V. Freitas

Influence of Race/Skin Color on Delays in Care for Oral Cavity Cancer in Brazil: The Mediating Role of Geography and Clinical Severity

Ethnic-racial relationships within the healthcare service for the diagnosis and treatment of oral cavity cancer in Brazil

Introduction: The social, economic, cultural, and ethnic-racial disparities in Brazil may be related to the time it takes for healthcare services to diagnose and treat oral cavity cancer. Objective: To analyze the relationship between race/skin color and different time intervals for the diagnosis and treatment of oral cavity cancer in Brazilian health services. Method: Observational, hospital-based study with 12,421 cases retrieved from the Brazilian Hospital Cancer Registries. Ethnic-racial classification was based on the combination of color and race categories used by the Brazilian Institute of Geography and Statistics. The Wilcoxon rank-sum test, Poisson regression model, and causal mediation analysis were applied. Results: The retrieved records represented 6,523 (53%) white individuals and 5,898 (47%) non-white individuals. The groups showed heterogeneity in sociodemographic, clinical, and therapeutic variables, but were homogeneous regarding the main risk factors for the disease. Significant differences were observed in all key points analyzed (p<0.001). Non-white individuals have a longer health services interval than white individuals (median of 71 vs. 57 days, respectively), with the direct effect of race/skin color being significant (p<0.001) even when mediated by region of residence or clinical stage of the disease. Conclusion: Race/skin color has a decisive impact on waiting times in Brazilian healthcare services, where non-white individuals wait, on average, 16.2 days longer than white individuals.

Clinical-epidemiological Profile of Individuals with Oral Cancer Treated at a Reference Center in the Semiarid Region of Bahia

Introduction: Squamous cell carcinoma (SCC) is the most common oral malignancy, frequently associated with chronic exposure to ultraviolet radiation. It can invade tissues locally and presents a risk of metastasis. Objective: To analyze the clinical and demographic profile of individuals diagnosed with squamous cell carcinoma (SCC) treated at the “Centro de Referência de Lesões Labiais” (CRLB) of the “Universidade Estadual de Feira de Santana (Uefs), between 2008 and 2024. Method: This is a cross-sectional, descriptive study based on the analysis of secondary data from physical medical records. All cases with a confirmed histopathological diagnosis of SCC were included, totaling 244 individuals. The variables analyzed included sociodemographic characteristics, lifestyle habits, and clinical aspects of the lesions. Data were analyzed using descriptive statistics (absolute and relative frequencies), utilizing IBM SPSS Statistics software, version 23.0. Results: A predominance of men (70.9%; n=173), aged 40 years or older (97.1%; n=237), with occupational sun exposure (73.6%; n=109), tobacco use (68.5%; n=165), and alcohol use (57.7%; n=139) was observed. Most presented lesions larger than 1 cm (98.8%; n=163), lasting longer than 30 days (77.8%; n=140), presenting red coloration (63.0%; n=114), and exophytic growth (61.0%; n=100). Only 9.8% (n=24) of the cases were diagnosed in situ. Conclusion: The findings highlight clinical patterns and exposure factors potentially related to oral cancer and also indicate a possible delay in diagnosis. The importance of educational initiatives, training of primary care professionals, and decentralization of specialized services is highlighted as key strategies to improve the management of squamous cell carcinoma (SCC) in the region.

Interval Between Diagnosis and Treatment of Oral Cavity Cancer in Health Services in the State of Bahia, 2000-2022

Time range to begin treatment at health services in Bahia exceeds 90 days, potentially compromising treatment outcomes, prognosis, and quality of life.

Factors Associated with Oral Cancer Mortality Rates in the State of Alagoas: Decade-Long Analysis

The study demonstrated the persistent occurrence of oral cancer mortality throughout the analyzed decade, as well as low socioeconomic and healthcare access indicators in medium- and large-sized municipalities in the state of Alagoas.