Delay in diagnosis of oral cancer: a systematic review / Retraso en el diagnóstico del cáncer bucal: una revisión sistemática

ABSTRACT

Background: Oral cancer represents a worldwide public health problem, being among the most prevalent, associ-ated with high morbidity and mortality rates. This systematic review aimed to review the causes of the delayeddiagnosis of oral cancer mainly in the elderly, in developed and developing countries.Material and Methods: Search strategy was developed for MEDLINE databases (via PubMed), EMBASE, Webof Science, SCOPUS, and LILACS and for grey literature (Google Scholar, ProQuest and OpenGrey), withoutlanguage or period restrictions. The risk of bias was assessed using instruments from the Joanna Briggs Instituteand the quality of evidence according to the GRADE system.Results: The search resulted in 14,473 records, of which only 13 met the eligibility criteria. The total sample was1,705 participants, with a predominance of males. All studies included reported causes of delayed diagnosis of oralcancer related to the patient and five also reported causes related to health professionals. The scarce knowledge ofthe population was pointed out as the main cause of delayed diagnosis of this cancer. Regarding the risk of bias,ten studies were classified as low risk and three, as moderate risk. The quality of the evidence was very low forthe outcome related to delayed diagnosis of oral cancer.Conclusions: Wide dissemination of information on oral cancer is needed, especially for the elderly, such as itsinitial signs and symptoms, in developed and developing countries. Further studies should be conducted to bet-ter understand the causes of delayed diagnosis of oral cancer in countries with different socioeconomic statuses.(AU)