Temporal trend and spatial analysis of oral cancer cases in Brazil: Correlation between socioeconomic factors and delay in diagnosis and treatment.

Abstract

Objective: To evaluate the temporal trend and spatial distribution of oral cancer cases in Brazil, and to evaluate the relationship between oral cancer cases and socioeconomic conditions.

Methods: Data on oral cancer cases, between 2013 and 2019, were extracted from the Painel-Oncologia website, and the socioeconomic indicators selected were Municipal Human Development Index and Social Vulnerability Index. The endpoints were late diagnosis (staging III and IV) and delay in treatment (>60 days), along with oral cancer prevalence. Spearman's correlation was done between oral cancer cases and Municipal Human Development Index/ Social Vulnerability Index. Temporal trends were evaluated using a segmented linear regression model. As for spatial analysis, global and local Moran indices were applied, together with spatiotemporal scan statistics, to detect risk clusters.

Results: In the period studied, there was a prevalence of 5.3 oral cancer cases/100,000 inhabitants. A significant inverse correlation was found with the Social Vulnerability Index, and a direct correlation linking the Municipal Human Development Index and oral cancer cases, delayed treatment, and diagnosis cases too. An increasing trend of oral cancer prevalence rate and a stable trend of delayed diagnosis and treatment cases were observed in the country. There was a concentration of oral cancer cases in the South and Southeast regions. A high-risk oral cancer cluster was identified covering the South and Southeast regions, and part of the Midwest region and four secondary clusters of delayed treatment cases in the Northeast region.

Conclusion: There was no short-term improvement in data related to oral cancer in Brazil, since the prevalence trend was increasing and there was a correlation with socioeconomic conditions.