Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer

• Published in: BMC cancer 2017-10, Vol.17 (1), p.706-706, Article 706
• Main Authors: Rocha, Thiago Augusto Hernandes, Thomaz, Erika Bárbara Abreu Fonseca, da Silva, Núbia Cristina, de Sousa Queiroz, Rejane Christine, de Souza, Marta Rovery, Barbosa, Allan Claudius Queiroz, Thumé, Elaine, Rocha, João Victor Muniz, Alvares, Viviane, de Almeida, Dante Grapiuna, Vissoci, João Ricardo Nickenig, Staton, Catherine Ann, Facchini, Luiz Augusto
• Format: Article
• Language: English
• Subjects: Ecological studies; Health care; Health inequalities; Health risk assessment; Health systems; Information systems; Medical screening; Mortality; Mouth cancer; Mouth neoplasms; Oral cancer; Oral hygiene; Population; Prevalence studies (Epidemiology); Primary care; Primary health care; Public health; Quality of life; Socioeconomic factors; Statistics; Studies
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-017-3700-z

Oral cancer is a potentially fatal disease, especially when diagnosed in advanced stages. In Brazil, the primary health care (PHC) system is responsible for promoting oral health in order to prevent oral diseases. However, there is insufficient evidence to assess whether actions of the PHC system have some effect on the morbidity and mortality from oral cancer. The purpose of this study was to analyze the effect of PHC structure and work processes on the incidence and mortality rates of oral cancer after adjusting for contextual variables. An ecological, longitudinal and analytical study was carried out. Data were obtained from different secondary data sources, including three surveys that were nationally representative of Brazilian PHC and carried out over the course of 10 years (2002-2012). Data were aggregated at the state level at different times. Oral cancer incidence and mortality rates, standardized by age and gender, served as the dependent variables. Covariables (sociodemographic, structure of basic health units, and work process in oral health) were entered in the regression models using a hierarchical approach based on a theoretical model. Analysis of mixed effects with random intercept model was also conducted (alpha = 5%). The oral cancer incidence rate was positively association with the proportion of of adults over 60 years (β = 0.59; p = 0.010) and adult smokers (β = 0.29; p = 0.010). The oral cancer related mortality rate was positively associated with the proportion of of adults over 60 years (β = 0.24; p