Comparison of oral cancer survival in a cancer hospital registry and a screening program

Keywords

oral cancer screening - oral cancer prevention - public health - oncology

Introduction: Squamous cell carcinoma (SCC) in the oral cavity represents a significant burden of morbidity and mortality globally. The National Cancer Institute (INCA) estimates that annually, during the 2023/2025 triennium, approximately 15,100 new cases of oral and oropharyngeal cancer will be diagnosed in Brazil, 10,900 in men and 4,200 in women. What characterizes patients with oral cancer is that they are mostly men, with advanced diagnosis (stages III and IV), with low education, smokers and heavy drinkers.

Objective: To analyze the specific survival at 1, 3, and 5 years of patients diagnosed in the oral cancer screening program of a reference institution in the years 2014 to 2022.

Methodology: Retrospective study of oral cancer cases from the Hospital Cancer Registry (HCR) and cases diagnosed in the oral cancer screening program of the Barretos Cancer Hospital (BCH). The BCH oral cancer prevention program recruits the high-risk population of the 18 municipalities of the Regional Health District of Barretos, São Paulo. The high-risk population is smokers or former smokers who have quit smoking in the last 20 years, drinkers or former drinkers who have stopped drinking in the last 20 years, with a minimum age of 35 years or, regardless of the previous criteria, who have had an oral cavity lesion for at least 2 weeks, and invites them to participate in the prevention program. The sample consisted of 2401 cases of oral cancer, diagnosed from 2014 to 2022, of which 333 were diagnosed in the HCB screening program. The survival analysis considered death due to cancer to be censored, estimated from Cox's univariate analysis.

Results: The patients in the HCR and the screening were, respectively: 77.1% and 83.5% men, with a median age of 60 years and 62 years, 89.4% and 87.1% with less than eight years of schooling. There was a difference in survival curves when comparing patients who were and were not diagnosed at screening (p<0.001). It is estimated that 85.8% of patients who were screened were alive at 1 year and 66.5% at 5 years, while patients who did not receive screening were alive at 1 year, 80.4% and 55.6% at 5 years (p<0.001). In Cox regression, those who were not diagnosed at screening were 1.45 times more likely to die.

Conclusion: Oral cancer screening in the high-risk population can reduce mortality and increase patient survival.

Corresponding author: Fabiana de Lima Vazquez (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025