Impact of Primary Health Care on Oral Cancer Incidence and Mortality

Overview of Oral Cancer Statistics

A recent study explored how Primary Health Care (PHC) influences the incidence and mortality rates of oral cancer. With over 600,000 new cases diagnosed annually, head and neck cancers rank as the seventh most prevalent malignancies worldwide. Notably, around half of these cases are linked to oral cancer. While the global occurrence of oral cancer is increasing, its distribution varies significantly. Countries like India and France report some of the highest incidence rates, while South America leads among continents. Brazil, in particular, saw a rise in cases, recording 16,340 new diagnoses in 2016. Furthermore, oral cancer is more prevalent in men compared to women.

Causes and Management of Oral Cancer

The etiology of oral cancer involves various genetic, environmental, and behavioral factors, including smoking and alcohol use. Depending on the type and stage at diagnosis, oral cancer can be managed effectively, and in some cases, cured. However, research focusing on the role of primary health care in managing oral cancer is limited, and there is insufficient evidence on the impact of public health initiatives on its incidence and mortality.

The Role of Primary Health Care in Brazil

In Brazil, primary health care (PHC) serves as the main entry point into the public health system, providing a platform for risk identification, early diagnosis, and optimal care for cancer patients. Since 2004, the diagnosis of oral cavity lesions has been included in routine PHC examinations. Primary care professionals are encouraged to perform regular oral screenings to detect, diagnose, and treat early-stage cancers, thereby improving survival rates.

Challenges in Primary Health Care Access

Despite advancements in dental service access, significant challenges persist within the structure and processes of PHC. A low number of dental professionals are involved in early detection efforts, and as of 2016, only 37% of the Brazilian population was covered by the PHC oral health policy. Additional issues include inadequate training, lack of preventative screening, and socioeconomic disparities.

Importance of a Diagnostic Network

Establishing a diagnostic network is crucial for primary care services to identify potentially malignant lesions, which can reduce the number of patients seeking care at advanced disease stages. Over the past 40 years, the proportion of patients diagnosed with advanced oral cancer has not improved. Evidence suggests that a well-structured PHC could lead to decreased incidence and mortality rates of oral cancer. However, the operational structure and processes of oral primary care remain poorly defined in low- to middle-income countries.

Findings of the Recent Study

The recent study published in BMC Cancer aimed to evaluate how various aspects of PHC structure and processes affect oral cancer incidence and mortality rates. The researchers hypothesized that enhanced coverage, resource availability, and preventative measures in primary health care would positively influence these rates.

Study Results and Implications

The findings revealed a positive correlation between oral cancer incidence and the proportion of adults over 60 years and smokers. Additionally, there was a link between oral cancer-related mortality and the same demographic factors, along with the execution of preventive and diagnostic initiatives. An inverse relationship was noted between mortality rates and PHC team coverage; as coverage decreased, mortality increased.

This study concluded that while the PHC structure and processes in Brazil contribute to lowering oral cancer mortality rates, they do not significantly impact the incidence of the disease. These results underscore the necessity for increased investment in PHC to prevent deaths related to oral cancer.

About the Author

Written by Jade Marie Evans, MPharm, Medical Writer.

Reference

Rocha et al. (2017). Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer. Available: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-017-3700-z. Last accessed 18th Nov 2017.