Impact of Primary Health Care on Oral Cancer Incidence and Mortality
Overview of Oral Cancer Statistics
A recent study examined the influence of Primary Health Care (PHC) on 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 approximately half of these cases. The global distribution of oral cancer rates is uneven, with countries like India and France reporting some of the highest incidence rates. In South America, the incidence rates surpass those of other continents, and Brazil has seen a troubling rise, with 16,340 new cases documented in 2016. Men are more frequently affected by oral cancer than 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. While treatment options exist depending on the cancer type and stage, studies exploring the role of primary health care in managing and reducing oral cancer are limited. Furthermore, there is a scarcity of evidence regarding the effectiveness of public health initiatives on oral cancer incidence and mortality.
Role of Primary Health Care in Brazil
In Brazil, Primary Health Care (PHC) serves as the primary entry point into the public health system, facilitating risk identification, early diagnosis, and optimal care for cancer patients. Since 2004, the diagnosis of oral cavity lesions has been incorporated into routine PHC examinations. Health professionals in primary care are encouraged to conduct regular oral examinations to detect and treat early-stage cancers, thus improving survival rates.
Challenges in Primary Health Care
Despite advancements in dental service access, significant challenges persist within the PHC structure and work processes. A shortage of dental practitioners involved in early detection initiatives remains a critical issue. In 2016, only 37% of the Brazilian population was covered by the PHC oral health policy. Additional challenges include inadequate training, lack of preventive screening actions, and socioeconomic disparities.
Establishing a Diagnostic Network
The establishment of a diagnostic network is essential for primary care services to identify potentially malignant lesions, which is vital in reducing the number of patients seeking care at advanced cancer stages. Over the past 40 years, the proportion of patients diagnosed with advanced oral cancer stages has not changed. Research indicates that a well-structured PHC could significantly lower both the incidence and mortality rates of oral cancer. However, the framework and operational processes of oral primary care remain undefined in many low- and middle-income countries.
Study Findings and Implications
The recent study published in BMC Cancer aimed to assess how various PHC structural parameters and work processes affect oral cancer incidence and mortality rates in Brazil. The researchers hypothesized that enhanced coverage, availability of resources, and preventive measures in primary health care would positively influence the reduction of oral cancer incidence and mortality.
The study’s findings revealed that the incidence rate of oral cancer was positively associated with the percentage of adults over 60 years and adult smokers. Additionally, a positive correlation was found between oral cancer-related mortality and the proportion of older adults, as well as the implementation of preventive and diagnostic actions. Conversely, an inverse relationship was noted between mortality rates and the coverage of primary care teams; decreased coverage correlated with increased mortality.
This research underscores that while the structure and processes of primary health care in Brazil can help reduce oral cancer mortality, they do not significantly impact the incidence of the disease itself. The results advocate for increased investment in PHC to help prevent deaths related to oral cancer.
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.