Almeida Fernanda Campos Sousa de, Cazal Claudia, Pucca Júnior Gilberto Alfredo, Silva Dorival Pedroso da, Frias Antonio Carlos, Araújo Maria Ercilia de
Biodentistry Program, Ibirapuera University, São Paulo, Brazil.
Braz Dent J. 2012;23(3):241-5. doi: 10.1590/s0103-64402012000300010.
This study presents the strategies for prevention and early detection of oral cancer by means of screening in the elderly population of São Paulo, the richest and the most populous state of Brazil. This research was a retrospective longitudinal study based on the analysis of secondary data. The variables - number of participating cities, coverage of screening, and number of suspicious and confirmed cases of oral cancer - were divided into two periods: 2001-2004 and 2005-2008. Data were analyzed statistically by the chi-square test at 5% significance level. The implementation of a nationwide public oral health policy in 2004 and the reorganization of the secondary and tertiary health care were evaluated as mediator factors able to interfere in the achieved outcomes. From 2001 to 2008, 2,229,273 oral examinations were performed. There was an addition of 205 participating cities by the end of the studied period (p<0.0001). The coverage of oral cancer screening increased from 4.1% to 16% (p<0.0001). There was a decrease in the number of suspicious lesions (from 9% in 2005 to 5% in 2008) (p<0.0001) and in the rate of confirmed oral cancer cases per 100,000 examinations (from 20.89 in 2001 to 10.40 in 2008) (p<0.0001). After 8 years of screening, there was a decrease in the number of suspicious lesions and confirmed cases of oral cancer in the population. The reorganization of secondary and tertiary health care levels of oral care seems to have contributed to modify these numbers, having a positive impact on the outcomes of oral cancer screening in the São Paulo State.
本研究介绍了通过在巴西最富有且人口最多的圣保罗州老年人群中进行筛查来预防和早期发现口腔癌的策略。本研究是一项基于二手数据分析的回顾性纵向研究。变量——参与城市数量、筛查覆盖率以及口腔癌可疑和确诊病例数——分为两个时期：2001 - 2004年和2005 - 2008年。数据采用卡方检验进行统计学分析，显著性水平为5%。2004年全国公共口腔卫生政策的实施以及二级和三级医疗保健的重组被评估为能够干扰所取得结果的中介因素。2001年至2008年期间，共进行了2,229,273次口腔检查。到研究期末，新增了205个参与城市（p<0.0001）。口腔癌筛查覆盖率从4.1%提高到了16%（p<0.0001）。可疑病变数量有所减少（从2005年的9%降至2008年的5%）（p<0.0001），每10万次检查中确诊的口腔癌病例率也有所下降（从2001年的20.89降至2008年的10.40）（p<0.0001）。经过8年的筛查，人群中口腔癌可疑病变和确诊病例数量有所减少。口腔护理二级和三级医疗保健水平的重组似乎有助于改变这些数字，对圣保罗州口腔癌筛查结果产生了积极影响。
