Socio-demographic characteristics are related to the advanced clinical stage of oral cancer.

BACKGROUND: Social determinants may be associated with the onset and progression of the clinical stage of oral cancer. AIM: To evaluate the impact of socio-demographic characteristics on the prevalence of advanced clinical stage of oral cancer. MATERIAL AND METHODS: Information about 51,116 cases of oral cancer, from all Brazilian states, between 2000 and 2012, was obtained from the Cancer Registry Information System. The clinical stage of oral cancer (dependent variable) was classified as initial (stages I and II) or advanced (stages III and IV). The relationship between the clinical stage of oral cancer and the following independent variables was analyzed: sex, age, schooling, marital status, family history of cancer, and origin of referral. Analyses on frequency distribution and multivariate binary logistic regression model were performed (α<0.05). RESULTS: Compared to individuals with no schooling, those who attended elementary to high school (OR=2.461) and college education (OR = 3.050) had a higher prevalence of advanced cases of oral cancer. Individuals without a partner (OR = 14,209) demonstrated a higher prevalence compared to married individuals. Subjects aged 20-44 years (OR = 4.081) and 45-64 years (OR = 14.875) had a higher prevalence compared to those aged 15-19 years. The variables gender, family history of cancer and origin of referral integrated the binary model of logistic regression, but did not present statistical significance. CONCLUSIONS: Socioeconomic factors may be related to the advanced clinical stage of oral cancer.

Impact of the anatomical location, alcoholism and smoking on the prevalence of advanced oral cancer in Brazil.

BACKGROUND: To evaluate the prevalence of oral cancer in Brazil according to the clinical stage, anatomical location, alcoholism and smoking. MATERIAL AND METHODS: Data referring to 31,217 cases of oral cancer, from 2000 to 2010, were obtained from the Integrator Module of the Hospital Registry of Cancer. Inconsistent data ("non-classified" cases) was eliminated and 21,160 cases were analyzed. The frequency distribution according to clinical stage, anatomical location, alcoholism and smoking was analyzed descriptively and through a binary logistic regression model (α<0.05). The clinical stage (dependent variable) was dichotomized in early stage (I and II) or advanced stage (III and IV). The year of diagnosis, anatomical location and deleterious habits (alcoholism and smoking) were considered independent variables. RESULTS: The most frequent characteristics were: oropharynx location (n=3856, 18.41%), clinical stage IV (n=11924, 56.09%) and combined use of alcohol and tobacco (n=19226; 61.59%). The year 2009 (p<0.01, PR = 1.162, CI-95%=1.053-1.283) and location at the base of tongue (p<0.01, PR = 2.485, CI-95% = 2.182-2.807) presented a higher prevalence ratio for advanced stage oral cancer. The combined use of alcohol and tobacco showed a higher prevalence rate for the advanced clinical stage of cancer (p<0.01, PR =1.449, CI-95%=1.382-1.520) if compared to individuals without habits, or just alcoholics. CONCLUSIONS: Higher prevalence of advanced stage of oral cancer is related to the localization at the base of the tongue and to the concomitant use of alcohol and tobacco. Therefore, it can be suggested that all these characteristics lead to a worse prognosis of oral cancer.