Dados do Trabalho

Título

ORAL CANCER SCREENING: PERFORMANCE AND OUTCOMES IN THE LATIN AMERICAN REGION

Introdução

Oral cancer is an important global health issue, and there is worldwide variation concerning disease incidence and mortality, with higher incidence found in lower-and-middle-income countries, especially in Latin American countries. To reduce oral cancer mortality rates, screening for early detection of subjects with suspicious or innocuous oral lesions has been promoted. In this context, understanding the performance of screening programs undertaken for oral cancer screening is essential to refine future screening strategies, to reduce deaths related to the disease.

Objetivo

Aims to systematically review the performance and outcomes of all screening programs already performed in the Latin American region. The focused question for this review is: What are the performance and outcomes of screening tests and programs undertaken to detect oral cancer in adults in the Latin American region?

Métodos

An electronic search was conducted in eight databases and grey literature. The eligibility criteria included screening where adult participants underwent any screening test during an organized screening program to detect oral cancer. Screening programs were assessed to understand trends in oral cancer diagnosis over the years. Rates of oral cancers diagnosed in
screening programs were classified as increase, decrease, or stable based on each year assessed.

Resultados

Following our searches, twelve studies conducted in Brazil and Cuba were included. The screening tests reported were visual oral examination (VOE) and in one study in addition light-based fluorescence testing. In a total of twelve reported studies, 13,277,608 individuals were screened and a total of 1,516 oral cancers were detected (0.01%). Only two studies aimed to screen high-risk individuals (smokers and drinkers). Oral cancer cases diagnosed during screening programs are proportionately stable over the years 1997 to 2009 but increased from 2010 to 2021. Only 2 of the 12 studies provided adequate data to analyze the sensitivity and specificity rates. Sensitivity for VOE and fluorescence were 100% while specificity range from 75% to 90%.

Conclusões

Screening studies conducted in Latin American countries had serious limitations both in methodology (lack of examiner training) and in reporting data (lack of description of clinical categories of screen positives). Capacitation of health workers to perform VOE in well-designed screening programs should be implemented.

Palavras-chave

oral cancer, screening, early detection, diagnosis, systematic review.

Financiador do resumo

FAPESP

Área

Estudo Clínico - Tumores de Cabeça e Pescoço