The Burden of OSCC in a Rural, Region in Sri Lanka: another tale of disparities
Oral cancer burden, socioeconomic disadvantage, disparities, Sri Lanka
ML Pererra, IR Perera, S Colombage and N. Johnson
Objectives: Sri Lanka is a developing middle income country with a dominant public health care delivery model. However, oral cancer is an important public health problem in the country. The Uva Province is predominantly rural and remote, socioeconomically disadvantaged region in the country with a high oral cancer burden. This study aims to describe the burden of oral cancer in this region, to describe socio-demographic attributes, to illustrate disparities that compound the burden of oral cancer,
Methods: The patient-statistics were collected for the year 2013 and Jan-March 2014 from the Oral & Maxillo-Facial Unit of the main public hospital. The socioeconomic data were accessed from the National Census of Population and Housing 2011 and poverty statistics issued by the Department of Census and Statistics Sri Lanka. Descriptive statistics used. These findings highlight the population specific demographic pattern; topography influenced particular risk factors for oral cancer as applied to Sri Lankan context.
Results: A total of 178 oral cancer cases reported. The majority 79.2% was Sinhalese, 19.1% was Tamil and the rest was Muslim. Males dominated the affected cases (78.1%) and three age groupsdominated,60-69 years (32%), 50-59 years: (25.3)% and 70-79 years( 24.2%) followed by 30-49 years (16.7%). The buccal mucosa was the most common sub- site affected 40.5% followed by tongue 14%. The overwhelming majority consisted of well differentiated squamous cell carcinomas (60.1%) and moderately differentiated squamous cell carcinomas (8.4%). Social disadvantage disparities were evident in the region.
Conclusions: There is a high burden of oral cancer in the Uva Province of Sri Lanka with socioeconomic disadvantage leading to disparities which need to be considered in finding solutions.