Sobrevida específica, ocorrências e óbitos para pacientes apresentados e em tratamento oncológico ambulatorial para câncer de boca no sistema único de saúde: uma abordagem espacial

Abstract

Oral cancer showed significant rates of incidence and mortality in Brazil. It has also been associated with delayed diagnosis and, consequently, lower survival rate. Smoking and drinking are known individual risk factors associated with increased incidence of cancer. However, other factors, not only the individual, seem to influence its incidence and mortality. Thus, the focus is the context that affects the health of these groups: cultural, economic, demographic and environmental factors, whether at national, regional or local scale. The study aimed to analyze the specific survival five-year oral cancer survival rate and associated factors, and the distribution of oral cancer cases and deaths in a spatial approach. Two studies were used to achieve this goal. The first was a retrospective cohort study using the Oncological Database as the source, with probabilistic-deterministic linkage of all records for authorization of radiotherapy and/or chemotherapy in the Unified National Health System from 2000 to 2006, generating a single record for each patient.Its included patients diagnosed with oral cancer from 2002 to 2003(except for cancer of lip), and ranging from 19 to 100 years of age The event of interest was the time between the diagnosis of oral cancer and death from this cancer. The Cox regression model was used to evaluate the individual factors associated with the event of interest. To evaluate the influence of residence in particular Brazilian state specific survival for oral cancer, the model was employed Fragility. The second study used cases of mouth cancer available to previous resident analysis in Belo Horizonte. Analysis of cases and deaths was carried out by looking up its relationship with the variables, average education and average income of head of household of a given census tract and away from the main thoroughfares of the city access. In the first study (N = 6180), Specific five-year survival was 60%. Decreased specific survival was associated with: age > 40 years; stage III or IV; location on the tongue, floor of the mouth, or base of tongue; not performingsurgical treatment; performing only chemotherapy or radiotherapy and chemotherapy, and residence in certain States of Brazil.In the second study, the Kernel estimation and analysis of distribution of cases and deaths, according to the variables, average income and average education level of the head of household, area of health risk and distance from the main access roads not identified any area higher intensity of cases or deaths to Belo Horizonte city. These results reinforce the need to include assessment of the spatial distribution of events in the territories of health planning as possible to better plan and improve health actions and survival for this cancer.