Abstract
Diagnosis of oral and oropharyngeal cancer in advanced stages may be associated with social nature factors, access to health care, education, occupation, and behavioral/ cultural factors. Aim: To determine the factors related to high clinical-staging in patients diagnosed with squamous cell carcinoma in the oral and oropharyngeal region in a Cancer Center in Brazil between 2009 and 2015. Methods: It is an epidemiological, retrospective, and exploratory study. Patients diagnosed with squamous cell carcinoma had their medical records analyzed. The variables considered were sociodemographic, lifestyle, and disease characteristics. Descriptive and exploratory tests (Pearson’s, chi-square test and, Student’s t-test) were realized. Results: We analyzed 365 patient records, among which 289 (79.17%) were male, and 73 (20.0%) were female. Age ranged from 16 to 101 years, with a mean of 61.13. Regarding education, 157 (43.01%) studied < 8 years, 103 (28.21%) were illiterate and 102 (27.94%) studied > 8 years. 305 (83.56%) patients live in urban areas. There was an association between high clinical-staging and low educational level. For high clinical-staging, symptomatology, tobacco, and alcohol intake as well. Conclusion: Patients with low educational levels tend to report the disease later, and their diagnostics occurred in advanced stages. Thus, specific public health policies for this population, including access to dental care to recognize the clinical signs and early diagnosis, are necessary.
Highlights
About 40 to 60% of patients diagnosed with oral and oropharyngeal squamous cell carcinoma (OPSCC) start the treatment in the advanced-stages of the disease[1]
The health care used for 92.31% of the patients was the Brazilian public health system, Sistema Único de Saúde or Health Unic System (SUS), and 24 (6.59%) used private health care
This study describes the clinical and sociodemographic aspects of 365 cases of OPSCC, and the results show that educational level, consumption of tobacco, and alcohol are associated with high CS
Summary
About 40 to 60% of patients diagnosed with oral and oropharyngeal squamous cell carcinoma (OPSCC) start the treatment in the advanced-stages of the disease[1]. Several factors of social nature, such as the time between the disease perception, diagnosis, and treatment, are responsible for the disease identification in advanced-stages. Access to health care services, education, occupation, behavioral/cultural factors, exposure to risk factors such as tobacco, topographical distribution of the disease, and the tumor stage may affect the disease perception as well[2]. Individuals in an underprivileged socioeconomic situation usually present a higher prevalence of head and neck cancer and inadequate medical access. Socio-demographic characteristics are related to the advanced clinical staging of oral cancer and its diagnosis delay[5]. The delay in diagnosis compromises the treatment, its prognosis, and survival[6]
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