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

Freire, Aldelany Ramalho; Freire, Déborah Ellen Wanderley Gomes; Araújo, Elza Cristina Farias de; Lucena, Edson Hilan Gomes de; Cavalcanti, Yuri Wanderley

doi:10.3390/ijerph18010238

Cited by 22 publications

(32 citation statements)

References 27 publications

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“…Our smaller HPV prevalence could be due to Brazil’s northern region having many cities surrounded by hydrographic access routes, which make it difficult to access health care. In addition, the distances between major urban areas and countryside cities are higher than in southern Brazil [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Genotyping of HPV in Oral Squamous Cell Carcinoma in Northern Brazil

et al. 2022

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Highly oncogenic human papillomavirus (HPV) is well known to be associated with and a risk factor for various types of oral carcinomas such as oral squamous cell carcinoma (OSCC). The aim of this study was to evaluate and describe the HPV-induced OSCC prevalence and genotyping in the city of Belém, northern Brazil. This cross-sectional study features 101 participants who attended an oral pathology referral center in a dental college looking for diagnoses of oral lesions (OL). After signing the consent term and meeting the inclusion criteria, all participants went through a sociodemographic and epidemiological questionnaire. Then, OL were collected by excisional or incisional biopsy depending on OL size; after that, OL tissues were preserved in paraffin blocks to histopathological diagnoses. Afterwards, paraffin blocks were divided into benign and malignant/premalignant lesions based on the classification of potentially malignant disorders of the oral and oropharyngeal mucosa. Then, the paraffin blocks had DNA extraction performed by the ReliaPrep FFPE gDNA Miniprep method in order to identify HPV DNA of high oncogenic risk and low oncogenic risk. Then, the viral DNA was amplified and typed using the Inno-Lipa genotyping Extra II method, and the collected data were analyzed by Chi-square and G-tests. In total, 59/101 (58.4%) OL were malignant/premalignant lesions, of which OSCC was the most prevalent with 40/59 (67.7%) and 42/101 (41.6%) benign lesions. The most common area of OL incidence was upper gingiva 46/101 (45.5%). Regarding HPV DNA detection, approximately 27/101 (26.7%) had positive results; of these, 17/59 (28.8%) were malignant/premalignant lesions, and the most prevalent genotypes detected were 16, 18, 52 and 58, while among benign lesions, 10/42 (66.6%) had HPV-positive results, and the most prevalent genotypes detected were 6, 11 and 42. Age range was the only risk factor with a significant association between HPV and OSCC presence (p-value: 0.0004). A correlation between OSCC and oral HPV among analyzed samples could not be demonstrated in our small cohort.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Genotyping of HPV in Oral Squamous Cell Carcinoma in Northern Brazil

et al. 2022

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“…The epidemiological profile of the oral cancer disease consists of men, aged between 40 and 60 years ( 2 ), mostly with low socioeconomic status and low education ( 3 ). The main risk factors are smoking and alcohol abuse ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…A better prognosis can be achieved when the diagnosis is made early ( 10 ). However, the high rate of morbidity and mortality from oral cancer in Brazil is due to late hospitalization of patients in advanced stages of the disease ( 1 , 3 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…These records allow to monitoring the severity of cancer cases, as well as their possible relationship with socioeconomic factors ( 12 ). Some studies from our research group have used the Hospital Cancer Records from INCA to discuss the association between oral cancer, socioeconomic factors and public health coverage ( 3 , 4 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

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Association between socioeconomic factors and origin of hospital referrals among patients with oral cancer

Raymundo

Ferreira²,

Gomes-Freire³

et al. 2022

Med Oral

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Background The Brazilian Unified Health System (SUS) is responsible for offering free assistance to more than 100 million Brazilians, including treatment of oral cancer lesions. Considering that the Brazilian public system aids the most vulnerable population, this study analyzed whether the origin of hospital referrals of patients with oral cancer is associated with socioeconomic factors. Material and Methods A cross-sectional study was carried out from cancer hospital records of the National Cancer Institute (RHC-INCA), considering the primary locations (C00 to C06) diagnosed between 2016 and 2019. Data on gender, skin color (white and non-white), education (no schooling, incomplete or complete elementary education; high school; incomplete and complete higher education) and origin of referral (SUS and non-SUS) were analyzed by multiple logistic regression ( p <0.05). Results Higher referral rates by the SUS were observed in 2017 (OR=1.27; 95% CI=1.098-1.480) and 2018 (OR=1.28; 95% CI=1.101-1.490); no differences were found between the years 2016 and 2019. Regarding gender, men were 40% more likely to have the SUS as the source of referral (OR=1.40; 95% CI=1.233-1.600). Non-white individuals were 34% more likely to have the SUS as the source of the referral (OR=1.34; 95% CI=1.190-1.512). Illiterate individuals or individuals who only attended elementary school were 6.38 times more likely to be referred by the SUS than individuals with higher education (OR=6.38; 95% CI=5.228-7.796). Conclusions It is concluded that the origin of hospital referrals via SUS of patients with oral cancer is associated with socioeconomic factors. Key words: Mouth neoplasms, oral diagnosis, health service coverage.

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“…Prior studies carried out in Brazil indicated that a good service structure is associated with better work processes in primary health care (PHC) 12 . Also, greater coverage of oral health services in PHC 13 and Dental Specialties Centers (acronym in Portuguese, CEO) 12 were associated with lower OC mortality rates. In Brazil, the National Oral Health Policy (acronym in Portuguese, PNSB) and the National Oncological Care Policy (acronym in Portuguese, PNAO) were implemented in 2004 and 2005, respectively, to articulate primary, specialized, and hospital care, organize a care line and reduce OC burden.…”

Section: Introductionmentioning

confidence: 99%

Advances and weaknesses of the work process of the oral cancer care network in Brazil: A latent class transition analysis

Thomaz

Costa

Queiroz

et al. 2021

Comm Dent Oral Epid

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Objective To analyse the provision of oral cancer (OC) care services in the Dental Specialties Centers (Centros de Especialidades Odontológicas‐CEO) in Brazil and identify changes over two cycles of external evaluation of the Program for the Improvement of Access and Quality‐PMAQ, in 2014 and 2018. Method This is a nationwide panel ecological study, including 916 CEO. Data from interviews with managers and dentists of the CEO were used, including variables related to training on OC, clinical protocols, biopsies, referral for diagnosis and treatment, and registration of users with OC. We carried out Latent Transition Analysis (LTA) to identify patterns (latent status LS) of service adequacy and work processes’ changes between the two assessment cycles. We tested models with three, four, and five LS, selecting the one with the best conceptual interpretability and good model fit parameters. Data from the LS were plotted on choropleth and hotspots maps in Brazil allowing us to identify areas with the better or worse provision of specialized OC services. Results The model with four LS was chosen. The four LS were named: 1.’Most indicators inadequate for OC care’ (the worst); 2. ‘Most indicators suitable for OC care’ (the best); 3. ‘CEO with a poor relation with Primary Health Care (PHC) services’; and 4. ‘CEO with a poor relation with tertiary hospital services’. The comparison of the LS transition between the two cycles revealed that 419 (45.7%) CEO remained in the same LS (1→1, 3→4, 2→2); 228 (24.9%) switched to a worse status (2→1, 2→4, 3→1) and 269 (29.4%) switched to a better LS (1→2, 1→4, 3→2). While the majority of the CEO improved, we identified a decline of 17.8% in those who reported performing biopsies and 18.3% in the number of CEO that had hospitals for referring confirmed OC cases. Almost all Brazilian states had CEO that improved the work process. The Southeast and South regions had the highest percentage of CEO with the better work process in both cycles. Hotspots showed areas concentrating improvements in the work process in the Northeast region. However, some hotspots in the North revealed some CEO where the work process deteriorated or remained unsatisfactory. Conclusions There are regional inequities in the provision of OC care in CEO. Most services improved their work process or remained stable. However, the biopsies and the referral to hospital care for confirmed cases declined, indicating that CEO need to improve planning and care provision to reduce OC morbimortality.

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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

Cited by 22 publications

References 27 publications

Prevalence and Genotyping of HPV in Oral Squamous Cell Carcinoma in Northern Brazil

Prevalence and Genotyping of HPV in Oral Squamous Cell Carcinoma in Northern Brazil

Association between socioeconomic factors and origin of hospital referrals among patients with oral cancer

Advances and weaknesses of the work process of the oral cancer care network in Brazil: A latent class transition analysis

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