Impact of Primary Health Care on Oral Cancer Incidence and Mortality
Overview of Oral Cancer Statistics
A recent study has examined how Primary Health Care (PHC) influences the incidence and mortality rates associated with oral cancer. Head and neck cancers rank as the seventh most common malignancies worldwide, with over 600,000 new cases diagnosed annually. Notably, oral cancer accounts for half of these cases. While the global incidence of oral cancer is increasing, it is not uniformly distributed. Countries like India and France report some of the highest incidence rates, whereas South America exhibits the highest rates across continents. Specifically, Brazil has shown a rising trend, with approximately 16,340 new cases diagnosed in 2016. Additionally, oral cancer is more prevalent in men than in women.
Causes and Management of Oral Cancer
The development of oral cancer is linked to various genetic, environmental, and behavioral factors, including smoking and alcohol consumption. Depending on the type and stage of the disease, oral cancer can be treated and potentially cured. However, there is a scarcity of research focusing on the role of primary health care in mitigating the incidence and mortality of oral cancer, as well as limited evidence regarding the impact of public health initiatives.
Primary Health Care in Brazil
In Brazil, Primary Health Care (PHC) serves as the primary gateway to the public health system. It plays a crucial role in identifying risks, facilitating early diagnoses, and providing optimal care for cancer patients. Since 2004, the routine examinations in PHC have included the diagnosis of oral cavity lesions. Health professionals in primary care are encouraged to conduct regular oral examinations to detect, diagnose, and treat early-stage cancers, thereby improving survival rates.
Challenges in Primary Health Care
Despite advancements in access to dental services, significant challenges remain within the structure and operational processes of PHC. There is a shortage of dental practitioners involved in early detection initiatives, and as of 2016, only 37% of the Brazilian population was covered by the PHC oral health policy. Other issues affecting the Brazilian PHC system include inadequate training, insufficient preventive screening actions, and socioeconomic disparities.
Diagnostic Networks and Early Detection
The establishment of a diagnostic network is essential for primary care services to identify potentially malignant lesions, which can significantly reduce the number of patients seeking care at advanced stages of oral cancer. Over the past four decades, the proportion of patients diagnosed with advanced stages of oral cancer has remained stable. Evidence indicates that a well-structured PHC could help lower both the incidence and mortality rates of oral cancer. Unfortunately, the framework and processes of oral primary care are still undefined in low to middle-income countries.
Study Findings and Implications
The recent study published in BMC Cancer aimed to analyze how aspects of PHC structure and processes affect oral cancer incidence and mortality rates in Brazil. The researchers proposed that improved coverage, availability of resources, and preventive measures in primary health care would positively influence reductions in these rates.
The findings revealed a positive correlation between oral cancer incidence and the proportion of adults over 60 years and adult smokers. Furthermore, there was a positive relationship between oral cancer-related mortality and the percentage of older adults and the execution of preventive and diagnostic actions. Conversely, an inverse relationship was found between mortality and the coverage of primary care teams, indicating that lower coverage leads to increased mortality rates.
This study concludes that while the structure and processes of primary health care in Brazil contribute to a decrease in oral cancer mortality rates, they do not significantly affect the overall incidence of the disease. The results underscore the urgent need for increased investments in PHC to prevent deaths related to oral cancer.
Reference
Rocha et al. (2017). Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer. Available at: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-017-3700-z. Last accessed 18th Nov 2017.