Factors Associated with Late Diagnosis of Oral Cancer
Author(s)
Jerlucia Cavalcanti das Neves1*,
Lívia Soraya Toledano2,
Fabiana Moura da Motta Silveira1,
Paulo Sávio Angeiras de Góes3, 4
Affiliation(s)
1 Postgraduate Program in Dentistry (Collective Health), Faculdade de Odontologia de Pernambuco, Universidade de Pernambuco, Recife, Brazil. 2 Faculdade de Odontologia do Recife, Recife, Brazil. 3 Epidemiology and Public Health, University of London, London, UK. 4 Department of General and Preventive Dentistry, Universidade Federal de Pernambuco, Recife, Brazil.
1 Postgraduate Program in Dentistry (Collective Health), Faculdade de Odontologia de Pernambuco, Universidade de Pernambuco, Recife, Brazil. 2 Faculdade de Odontologia do Recife, Recife, Brazil. 3 Epidemiology and Public Health, University of London, London, UK. 4 Department of General and Preventive Dentistry, Universidade Federal de Pernambuco, Recife, Brazil.
ABSTRACT
Objective: The aim of the present study was to determine associations between the late diagnosis of oral cancer and demographic/clinical factors. A quantitative cross-sectional study was carried out in 2007. Material and Method: Oral tumors were recorded based on the TNM staging system, with T1 and T2 considered early diagnosis and T3 and T4 considered late diagnosis. Results: Patient age ranged from 30 to 105 years (mean: 64.7). Just over half of the patients (54.9%) resided in urban areas and approximately 1/4 (25.7%) had an agricultural occupation. The majority had smoking habits (89.9%) and consumed alcohol (62.5%). The most frequent tumor site was the tongue (42.4%), followed by the hard palate (19.2%) and lip (12.2%). The majority (70.1%) were in advanced stages (III and IV). A greater percentage of smokers were in advanced stages than non-smokers. The percentage of cases in the early stages was lowest when the tumor was located in the tongue (14.1%) and highest when located in the buccal mucosa (80.0%). Conclusion: The main causes of the late diagnosis of oral cancer are insufficient training on the part of physicians and dentists in the field of pathology, delays on the part of patients in seeking medical assistance and deficient access to quality medical care, reflecting the absence of preventive public health programs and an effective healthcare system.
Cite this paper
Neves, J. , Toledano, L. , Silveira, F. , Góes, P. (2015) Factors Associated with Late Diagnosis of Oral Cancer. International Journal of Clinical Medicine, 6, 105-111. doi: 10.4236/ijcm.2015.62015.
Neves, J. , Toledano, L. , Silveira, F. , Góes, P. (2015) Factors Associated with Late Diagnosis of Oral Cancer. International Journal of Clinical Medicine, 6, 105-111. doi: 10.4236/ijcm.2015.62015.
References
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http://dx.doi.org/10.1111/j.1600-0714.2010.00915.x
[1] Oliveira, L.R., Ribeiro-Silva, A. and Zucoloto, S. (2006) Perfil da incidência e da sobrevida de pacientes com carcinoma epidermóide oral em uma populacao brasileira. The Jornal Brasileiro de Patologia e Medicina Laboratorial, 42, 385-392. http://dx.doi.org/10.1590/S1676-24442006000500010 [2] Brasil, Ministério da Saúde. Instituto Nacional do Cancer (2010) Prevencao e deteccao—Cancer de boca.
http://www.inca.gov.br/conteudo_view.asp?id=324 [3] Boyle, P., Macfarlane, G.J. and Scully, C. (1993) Oral Cancer—Necessity for Prevention Strategies. The Lancet, 342, 1129. http://dx.doi.org/10.1016/0140-6736(93)92119-E [4] Franco, E.L., et al. (1989) Risc Factors for Oral Cancer in Brazil: A Case Control Study. International Journal of Cancer, 43, 992-1000. http://dx.doi.org/10.1002/ijc.2910430607 [5] Almeida, O.P. and Lopes, M.A. (2003) Prevencao das Doencas Bucais. In: Kriger, L., Ed., Promocao de Saúde Bucal: Paradigma, Ciência, Humanizacao, 3rd Edition, Artes Médicas, Sao Paulo, 463-473. [6] Lissowska, J., et al. (2003) Smoking, Alcohol, Diet, Dentition and Sexual Practices in the Epidemiology of Oral Cancer in Poland. European Journal of Cancer Prevention, 12, 25-33.
http://dx.doi.org/10.1097/00008469-200302000-00005 [7] Chen, Y.K., et al. (1999) Primary Oral Squamous Cell Carcinoma: An Analysis of 703 Cases in Southern Taiwan. Oral Oncology, 35, 173-179. http://dx.doi.org/10.1016/S1368-8375(98)00101-8 [8] Jitomirski, F. (2000) Cancer Bucal. In: Pinto, V.G., Ed., Saúde Bucal Coletiva, 4th Edition, Santos, Sao Paulo, 445-456. [9] Lo, W.L., et al. (2003) Outcomes of Oral Squamous Cell Carcinoma in Taiwan after Surgical Therapy: Factors Affecting Survival. The Journal of Oral and Maxillofacial Surgery, 61, 751-758.
http://dx.doi.org/10.1016/S0278-2391(03)00149-6 [10] Borges, D.M.L., et al. (2009) Mortalidade por cancer de boca e condicao sócio economica no Brasil. Cadernos de Saúde Pública, 25, 321-327. http://dx.doi.org/10.1590/S0102-311X2009000200010 [11] Santos, L.C.O., Batista, O.M. and Cangussu, M.C.T. (2010) Characterization of Oral Cancer Diagnostic Delay in the State of Alagoas. Brazilian Journal of Otorhinolaryngology, 76, 416-422. [12] Teixeira, A.K.M., de Almeida, M.E.L., Holanda, M.E., Sousa, F.B. and de Almeida, P.C. (2009) Carcinoma espinocelular da cavidade bucal: Um estudo epidemiológico na Santa Casa de Misericórdia de Fortaleza. Revista Brasileira de Cancerologia, 55, 229-236. [13] de Lima, A.A.S., Franca, B.H.S., Ignácio, S.A. and Baioni, C.S. (2005) Conhecimento de alunos universitários sobre cancer bucal. Revista Brasileira de Cancerologia, 51, 283-288. [14] Kowalski, L.P., Franco, E.L., Torloni, H., Fava, A.S., de Andrade Sobrinho, J., Ramos, G., et al. (1994) Lateness of Diagnosis of Oral and Oropharyngeal Carcinoma: Factors Related to the Tumour, the Patient and Health Professionals. European Journal of Cancer Part B: Oral Oncology, 30, 167-173. http://dx.doi.org/10.1016/0964-1955(94)90086-8 [15] Dedivitis, R.A., Franca, C.M., Mafra, A.C.B., Guimaraes, F.T. and Guimaraes, A.V. (2004) Características clínico-epidemiológicas no carcinoma espinocelular de boca e orofaringe. Revista Brasileira de Otorrinolaringologia, 70, 35-40. http://dx.doi.org/10.1590/S0034-72992004000100006 [16] Courtenay, W.H. (2000) Constructions of Masculinity and Their Influence on Men’s Well-Being: A Theory of Gender and Health. Social Science Medicine, 50, 1385-1401. http://dx.doi.org/10.1016/S0277-9536(99)00390-1 [17] Laurenti, R., Mello-Jorge, M.H.P. and Gotlieb, S.L.D. (2005) Perfil epidemiológico da morbi-mortalidade masculina. Ciência & Saúde Coletiva, 10, 35-46. http://dx.doi.org/10.1590/S1413-81232005000100010 [18] Luck, M., Bamford, M. and Williamson, P. (2000) Men’s Health: Perspectives, Diversity and Paradox. Blackwell Sciences, London. [19] Figueiredo, W. (2005) Assistência à saúde dos homens: Um desafio para os servicos de atencao primária. Ciência & Saúde Coletiva, 10, 105-109. http://dx.doi.org/10.1590/S1413-81232005000100017 [20] Pinheiro, R.S., Viacava, F., Travassos, C. and dos Santos Brito, A. (2002) Gênero, morbidade, acesso e utilizacao de servicos de saúde no Brasil. Ciência & Saúde Coletiva, 7, 687-707.
http://dx.doi.org/10.1590/S1413-81232002000400007 [21] Soudry, E., Preis, M., Hod, R., Hamzany, Y., Hadar, T., Bahar, G., et al. (2010) Squamous Cell Carcinoma of the Oral Tongue in Patients Younger than 30 Years: Clinicopathologic Features and Outcome. Clinical Otolaryngology, 35, 307-312. http://dx.doi.org/10.1111/j.1749-4486.2010.02164.x [22] Kao, S.-Y., Chen, Y.-W., Chang, K.-W. and Liu, T.-Y. (2009) Detection and Screening of Oral Cancer and Pre-Cancerous Lesions. Journal of the Chinese Medical Association, 72, 227-233.
http://dx.doi.org/10.1016/S1726-4901(09)70062-0 [23] Chen, H.T. (1990) Theory-Driven Evaluations. Sage Publications, Newbury Park. [24] Leite, I.C.G. and Koifman, S. (1998) Survival Analysis in a Sample of Oral Cancer Patients at a Reference Hospital in Rio de Janeiro, Brazil. Oral Oncology, 34, 347-352. http://dx.doi.org/10.1016/S1368-8375(98)00019-0 [25] Sciubba, J.J. (2001) Oral Cancer: The Importance of Early Diagnosis and Treatment. American Journal of Clinical Dermatology, 2, 239-251. http://dx.doi.org/10.2165/00128071-200102040-00005 [26] Brocklehurst, P., Kujan, O., Glenny, A.M., Oliver, R., Sloan, P., Ogden, G. and Shepherd, S. (2010) Screening Programmes for the Early Detection and Prevention of Oral Cancer. Cochrane Database of Systematic Reviews, Article ID: CD004150. [27] Brocklehurst, P.R., Baker, S.R. and Speight, P.M. (2010) Oral Cancer Screening: What Have We Learnt and What Is There Still to Achieve? Future Oncology, 6, 299-304. http://dx.doi.org/10.2217/fon.09.163 [28] Steele, T.O. and Meyers, A. (2011) Early Detection of Premalignant Lesions and Oral Cancer. Otolaryngologic Clinics of North America, 44, 221-229. http://dx.doi.org/10.1016/j.otc.2010.10.002 [29] Warnakulasuriya, S., Kashyap, R. and Dasanayake, A.P. (2010) Is Workplace Screening for Potentially Malignant Oral Disorders Feasible in India? Journal of Oral Pathology Medicine, 39, 672-676.
http://dx.doi.org/10.1111/j.1600-0714.2010.00915.x