methods Medical charts of 547 patients with OSCC from a public hospital in northeastern Brazil seen between 1999 and 2013 were evaluated. Survival analysis was performed using the Kaplan-Meier method. The influence of age, sex, ethnicity, clinical stage, anatomical location, type of treatment, and comorbidities on the patients’ prognosis was evaluated. Cox proportional hazards regression model was used to identify independent prognostic factors.
Results The 5-year OS was 39%. Multivariate analysis showed that age < 40 years (HR = 2.20; 95%CI: 1.02-4.72) and a single treatment modality (HR = 1.91; 95%CI: 1.37-2.67) were associated with a poor prognosis, while early clinical stage resulted in better outcomes (HR = 0.38; 95%CI: 0.25-0.58).
Conclusions OSCC patients in advanced clinical stages, diagnosed at a younger age, and submitted to a single therapeutic modality have a poorer prognosis. Key words:Head and neck cancer, oral cancer, oral squamous cell carcinoma, survival, prognosis.
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Affiliation(s)
- A-K Ferreira
- Department of Pathology Avenida Professor Moraes Rego, 1235 CEP 50670-901, Recife, Pernambuco, Brazil
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Freire AR, Freire DEWG, Pucca Júnior GA, Carrer FCDA, Sousa SAD, Lucena EHGD, Cavalcanti YW. Diagnosis of mucosal changes and hospitalized oral cancer patients in Brazil: influence of socioeconomic factors. Braz Oral Res 2021; 35:e042. [PMID: 33909864 DOI: 10.1590/1807-3107bor-2021.vol35.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 10/22/2020] [Indexed: 12/24/2022] Open
Abstract
This study aimed to analyze the influence of socioeconomic factors on the frequency of diagnoses of oral mucosal changes and the number of hospitalized patients with oral and oropharyngeal cancer in Brazil. This cross-sectional study analyzed data from all Brazilian cities in the period 2011-2017. The frequency of diagnoses of oral mucosal changes and the number of hospitalized patients of oral and oropharyngeal cancer in Brazil were extracted from the Primary Care Information System (SIAB) and Brazilian National Cancer Institute (INCA) databases. The socioeconomic factors evaluated were the Gini coefficient of inequality, municipal Human Development Index (MHDI), inadequate basic sanitation rate, employment rate, illiteracy rate and expected years of schooling. Associated factors were examined using bivariate Spearman's correlations and multivariate Poisson regressions, and statistically significant (p < 0.05) correlations between study variables and regression coefficients were obtained. A higher frequency of diagnoses of mucosal changes was observed in cities with a higher Gini coefficient (B = 11.614; p < 0.001), higher MHDI (B = 11.298; p < 0.001), and higher number of hospitalized patients with oral and oropharyngeal cancer (B = 0.001, p < 0.002). Cities with higher Gini coefficients (B = 8.159, p < 0.001), higher inadequate basic sanitation rates (B = 0.09, p = 0.001), lower expected years of schooling (B = -0.718, p < 0.001), and higher illiteracy rates (B = 0.191, p < 0.001) had a higher frequency of hospitalized patients with oral and oropharyngeal cancer. In conclusion, more developed cities showed a higher frequency of diagnoses of mucosal changes. Greater inequality and worse socioeconomic conditions are associated with a higher frequency of hospitalized patients with oral and oropharyngeal cancer in Brazil.
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Affiliation(s)
- Aldelany Ramalho Freire
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Department of Social Medicine and Dentistry, João Pessoa, PB, Brazil
| | | | | | | | - Simone Alves de Sousa
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Department of Social Medicine and Dentistry, João Pessoa, PB, Brazil
| | - Edson Hilan Gomes de Lucena
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Department of Social Medicine and Dentistry, João Pessoa, PB, Brazil
| | - Yuri Wanderley Cavalcanti
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Department of Social Medicine and Dentistry, João Pessoa, PB, Brazil
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Time-to-Treatment in Oral Cancer: Causes and Implications for Survival. Cancers (Basel) 2021; 13:cancers13061321. [PMID: 33809427 PMCID: PMC8000007 DOI: 10.3390/cancers13061321] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 12/24/2022] Open
Abstract
The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer.
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Chellappa LR, Balasubramaniam A, Indiran MA, Rathinavelu PK. A qualitative study on attitude towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status. J Family Med Prim Care 2021; 10:1282-1287. [PMID: 34041166 PMCID: PMC8140283 DOI: 10.4103/jfmpc.jfmpc_1628_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/06/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Tobacco consumed as smoke and smokeless forms is an important preventable public health issue projected to be the single largest cause of mortality worldwide. The aim of the study was to qualitatively assess the attitudes towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status. MATERIALS AND METHODS An in-depth interview for 10 current smokers and a focus group discussion comprising of 10 current smokers was conducted with a guide and moderator which was audio recorded. About 6, 8 and 6 subjects from white collar, blue collar, and black collar employee status participated in the study. Their tobacco consumption and dependence using the Fagerstrom Test for Nicotine Dependence scale (FTNDS) was assessed. RESULTS About 50% of the participants had low; 30% had moderate and 20% had high nicotine dependency. Most of the participants started smoking by peer influence and continued as it made them to socialize. Relapses during their quit attempt was mainly due to work stress. Participants heard about the control of tobacco act but were unsure of the features in it. They perceived that no changes will happen if government bans production and selling of tobacco products. Also anti-tobacco commercials in social media will have no use. Nicotine replacement therapy may help in quitting the habit. CONCLUSION The study concluded that people in low socio-economic status had high nicotine dependency with inadequate knowledge on tobacco control policies. They strongly believe that an individual's self-restrain only can succeed him in quitting the habit.
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Affiliation(s)
- Lalitha Rani Chellappa
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
| | - Arthi Balasubramaniam
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
| | - Meignana Arumugham Indiran
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
| | - Pradeep Kumar Rathinavelu
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
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Chellappa LR, Leelavathi L, Indiran MA, Rathinavelu PK. Prevalence and dependency of tobacco use among tribal gypsies in Thoothukudi district - A cross sectional study. J Family Med Prim Care 2021; 10:738-744. [PMID: 34041070 PMCID: PMC8138420 DOI: 10.4103/jfmpc.jfmpc_1344_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/13/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: The Narikuravars or “gypsy” are a semi vagrant groups distributed across borders, but primarily live in Tamil Nadu, India. They are notorious to face discrimination that interprets into low education level, low socio-economic status and lack of pertinent access to health care. The focus of the present study is to determine the prevalence and dependency with tobacco use among tribal gypsies in Thoothukudi district. Materials and Methods: The study design of the present study was a cross sectional which was done in Thoothukudi district in the month of December, 2019. Oral health status of the study population was analysed by WHO assessment form (adults), 2013. Tobacco dependence was analysed by Fagerstrom Nicotine dependency scale. The inclusion criteria were to include every gypsy person who is a citizen of Thoothukudi district and of all ages. The study included all the narikuravars (164) whose origin is Thoothukudi district. SPSS version 20.0 was used for statistical analysis. Descriptive statistics and Chi square tests were done to establish the distribution and association of the variables, respectively. Results: The total study participants of this cross-sectional study were 164, among them 128 were adults and 36 were children. Results revealed that among the adult population 64.55% were using tobacco, among them 29.1% were using smoking tobacco, 63.4% were using smokeless tobacco and 7.5% were using both. Medium nicotine dependency was more prevalent in both smoking and smokeless tobacco users (82.75% and 53.57%). The association between prevalence of tobacco use and gingival bleeding was statistically significant. Gingival bleeding was present in 88.9% of tobacco users and 11% of non-users (p value- 0.01). Significant association was found between gender and tobacco usage (p value- 0.042), dental erosion and tobacco usage (p value- 0.007). There exists significant association established between gender and nicotine dependency. (p value - 0.000). Conclusion: More than 60% of the adult study participants were using some form of tobacco. Medium tobacco dependency was prevalent among tobacco users. The tribal people have no access to all the services as their counterparts and it's our duty to educate them and create an insight about the ill effects of tobacco usage.
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Affiliation(s)
- Lalitha Rani Chellappa
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - L Leelavathi
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Meignana Arumugham Indiran
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Pradeep Kumar Rathinavelu
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Braun LW, Martins MAT, Romanini J, Rados PV, Martins MD, Carrard VC. Continuing education activities improve dentists' self-efficacy to manage oral mucosal lesions and oral cancer. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:28-34. [PMID: 32767592 DOI: 10.1111/eje.12574] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/16/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This cross-sectional study aims to evaluate whether Continuing Education Activities (CEA) influence dentists' behaviour in relation to oral lesions. The secondary aim is to assess the association between dentists' perception of learning adequacy and self-efficacy for oral mucosal lesion management. METHODS A self-administered online questionnaire was conducted on dentists working at the public health system of Rio Grande do Sul State, Brazil. The questionnaire included questions pertaining to perception of adequacy for oral diagnosis classes upon graduation, participation in oral cancer CEA and self-efficacy in managing oral mucosal lesions. RESULTS 221 dentists from 91 municipalities answered the questionnaire. Most participants were female (71.5%) with a mean age of 38.3 years. Perception of learning as adequate during undergraduate coursework was associated with self-efficacy to diagnose, biopsy, and treat oral mucosal lesions (P < .05, Chi-squared test). However, 83.3% of dentists considered the time devoted to these topics prior to graduation insufficient. The frequency of oral lesion detection was related to self-efficacy to treat oral lesions and detecting oral cancer (P < .05, Chi-squared test). Among dentists who detected oral lesions frequently, 88.9% had attended CEA, whereas 11.1% of them had never attended these activities. CONCLUSIONS CEA may improve awareness and efficacy of primary healthcare professional's detection of oral cancer.
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Affiliation(s)
- Liliana W Braun
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco A T Martins
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Juliana Romanini
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Dental Specialty /Stomatology Center, Porto Alegre, Brazil
| | - Pantelis V Rados
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Manoela D Martins
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vinicius C Carrard
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Telessaude RS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Raymundo MLB, Freire AR, Gomes-Freire DE, Silva RO, Araújo EC, Ishigame RT, Sousa SA, Lucena EH, Cavalcanti YW. Trend of hospitalized cases of oral cancer in Brazil and its relationship with oral health coverage in public health system between 2009 and 2017. Med Oral Patol Oral Cir Bucal 2021; 26:e78-e83. [PMID: 33247574 PMCID: PMC7806343 DOI: 10.4317/medoral.24009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/23/2020] [Indexed: 12/16/2022] Open
Abstract
Background This study aimed to analyze the trend in the number of hospitalized cases of oral cancer in Brazil, according to the coverage of oral health services in public health system, and also investigate the influence of healthcare and clinical characteristics on the severity of oral cancer cases.
Material and Methods This retrospective study considered the period between 2009 and 2017. Data from the Hospital Registry of Cancer from the National Cancer Institute were used, considering the primary locations C00 to C06. Detailed information including sex, age, alcohol and tobacco use, year of first consultation, and the clinical stage of the cases were also collected. The frequency of hospitalized cases was correlated with the coverage of Primary Care Oral Health Teams (ESB) and the number of Dental Specialty Centers (CEO). It was also estimated the chance of advanced oral cancer cases, according to healthcare and clinical characteristics. Data were analyzed using Tweedie's multiple regression and multiple binary logistic regression (α<0.05).
Results There was an increasing trend in the number of hospitalized cases of oral cancer in Brazil between 2009 and 2017 (B=0.043, p<0.001, PR=1.044). The increase in ESB coverage was associated with small increase in the number of hospitalized cases of oral cancer (B=0.001, p=0.003, PR=1.001). The increase in the number of CEO was associated with decrease in the number of hospitalized cases of oral cancer (B=-0.085, p<0.001, PR =0.918). The increase of ESB (OR=0.998) and CEO (OR=0.974) contributed for reducing the number of stage IV cases, whilst the history of alcohol and tobacco use (OR=1.574) was associated with an increase in the number of stage IV cases.
Conclusions Although an increasing trend was detected, the expansion of the public health system reduced the number of hospitalized cases and the frequency of advanced oral cancer cases in Brazil. Key words:Mouth neoplasms, squamous cell carcinoma, oral diagnosis.
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Affiliation(s)
- M-L-B Raymundo
- Department of Clinical and Social Dentistry Center for Health Sciences, Federal University of Paraíba - Campus I University City João Pessoa, CEP 58051-900 PB Brazil
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Freire AR, Freire DEWG, de Araújo ECF, de Lucena EHG, Cavalcanti YW. Influence of Public Oral Health Services and Socioeconomic Indicators on the Frequency of Hospitalization and Deaths due to Oral Cancer in Brazil, between 2002-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E238. [PMID: 33396190 PMCID: PMC7795570 DOI: 10.3390/ijerph18010238] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022]
Abstract
Background: Oral cancer is a frequent neoplasm worldwide, and socioeconomic factors and access to health services may be associated with its risk. Aim: To analyze effect of socioeconomic variables and the influence of public oral health services availability on the frequency of new hospitalized cases and mortality of oral cancer in Brazil. Materials and Methods: This observational study analyzed all Brazilian cities with at least one hospitalized case of oral cancer in the National Cancer Institute database (2002-2017). For each city were collected: population size, Municipal Human Development Index (MHDI), Gini Coefficient, oral health coverage in primary care, number of Dental Specialized Centers (DSC) and absolute frequency of deaths after one year of the first treatment. The risk ratio was determined by COX regression, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Poisson regression was used to determine factors associated with higher mortality frequency. Results: Cities above 50,000 inhabitants, with high or very high MHDI, more unequal (Gini > 0.4), with less oral health coverage in primary care (<50%) and without DSC had a greater accumulated risk of having 1 or more cases (p < 0.001). Higher frequency of deaths was also associated with higher population size, higher MHDI, higher Gini and lower oral health coverage in primary care (p < 0.001). Conclusions: The number hospitalization and deaths due to oral cancer in Brazil was influenced by the cities' population size, the population's socioeconomic status and the availability of public dental services.
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Affiliation(s)
| | | | | | | | - Yuri W. Cavalcanti
- Graduate Program in Dentistry, Department of Clinic and Social Dentistry, Federal University of Paraíba, University City, João Pessoa-PB 58046-600, Brazil; (A.R.F.); (D.E.W.G.F.); (E.C.F.d.A.); (E.H.G.d.L.)
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Lima FLTD, O’Dwyer G. Políticas de Prevenção e Controle do Câncer Bucal à luz da Teoria da Estruturação de Giddens. CIENCIA & SAUDE COLETIVA 2020; 25:3201-3214. [DOI: 10.1590/1413-81232020258.17182018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 11/26/2018] [Indexed: 11/22/2022] Open
Abstract
Resumo Passados mais de dez anos de continuidade das políticas de prevenção e controle do câncer e de saúde bucal, persistem desafios para garantia do acesso ao diagnóstico e tratamento. O objetivo do estudo é analisar as políticas de oncologia e de saúde bucal em vigor, no que se refere ao processo de implantação dos componentes assistenciais relacionados ao câncer bucal. Foram analisadas dez normativas que estruturam essas políticas, sob a ótica da Teoria da Estruturação, além de dados de oferta de serviços entre 2002 e 2017. Nas atenções básica e secundária, destacou-se a baixa cobertura assistencial e a distribuição regional inadequada, apesar do aumento do financiamento e do número de serviços. Na atenção terciária foi identificada a distribuição desigual da realização de cirurgias. Por sua vez, a limitação de serviços da atenção domiciliar tem dificultado o acesso dos usuários aos cuidados paliativos. Houve convergência entre as políticas analisadas e uma preocupação com a regulação dos recursos autoritativos e com o aumento de recursos alocativos, o que estimulou a expansão dos serviços. Deve-se investir na ampliação, regionalização e universalização dos serviços. Um possível retrocesso nessas políticas poderá agravar a situação e contribuir para o aumento das desigualdades em saúde.
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Saintrain MVDL, Bandeira ABV, Pequeno LL, Bizerril DO, Marques PLP, Viana FAC. Oral health of older people: tracking soft tissue injuries for the prevention of oral cancer. Rev Esc Enferm USP 2018; 52:e03380. [PMID: 30484486 DOI: 10.1590/s1980-220x2017033603380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 05/15/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To detect oral soft tissue injuries in older people. METHOD A quantitative analytical cross-sectional study conducted in Fortaleza, Ceará. Individual interviews addressed age, gender, marital status, income, and education. The community oral health indicator was used to detect oral soft tissue injuries and their location. RESULTS Most of the 821 participants aged 60-100 years were women (580; 70.6%), attended school for up to 5 years (401; 48.8%), were illiterate (201; 24.5%), were retired (608; 74.1%), and received up to 2 wages (701; 85.4%). A total of 604 participants (73.6%) wore dentures. Injuries included red patches (152; 55.9%), blisters (58; 21.3%), lesions and/or wounds (39; 14.3%), and white patches (30; 11%). Locations of injuries were the roof of the mouth (167; 61.4%), gums (62; 22.8%), cheeks (39; 14.3%), tongue (15; 5.5%), lips (15; 5.5%), and the floor of the mouth (12; 4.4%). Injuries were associated with age (p<0.001), retirement (p=0.005), education (p=0.010), dentures (p<0.001) and red patches (p<0.001). CONCLUSION Tracking soft tissue injuries and referring older adults with suspected malignant lesions to the health team should be included as oral cancer identification and prevention measures. Furthermore, health care providers should raise older adults' awareness of the importance of regular preventive examinations.
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Leuci S, Amato M, Calabria E, Spagnuolo G, Masucci M, Davide MM. Screening Projects for Oral Carcinoma in Relation to Health Education and Patients' Compliance: Study on 600 Participants. J Int Soc Prev Community Dent 2017; 7:S163-S169. [PMID: 29285472 PMCID: PMC5730979 DOI: 10.4103/jispcd.jispcd_370_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/30/2017] [Indexed: 12/25/2022] Open
Abstract
Aims and Objectives: The lack of information among the population regarding the existence of oral squamous cell carcinoma (OSCC) and the lack of attention and expertise in examining the oral cavity of dentists and clinicians still remain very worrying and could explain the high incidence of OSCC. The aim of this study is to evaluate the level of awareness of OSCC among 600 participants from Southern Italy. Materials and Methods: A 13-question survey was prepared and distributed to 600 participants divided into two subgroups, the first one of 300 patients referring to the Department of Neuroscience, Reproductive, and Odontostomatological Sciences, University Federico II of Naples, for the treatment of dental pathologies, and the second one of 300 patients referring to the Department of Internal Medicine of the Second University of Naples for the diagnosis and treatment of cardiovascular diseases. Statistical analysis consisted in the calculation of percentages related to the answers given by patients. Comparison of percentages was after performed between the two subgroups. Result: Only 175 participants (29.1%) knew about the existence of pathologies which can affect the oral mucosa, and only 46 (7.6%) were aware that carcinoma can arise in the oral cavity; 345 (57,5%) stated that they had periodical dental visits, at least once a year but none of them stated they had a visit for the identification of oral carcinomas. Conclusion: The data acquired must be taken into consideration to outline essential socio-healthcare educational projects on carcinoma and its risk factors, training programs to increase dentists and clinicians’ competences, and to evaluate the feasibility and effectiveness of oral carcinoma screening programs.
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Affiliation(s)
- Stefania Leuci
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Massimo Amato
- Department of Medicine, Dentistry Unit, Surgery and Dentistry, University of Salerno, Fisciano, Italy
| | - Elena Calabria
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Michele Masucci
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
| | - Michele Mignogna Davide
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - Oral Medicine Complex Unit - University "Federico II" of Naples, Napoli, Italy
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