Opportunistic Oral Cancer Screening Program in São Paulo, Brazil

Objectives: Oral cancer (OC), a devastating disease with low survival rates (~50% 5-year survival), is often diagnosed at advanced stages. While screening programmes seem to be effective for early detection of several cancers, there is limited evidence regarding OC. Here, we describe the spatiotemporal trends in coverage of a vaccination day-based screening for oral lesions in São Paulo State, Brazil from 2015-2019.
Methods: We use an oral lesions database from the Secretary of Health of Sao Paulo state, Brazil to fulfill our objective. Since 2015, during the national vaccination campaign against influenza, individuals are offered an oral health examination, which includes the assessment of oral lesions. The oral lesions diagnostic criterion categorizes according to no, low and high-risk lesions, respectively. We further linked this database to the Brazilian Institute of Geography and Statistics to obtain sociodemographic and geographic information of the population. We performed descriptive statistics to calculate the average coverage of screening across municipalities of the proportion of high-risk lesions. All the analyses were performed using the software R.
Results: An average of the coverage is slightly increased for the age group between 20 years old and < 60 years old through 2015-2019. However, in 2017, we observed a decline in the age group above 60 years old. The proportion of high-risk lesions diagnosed over most years was similar, although we observed a sharp decrease in 2018.
Conclusions: Our preliminary results suggest that the proportion of high lesions is similar over the years, except for a marked decrease in 2018. Further analysis will be performed to better understand the time trends in oral lesions in Sao Paulo, Brazil.