Late stage diagnosis of oral cancer: Components and possible solutions

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

“…Microscopic evaluation is understood to be required to establish the final diagnosis and, thus, the appropriate treatment in all cases of PMD and malignant lesions. 19,20 In many clinical cases, the lines dividing diagnoses of benign, PMD, and malignant lesions are very thin; clinicians face the challenges of formulating diagnostic hypotheses and predicting which PMD lesions will progress to malignancy. 33 A recent systematic review assessed the diagnostic accuracy of adjunctive tests combined with oral examination for oral cancer; due to the overall poor quality of studies included, the authors failed to identify a replacement for biopsy and histological assessment for final diagnosis.…”

“…However, oral examination alone is not sufficient for the detection and accurate distinction of benign, PMD, and malignant lesions. 19,20 Clinical screening followed by histopathological analysis is crucial, given the estimated annual number of new lip cancer cases worldwide and the wide range of lesions that occur in this location. 21,22 Biopsy, paired with clinical examination, is recommended for final diagnosis; in addition, this approach is recommended when lesions persist despite treatment or the removal of local irritants (of traumatic or inflammatory origin), when lesions do not recede in 2 weeks, when malignancy is suspected, and when lesions interfere with function or impair aesthetics.…”

Late diagnosis of oral cancer: how to face it under the Family Health Strategy.

“…Figures 1, 2 and 3 are based on several studies and show factors that may aid in understanding the late diagnosis for oral cancer in Brazil and in other countries. [6][7][8][9][10] The need for continuing education for healthcare professionals is one of these determining factors. Therefore, there is a need to improve public health education programs in order to promote new competences and knowledge that will reduce the impacts and the time spent between self-perception of signs and symptoms all the way until therapy.…”

“…Major factors of delayed diagnosis related to access (based on previous studies). [6][7][8][9][10] Lack of provision of diagnostic services Lack of staff Inadequate time Health system based on hospital-centered model Access not based on the Family Health Program…”

“…Major factors of delayed diagnosis related to patients (based on previous studies). [6][7][8][9][10] Misperception of symptoms and use of alternative therapies Misperception of presenting a "simple injury" Unknowing that oral cancer is increased in smokers Related to age, where young patients do not suspect they may be susceptible Since 2004, the Oral Health National Policy has proposed a reorientation of the healthcare model, supported by an adaptation of the working system of Oral Health teams so that they include actions of health promotion, protection and recovery. Human resources should be prepared to act in this system.…”