Jul 2026· Revista Brasileira de Cancerologia· Vol 72, pp. e065640· 0 citations· 35 references
TL;DR
Time range to begin treatment at health services in Bahia exceeds 90 days, potentially compromising treatment outcomes, prognosis, and quality of life.
Abstract
Introduction: Oral cavity cancer shows high mortality rates in Bahia, largely attributed to late diagnosis. Objective: To investigate factors associated with the diagnostic and treatment intervals for oral cavity cancer in health services across the state of Bahia between 2000 and 2022. Method: A cross-sectional, hospital-based study was conducted with 1,305 cases retrieved from Hospital Based Cancer Registries. Descriptive statistical analyses included absolute and relative frequencies for categorical variables, and medians with interquartile ranges for age and time intervals of interest (dates) were performed. A significance level of 5% (α=0.05) was adopted, and Poisson regression with a negative binomial distribution was applied. Results: Most of the 1,305 individuals with oral cancer were diagnosed at advanced-stage (69.2%), were referred through the Brazilian National Health System (98.2%), and had to leave their city of origin to receive oncologic care (69.9%). The median of days since entry into oncology services to treatment initiation was 91 days, ranging between 61 and 144 days. Time was associated with the necessity of transportation as protective factor (IRR 0.57) and with sex, age and staging. Conclusion: Time range to begin treatment at health services in Bahia exceeds 90 days, potentially compromising treatment outcomes, prognosis, and quality of life. Referral pathways and the need to travel for care emerged as key factors influencing the diagnostic and treatment timelines.
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.
Yasmin Tenorio Ferro Alencar, Sâmela da Silva Ferreira, Ana Clara da Silva Marinho et al.· Revista Brasileira de Cancer...· 0 citations
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.
Lidiane de Jesus Lisboa, J. C. Z. Contreras, V. Freitas· Revista Brasileira de Cancer...· 0 citations
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.
M. M. L. Falcão, Thomas Silva Gonçalves, Serena de Oliveira Guimarães Passos et al.· Revista Brasileira de Cancer...· 0 citations
IMPORTANCE
Evidence regarding the association of the diagnosis to treatment interval (DTI) and survival can inform clinical care and health policy. Data in this regard are currently lacking for cervical cancer.
OBJECTIVE
To examine the relationship between the DTI and overall survival (OS) in a contemporary cohort of cervical cancer patients receiving curative surgery.
METHODS
We conducted a retrospective cohort study using population-based data of incident cases of cervical cancer diagnosed January 2008-September 2023 followed to December 1st, 2023 in Ontario, Canada. Eligible patients were > 18 years of age with stage I-III disease who received curative surgery. Multivariable Cox Proportional Hazards regression analyses were performed to evaluate the association between the DTI and OS adjusting for important confounders. The DTI was modeled categorically and using restricted cubic splines to visualize non-linear relationships.
RESULTS
1501 incident cases of cervical cancer receiving curative surgery were included. The majority of patients were diagnosed with stage I disease (n = 1185, 79%). The median DTI was 80 (60-107) days. After multivariable adjustment, the hazard ratio (HR) estimates were elevated for the shortest and longest DTIs: >2-6 weeks HR: 2.33 (95%CI 1.14-4.77); >22-26 weeks HR: 1.76 (95%CI 0.59-5.27); in comparison to the middle referent interval >10-14 weeks. The restricted cubic splines exhibited a U-shaped pattern of risk, with higher effect estimates among the lowest and highest DTI values.
CONCLUSION
In this population-based study we did not find that prolonged DTIs to be significantly associated with poorer survival. Cautious interpretation of the results is needed given the potential impact of the waiting time paradox.
M. Jalink, W. King, Christopher M. Booth et al.· Cancer Epidemiology· 0 citations
This study analyzed the epidemiological profile and temporal trend of hospitalizations for malignant skin neoplasms in Brazil between 2015 and 2025, based on secondary data from the Hospital Information System of the Unified Health System (SIH/SUS). A total of 633,457 hospitalizations were recorded during the period, with a predominance of male sex (51.9%), self-declared White individuals (65.8%), and the age group of 60 years or older (72.3%). The Southeast and South regions concentrated the highest number of hospitalizations, while the North region presented the highest mortality rate (4.70%). A general upward trend was observed throughout the historical series, with a reduction in 2020 and a progressive recovery in subsequent years. The findings indicate a higher occurrence of hospitalizations in groups more vulnerable to cumulative ultraviolet radiation exposure and evidence regional inequalities in access to diagnosis and treatment, reinforcing the need for prevention strategies, early diagnosis, and strengthening of public health policies.
Geovanna Oliveira Martins Pinto, Matheus Oliveira Martins Pinto, Taynara dos Anjos Rodrigues et al.· O Mundo da Saúde· 0 citations
BACKGROUND
Delayed diagnosis of oral squamous cell carcinoma (OSCC) is associated with advanced-stage disease, more extensive treatment, and poorer survival. This study evaluated factors associated with diagnostic delay among patients with OSCC.
METHODS
A cross-sectional study was conducted among 100 patients with histopathologically confirmed OSCC attending a tertiary cancer centre. Demographic, behavioral, medical, clinical, and healthcare-related data were obtained through structured interviews and review of medical records. Total diagnostic delay was defined as the interval between symptom onset and histopathological diagnosis. Associations with diagnostic delay were analyzed using non-parametric tests, and independent predictors were identified using multivariable linear regression.
RESULTS
The median total diagnostic delay was 176.5 days (interquartile range: 107.0-279.5 days), with a mean delay of 190.2 ± 113.6 days. Educational status, diabetic status and primary lesion site stage were significantly associated with diagnostic delay (p < 0.05). Multivariable regression identified educational status as an independent factor associated with total diagnostic delay. Appointment delays, fear of diagnosis, financial constraints, lack of awareness, and symptom neglect were the most frequently reported reasons for delayed diagnosis.
CONCLUSIONS
Diagnostic delay in OSCC remains substantial and is influenced primarily by educational, clinical, and healthcare-related factors. Improving oral health literacy, public awareness, and referral pathways may facilitate earlier diagnosis and improve patient outcomes.
J. Philip, H. Abraham· Cancer Treatment and Researc...· 0 citations
