Nivel de información sobre el cáncer bucal en población mayor de 60 años / Level of information on oral cancer in the population over sixty years of age

RESUMEN Fundamentación: Los adultos mayores presentan factores de riesgo de naturaleza diversa asociados a la probabilidad de que desarrollen cáncer bucal. Objetivo: Determinar el nivel de información sobre el cáncer bucal de los adultos mayores de 60 años del consultorio 5 de Casilda. Metodología: Se realizó un estudio observacional descriptivo de corte transversal de noviembre del 2019 a abril del 2021. La muestra se obtuvo mediante muestreo aleatorio simple, estuvo constituida por 85 mayores de 60 años del consultorio 5 de Casilda. Se analizó la variable de respuesta principal: Nivel de información sobre el cáncer bucal. Se aplicó un cuestionario sobre cáncer bucal y una guía de observación del autoexamen bucal. Resultados: Se observó una edad promedio cercana a los 67 años; el 55.3 % de los adultos mayores fue del sexo femenino, predominó el nivel escolar primario con 38.8 %. Se constató un nivel de información bajo en el 89.4 % de la muestra estudiada. Conclusiones: El nivel de información sobre el cáncer bucal fue bajo en más de la tercera parte de los adultos mayores.

ABSTRACT Background: Older adults present risk factors of a diverse nature associated with the probability of developing oral cancer. Objective: To determine the level of information about oral cancer in adults older than 60 years in Casilda Doctor´s office 5. Methodology: A cross-sectional descriptive observational study of November 2019 to April 2021. The sample was obtained by simple random sampling, it was made up of 85 people over 60 years of age from the Casilda Doctor´s 5. It was analyzed main response variable: Level of information about oral cancer. A was applied an oral cancer questionnaire and an oral self-examination observation guide. Results: An average age close to 67 years was observed; 55.3% of adults older was female, the primary school level prevailed with 38.8%. It was found a low level of information in 89.4% of the studied sample. Conclusions: The level of information about oral cancer was low in more than the third part of older adults.

Lesiones bucales, factores de riesgo de cáncer bucal y autopercepción de irritación mecánica crónica en una campaña de prevención en la Ciudad de Buenos Aires / Oral lesions, oral cancer risk factors and self-perception of chronic mechanical irritation in a prevention campaign in Buenos Aires City

Objetivos: i) Describir las características poblaciona- les, la frecuencia de patologías de mucosa bucal y de factores de riesgo asociados al cáncer bucal en una Campaña de Pre- vención y Diagnóstico Precoz de Cáncer Bucal (CPDPCB) en la Ciudad de Buenos Aires; ii) establecer concordancia entre diagnóstico clínico profesional de irritación mecánica crónica (IMC) y autopercepción de trauma. Materiales y métodos: Se realizó un estudio descrip- tivo retrospectivo, en el que se utilizaron encuestas de 640 pa- cientes que participaron en las CPDPCB del Servicio de Odon- tología del Hospital Alemán entre los años 2016, 2017 y 2018. Se describen las variables demográficas, clínicas y cognitivas, y se analizan empleando chi cuadrado para variables cualitativas y ANOVA para variables cuantitativas comparando los años de campaña. Se realizó un estudio de concordancia entre el diag- nóstico clínico profesional de IMC y el trauma autopercibido mediante test Kappa, sensibilidad y especificidad. Resultados: Los sujetos participantes fueron predomi- nantemente mayores de edad, con bajo consumo de tabaco y alcohol. El porcentaje de pacientes con desórdenes potencial- mente malignos y cáncer bucal fue de 17,2%. La cartelería del hospital y la radio fueron las principales vías de información a los pacientes. El trauma autopercibido no presentó concor- dancia con el diagnóstico clínico profesional de IMC, y mos- tró sensibilidad de 0,41 y especificidad de 0,72. Conclusiones: El nivel de participación de los grupos de mayor riesgo de CBCE en la CPDPCB es bajo, y el perfil epidemiológico de los participantes no coincide generalmente con el perfil de los pacientes con CBCE. La autopercepción de trauma no sería una herramienta confiable para el diagnóstico de IMC (AU)

Aims: i) To describe population characteristics, frequency of oral mucosa pathologies, and risk factors for oral squamous cell carcinoma (OSCC) in a Campaign for the Prevention and Early Diagnosis of Oral Cancer (CPEDOC), and ii) to establish concordance between professional clinical diagnosis of chronic mechanical irritation (CMI) and self-perception of trauma. Materials and methods: A retrospective descriptive study was performed using surveys of 640 patients who had participated in the CPEDOC conducted by the Dentistry Ser- vice at the Hospital Alemán during 2016, 2017 and 2018. De- mographic, clinical and cognitive variables were described and analyzed, using chi-square for qualitative variables and ANOVA for quantitative variables, to compare campaign years. Concordance was studied between the professional clinical diagnosis of CMI and self-perceived trauma using the Kappa test, sensitivity and specificity. Results: Participants were predominantly older, with low consumption of tobacco and alcohol. The percentage of patients with potentially malignant disorders and oral cancer was 17.2%. Hospital posters and radio broadcasting were the main channels of information to patients. Self-perceived trauma did not agree with the professional clinical diagnosis of CMI. Self-perceived trauma sensitivity and specificity were 0.41 and 0.72, respectively. Conclusions: The level of participation in the CPEDOC by the groups at higher risk of OSCC was low, and the epide- miological profile of the participants did not generally coincide with the profile of patients with OSCC. Self-perception of trau- ma does not seem to be a reliable tool for the diagnosis of CMI (AU)

Câncer bucal: o que sabem os cirurgiões-dentistas da Baixada Litorânea-RJ? / Oral cancer: what do dentists from the Baixada Litorânea region - RJ know about?

Introdução: Apesar das estratégias para prevenção e diagnóstico precoce, o câncer bucal está entre os mais incidentes no Brasil. Objetivo: Avaliar o conhecimento de cirurgiões-dentistas da Atenção Primária à Saúde sobre o câncer bucal. Material e método: Pesquisa censitária, exploratória e quantitativa, realizada em 2021. Cirurgiões-dentistas vinculados à rede pública dos 9 municípios da Baixada Litorânea/RJ preencheram um questionário com 41 questões, divididas em 5 blocos: 1. Perfil sociodemográfico, 2. Conhecimento sobre câncer bucal, 3. Fatores de risco para câncer bucal, 4. Segurança para diagnóstico do câncer bucal e 5. Experiência na identificação de lesões suspeitas. Resultado: Dos 128 cirurgiões-dentistas habilitados, 89,1% (n=114) participaram e caracterizavam-se por terem menos de 40 anos (50%), serem do sexo feminino (64,9%) e formados há mais de 16 anos (57,9%). Quanto ao conhecimento sobre o câncer bucal e fatores de risco, 84,2% consideraram seu nível de conhecimento regular ou bom e 65,8% consideraram baixo o seu nível de segurança para realização de procedimentos de diagnóstico do câncer bucal. Quanto à identificação de lesões suspeitas de câncer bucal, 86,8% realizavam exame da cavidade bucal, 7,9% não realizam porque o tempo da consulta é insuficiente e 5,3% porque não sabem fazer. Além disso, 50,9% identificaram alguma lesão suspeita nos últimos 12 meses. Notou-se também que 65,8% dos CDs não tinham conhecimento do fluxograma do município para diagnóstico e tratamento do câncer bucal. Conclusão: Os achados evidenciaram lacunas com relação ao conhecimento e procedimentos para diagnóstico precoce do câncer bucal.

Introduction: Despite the strategies for prevention and diagnosis, oral cancer is among the most incidents in Brazil. Objective: To evaluate the knowledge about oral cancer of primary health care dentists. Material and method: This is a census, exploratory and quantitative study carried out in 2021. Dentists linked to the public network of the 9 municipalities of the "Baixada Litorânea" region/RJ filled out a questionnaire with 41 questions, divided into 5 blocks: 1. Sociodemographic profile, 2. Knowledge on oral cancer, 3. Risk factors for oral cancer, 4. Safety for diagnosing oral cancer and 5. Experience in identifying suspicious lesions. Result: Of the 128 dentists, 89.1% (n=114) participated and were characterized by being less than 40 years old (50%), female (64.9%) and for having the dentistry degree for more than 16 years (57.9%). As for knowledge about oral cancer and risk factors, 84.2% considered their level of knowledge regular or good and 65.8% considered their level of security low for carrying out diagnostic procedures for oral cancer. Regarding the identification of oral cancer suspicious lesions, 86.8% performed oral cavity examination, 7.9% did not perform it because the consultation time was insufficient and 5.3% because they did not know how to do it. In addition, 50.9% have identified a suspicious lesion in the last 12 months. It was also observed that 65.8% of dentists were not aware of the municipality's flowchart for the diagnosis and treatment of oral cancer. Conclusion: The findings showed that the knowledge about oral cancer was satisfactory; however, training regarding risk factors and diagnostic procedures related to oral cancer should be strengthened.

Perspectivas educativas em saúde bucal: possibilidades de criação na prevenção e no enfrentamento do câncer / Perspectives of oral health education: possibilities for creation in preventing and coping with cancer

Resumo Diferentes perspectivas acerca dos processos educativos podem indicar maneiras de abordá-los, inclusive no contexto dos processos de saúde e doença. Assumimos que o profissional de saúde é um educador, e essa função lhe permite contribuir efetivamente para a promoção da saúde dos indivíduos e populações. Este estudo tem como objetivo identificar e analisar, tanto em materiais educativos em saúde bucal, quanto nas vivências de usuários de um serviço odontológico em oncologia, elementos e características do trabalho educativo em saúde direcionado à prevenção e ao enfrentamento do câncer de boca. Tanto o material educativo quanto os dizeres dos pacientes foram tomados a partir das perspectivas que comparecem nos processos educativos em saúde bucal, conforme destacam-se: Tecnicismo, Pragmatismo, Construtivismo, Interacionismo e Pós-estruturalismo. Observaram-se modelos que reforçam uma relação assimétrica e autoritária entre profissionais e usuários, portanto, há necessidade de pensar a prevenção e o enfrentamento do câncer de boca de forma inovadora e poética, por meio de uma linha de fuga às generalizações que massificam o conhecimento sobre saúde bucal.

Abstract Different perspectives on educational processes can indicate ways of approaching them, with include health and disease processes. It is assumed that the health professional is an educator and this activity allows him to effectively contribute in health promotion. This study aims to identify and analyze, both in educational materials on oral health, and in experiences of users of a dental service in oncology, elements and characteristics of health education at preventing and coping with oral cancer. Both educational material and statements were analyzed from the perspectives that predominate in the oral health educational processes, as we highlight: Technicism, Pragmatism, Constructivism, sociocultural theory and Poststructuralism. There is a need to think prevention and health promotion in an innovative and poetic way through a possible way free of generalizations that massify knowledge about oral health.

Development of novel mucoadhesive gels containing nanoparticle for buccal administration of dexamethasone

Abstract This study aimed to develop promising and innovative mucoadhesive gel systems containing dexamethasone-loaded nanoparticle to increase the effectiveness of treatment for oral precancerous lesions and to reduce side effects. In this respect, a dexamethasone-loaded nanoparticle formulation was prepared by using emulsification/solvent evaporation method. The nanoparticle has high zeta potential (-10.3±0.5 mV), low particle size (218.42±2.1), low polydispersity index (0.070±0.014) and high encapsulation efficiency (95.018±2.982%). To improve the mucosal retention time, the dexamethasone-loaded nanoparticle was dispersed in mucoadhesive gel using gellan gum. The developed gels offered appropriate pH value, high drug content, suitable mechanical and mucoadhesive performance and appropriate viscosity for mucosal administration. All formulations exhibited plastic flow and typical gel-type mechanical spectra after the determined frequency value. The developed formulations exhibited extended drug release as intended for these systems. Cytotoxicity was tested by MTT assay in human epithelioid carcinoma cell (HeLa) in vitro. The MTT assay showed that the blank formulations were non-toxic to cells. It was observed that the bioactivity of the free dexamethasone was potentiated by mucoadhesive gels containing dexamethasone-loaded nanoparticle in HeLa cells. Results from this study indicate that mucoadhesive gels are effective for the local treatment of precancerous lesions. Our findings showed that the developed formulations were worthy of further studies.

Avaliação do conhecimento de pacientes idosos acerca do câncer bucal / Assessment of elderly patients' knowledge about oral cancer

O objetivo deste estudo foi avaliar o conhecimento de pacientes do Centro Universitário da Serra Gaúcha acerca do câncer oral. Foram aplicados questionários para idosos (n=60) de ambos os gêneros, diferentes etnias e graus de escolaridade. A análise dos dados foi realizada por meio do teste qui-quadrado com nível de confiança de 95%. Não houve relação estatisticamente significativa (p>0,05) entre gênero, estado civil e escolaridade. A presença de lesões bucais, ausência de dentes, visitas frequentes ao dentista, e uso de bebida alcoólica e tabagismo não influenciaram quanto ao conhecimento acerca do câncer bucal. Embora a maioria dos pacientes (85%) já tenha ouvido falar em câncer bucal, apenas a minoria relatou saber se prevenir (23%) e possuir o hábito de examinar a boca em casa (35%). Além disso, apesar de 55% dos pacientes visitarem regularmente o dentista, apenas 28,3% relatou ter recebido informações sobre o câncer bucal. Pôde-se concluir que mesmo sabendo da existência do câncer bucal, a população idosa não possui informações suficientes para o correto diagnóstico e prevenção da doença, sendo necessário melhorias nas orientações fornecidas pelos profissionais da área da saúde com relação a este tema(AU)

The aim of this study was to evaluate the knowledge of patients at Serra Gaucha University Center about oral cancer. Questionnaires were applied to the elderly (n = 60) of both genders, different ethnicities and educational levels. Data analysis was performed using the chi-square test with a 95% confidence level. There was no statistically significant relationship (p> 0.05) between gender, marital status and education. The presence of oral lesions, absence of teeth, frequent visits to the dentist, and the use of alcohol and smoking did not influence the knowledge about oral cancer. Although most patients (85%) have heard of oral cancer, only a minority reported knowing whether to prevent it (23%) and having the habit of examining their mouth at home (35%). In addition, although 55% of patients regularly visit the dentist, only 28.3% reported receiving oral cancer information. It can be concluded that even knowing the existence of oral cancer, the elderly population does not have enough information for the correct diagnosis and prevention of the disease, being necessary improvements in the guidance provided by health professionals regarding this theme(AU)

Prevention of upper aerodigestive tract cancer through active search strategies and use of equipped propaedeutics / Prevenção ao câncer do trato aerodigestivo superior através das estratégias de buscaativa e uso da propedêutica armada

Abstract Introduction Upper aerodigestive tract cancer is among the most frequent malignancies and has epidemiological importance worldwide. Most cases are already advanced at the diagnosis, with a strong negative impact on survival and high cost to the government. Campaigns directed against these cancers have often failed in Brazil. Objective To evaluate the effectiveness of screening for upper aerodigestive tract cancers, using active search strategies and the use of equipped propaedeutics. Methods A cross-sectional, prospective, descriptive, analytical and exploratory study, since its objectives are based on the visualization of cancerous lesions in a sample consisting of individuals with risk factors, aiming to expand the necessary knowledge for cancer detection, aiming at secondary prevention of the oral cavity, oropharynx, larynx and hypopharynx cancer. Results A total of 16.7% of precancerous lesions and 0.5% of cancer lesions located in the upper aerodigestive tract were clinically visualized. Conclusion The method was effective in the identification of precancerous lesions for the purpose of secondary prevention, but equally important against upper aerodigestive tract cancer, since in the present study the chance of finding the latter was increased by 22.7, showing it is an alternative for future campaigns against the disease.

Resumo Introdução O câncer do trato aerodigestivo superior configura-se entre os mais frequentes e apresenta-se com importância epidemiológica no mundo. A maior parte apresenta-se avançada ao diagnóstico, com forte impacto negativo na sobrevida e elevado custo ao erário. As campanhas feitas contra esses cânceres têm frequentemente falhado no Brasil. Objetivo Avaliar a efetividade do rastreamento para lesões cancerizáveis do trato aerodigestivo superior com estratégias de busca ativa e uso da propedêutica armada. Método Estudo transversal, prospectivo, descritivo, analítico e exploratório, uma vez que os seus objetivos se alicerçam na visualização das lesões cancerizáveis numa amostra composta por indivíduos com fatores de risco, de forma a aprofundar o conhecimento necessário para a sua detecção, visando à prevenção secundária do câncer da cavidade oral, orofaringe, laringe e hipofaringe. Resultado Foram visualizadas clinicamente 16,7% lesões cancerizáveis e 0,5% cânceres de localização no trato aerodigestivo superior. Conclusão O método mostrou-se efetivo na identificação de lesões cancerizáveis com intuito de prevenção secundária, mas igualmente importante contra o câncer do trato aerodigestivo superior, uma vez que neste presente estudo multiplicou-se a chance do encontro desse por 22,7; apresenta-se como opção para futuras campanhas contra a doença.

Políticas de prevenção e controle do câncer bucal à luz da teoria da estruturação de giddens / Policies for prevention and control of oral cancer in the light of giddens structuration theory

Resumo Passados mais de dez anos de continuidade das políticas de prevenção e controle do câncer e de saúde bucal, persistem desafios para garantia do acesso ao diagnóstico e tratamento. O objetivo do estudo é analisar as políticas de oncologia e de saúde bucal em vigor, no que se refere ao processo de implantação dos componentes assistenciais relacionados ao câncer bucal. Foram analisadas dez normativas que estruturam essas políticas, sob a ótica da Teoria da Estruturação, além de dados de oferta de serviços entre 2002 e 2017. Nas atenções básica e secundária, destacou-se a baixa cobertura assistencial e a distribuição regional inadequada, apesar do aumento do financiamento e do número de serviços. Na atenção terciária foi identificada a distribuição desigual da realização de cirurgias. Por sua vez, a limitação de serviços da atenção domiciliar tem dificultado o acesso dos usuários aos cuidados paliativos. Houve convergência entre as políticas analisadas e uma preocupação com a regulação dos recursos autoritativos e com o aumento de recursos alocativos, o que estimulou a expansão dos serviços. Deve-se investir na ampliação, regionalização e universalização dos serviços. Um possível retrocesso nessas políticas poderá agravar a situação e contribuir para o aumento das desigualdades em saúde.

Abstract Challenges remain to ensure access to diagnosis and treatment ten years into continuous cancer prevention, control, and oral health policies. This study aims to analyze the oncology and oral health policies in force regarding the process of implanting oral cancer-related care components. Ten policies were analyzed under the lenses of the Structuration Theory, besides data on the supply of services between 2002 and 2017. Low coverage and inadequate regional distribution were highlighted in primary and secondary health care levels, despite increased funding and number of services. Unequal distribution of performed surgeries was identified in tertiary care. The limitation of home care services has hindered users' access to palliative care. A convergence was identified between the analyzed policies and concern with the regulation of authoritative resources and the increase of allocative resources, which stirred the expansion of services. Investments should be made in the expansion, regionalization, and universalization of services. A possible setback in these policies could aggravate the situation and contribute to the increase in health inequalities.

Análisis de los Resultados nacionales obtenidos por grupos estatales de investigación del el cáncer ruso. Programa de Cribado de Enfermedades de la Mucosa Oral y Borde Bermellón / Analysis of The Results Obtained by National Research Groups with The Russian State Cancer Program for The Screening of Diseases of The Oral Mucosa and The Vermillion Border

This article analyzes the results obtained by national research groups in the implementation of the Russian State Cancer Program. From 2015 to the first half of 2019, specialists studied the epidemiology and structure of oncological and precancerous diseases of the oral mucosa and the vermillion border in 486,059 persons aged 18-92 years living in Tula, the Tula region, Moscow and Noyabrsk as a result of screening and medical aid appealability. In this period, the productivity of the research group from Tula grew by the factor of 18.92. The results of the research confirm low cancer alertness of practicing dentists. An individual patient registration card has been developed to systematize data and create a diagnostic register for the screening of cancer and precancerous diseases of the oral mucosa and the vermillion border.

Conocimientos sobre cáncer bucal en pacientes odontológicos de la Universidad Nacional Mayor de San Marcos / Knowledge about oral cancer among dental patients from the National University of San Marcos

RESUMEN Introducción: El cáncer bucal es un problema de salud pública mundial, el cual constituye la sexta causa más común de muerte relacionada con el cáncer. El conocimiento y concientización de la población sobre esta enfermedad es importante para reducir su alta tasa de mortalidad. Objetivo: Determinar el nivel de conocimiento sobre cáncer bucal en pacientes adultos que acudieron a la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos el año 2017. Métodos: Estudio observacional, descriptivo y transversal. La población estuvo compuesta por los pacientes que acudieron a la clínica de la Facultad de Odontología. La muestra fue de 223 pacientes y se obtuvo por un muestreo probabilístico aleatorio sistemático. El instrumento de evaluación fue una encuesta de 11 preguntas cerradas divididas en 5 dominios: conocimientos generales, factores de riesgo, signos y síntomas, repercusiones y prevención del cáncer bucal. El rango de calificación fue bajo, regular, alto. Resultados: El 56,5 por ciento (n= 126) de pacientes presentó un nivel de conocimiento bajo, 40,4 por ciento (n= 90) un nivel regular y 3,1 por ciento (n= 7) un nivel alto. El nivel de respuesta promedio fue 12,14 ± 2,90 (IC95 por ciento [10,17-14,89]). El sexo y la edad no tuvieron relación significativa con el nivel de conocimiento (p= 0,45 y p= 0,52, respectivamente); sin embargo, el nivel de educación sí tuvo relación significativa (p= 0,009). Conclusiones: En la población estudiada, el nivel de conocimiento sobre cáncer bucal es predominantemente bajo. El sexo y la edad no tienen influencia sobre el nivel de conocimiento de cáncer bucal, pero sí el nivel de educación(AU)

ABSTRACT Introduction: Oral cancer is a world health problem. It constitutes the sixth leading cause of cancer-related death. Knowledge about and awareness of this disease among the population is important to reduce its high mortality rate. Objective: Determine the level of knowledge about oral cancer among adult patients attending the Dental School at the National University of San Marcos in the year 2017. Methods: A cross-sectional observational descriptive study was conducted. The study population was the patients attending the Dental School clinic. The sample was 223 patients selected by systematic probabilistic random sampling. The evaluation tool was a survey containing 11 closed-ended questions divided into five domains: general knowledge, risk factors, signs and symptoms, repercussions and prevention of oral cancer. The grading scale was low, fair or high. Results: Of the patients surveyed, 56.5 percent (n= 126) had a low knowledge level, 40.4 percent (n= 90) a fair level and 3.1 percent (n= 7) a high level. Average answer level was 12.14 ± 2.90 (CI 95 percent [10.17-14.89]). Sex and age did not have a significant relationship to knowledge level (p= 0.45 and p= 0.52, respectively). However, educational level did have a significant relationship (p= 0.009). Conclusions: In the study population the level of knowledge about oral cancer is predominantly low. Sex and age do not have an influence on the level of knowledge about oral cancer, but educational level does(AU)

Conocimientos, Actitudes y prácticas de prevención de riesgo del cáncer bucal en población mayor de 15 años. Panamá. / [Knowledge, attitudes and practices of prevention of oral cancer risk in popul oral cancer risk in population over 15 years old. Panama.

Introducción: El Cáncer Bucal es una enfermedad de importancia en Salud Pública. En Panamá, se desconoce la incidencia y prevalencia de la enfermedad y no se dispone de información por tipo de patología, lesión, localización, ni estudios de conocimientos, ac­ titudes y prácticas, relacionados a los factores de riesgo. Objetivo General: analizar los conocimientos, actitudes y prácticas de prevención de Cáncer Bucal en la población mayor de 15 años. Materiales y Método: estudio descriptivo transversal, realizado en las Regiones Sanitarias de San Miguelito, Metropolitana y Panamá Oeste. Se realizó un muestreo por conveniencia en 42 instalaciones de salud del primer nivel de atención, a la población que acudió al servicio odontológico durante cuatro meses. Se aplicó una encuesta de Conocimiento, Actitudes y Prácticas de prevención de factores de riesgo al cáncer bucal, considerando variables de estilo de vida. Para el análisis estadístico, se utilizaron los programas Epi Info versión 7.2 y XLSTAT 2019 y presentados los datos en medidas paramétricas y no paramétricas. Resultados: se encuestó un total de 3,832 personas mayores de 15 años. La mayor proporción fueron mujeres en edades de 25 y 34 años. En relación al conocimiento, el 81% desconoce los factores de riesgo de cáncer bucal y según la actitud, el 63% no asiste al control odontológico periódicamente. Las prácticas reflejaron hábitos relaciona­ dos al consumo de tabaco y alcohol. Conclusión: La población mayor de 15 años del estudio, desconoce los factores de riesgo del cáncer bucal y manifiesta limitada actitud de práctica preventiva.

Introduction: Oral Cancer is an importance disease in Public Health. In Panama, the in­ cidence and prevalence of the disease is unknown and there is no information available by type of pathology, injury, location, or studies of knowledge, attitudes and practices re­ lated to risk factors. General Objective: to analyze the knowledge, attitudes and practi­ ces of prevention of Oral Cancer in the population over 15 years old. Materials and Methods: cross­sectional descriptive study, carried out in San Miguelito, Metropolitan and Panamá Oeste Health Regions. Sampling was carried out for convenience in 42 health facilities of the first level of health care, to the population that attended the dental service during four months. A survey of Knowledge, Attitudes and Practices of preven­ tion of risk factors to oral cancer was applied, considering Lifestyle variables. For the statistical analysis, the Epi Info version 7.2 and XLSTAT 2019 programs were used and the data presented in parametric and non­parametric measurements. Results: a total of 3,832 people over 15 years of age were surveyed. The highest propor­ tions were women between the ages of 25 and 34. In relation to knowledge, 81% do not know the risk factors for oral cancer and according to the attitude, 63%, do not attend pe­ riodically to a dental control. The practices reflected habits related to consumption of to­ bacco and alcohol. Conclusion: The population over 15 years old of the study ignores the risk factors of oral cancer and manifests a limited attitude of preventive practice.

Oral carcinoma development after 23 years of renal transplantation

Renal transplant patients are treated with immunosuppressive drugs that decrease the effectiveness of the immune system, making them more prone to developing cancer. Skin and lip carcinomas are common malignancies encountered after transplantation, whereas oral carcinomas are rare. We report the case of a 51-year-old female Caucasian patient, with no history of smoking, who presented white lesions on the tongue and an ulcerated lesion on the lower lip beginning 4 months prior. Diagnosis of squamous cell carcinoma for both lesions was made following incisional biopsies. Interestingly, the patient reported a renal transplantation 23 years prior, and was maintained on a combination of cyclosporine, mycophenolate sodium and prednisone. The patient also presented a history of several basal and squamous cell carcinomas on sun-exposed areas of the skin. Both lesions were surgically excised. No sign of recurrence or new lesions in the oral cavity have been observed; however, new skin lesions are frequently diagnosed. This case report highlights that oral cancers may occur in transplant patients in the absence of classical risk factors. Thus, clinicians must be aware of the importance of thorough oral examination in transplant patients in routine follow-up.

Informe de campaña "Lucha contra el cáncer bucal": Diciembre 2018. CABA / Campaign report "Fight against oral cancer": December 2018. CABA

Desde la Subgerencia Operativa Red de Odontología en Hospitales, dependiente de la Dirección General de Hospitales del Ministerio de Salud del GCABA, conjuntamente con la Dirección Nacional de Salud Bucodental de la Secretaria de Salud de la Nación, y la Facultad de Odontología de la UBA, se realizaron diversas actividades de Promoción y Prevención del Cáncer Bucal promoviendo el diagnóstico precoz, las medidas de prevención y de control de esta patología. Se informa sobre los resultados de población encuestada, factores de riesgo y género, uso de protección solar, y consumo de bebidas.

Câncer de boca em pacientes com tratamento oncológico no Sistema Único de Saúde (SUS), Brasil: análise de sobrevida (2005 - 2009) / Oral cancer in patients with cancer treatment in the Unified Health System (SUS), Brazil: survival analysis (2005 - 2009)

Introdução: O controle do câncer é um dos grandes desafios da saúde pública. O câncer de boca é considerado de alta incidência no mundo, apresentando altas taxas de morbidade e baixas taxas de sobrevida em 5 anos. O câncer de boca é definido como doença multifatorial, resultante da interação dos fatores etiológicos que afetam os processos de controle e reparação celular, como tabaco e álcool. O câncer de boca, conforme sua localização, é assintomático nos seus estágios iniciais, e sua detecção poderá ocorrer quando já em estágios avançados. O diagnóstico precoce reduz as complicações decorrentes do tratamento, e pode evitar sequelas estéticas e funcionais, além de aumentar a sobrevida e cura do paciente. Objetivo: Analisar a sobrevida de pacientes com câncer de boca, que iniciaram tratamento no SUS, no período de 2005-2009. Metodologia: Estudo observacional analítico de coorte retrospectivo utilizando a Base Nacional em Oncologia, desenvolvida por meio de pareamento determinístico-probabilístico dos sistemas de informação de saúde: ambulatorial (SIA), hospitalar (SIH) e de mortalidade (SIM). As probabilidades de sobrevida global foram estimadas pelo tempo decorrido entre a data do primeiro tratamento, entre 2005 e 2009, até o óbito dos pacientes ou 5 anos de acompanhamento. Utilizou-se o método de Kaplan-Meier para estimar a sobrevida e o teste de Log-rank. A análise dos fatores associados à sobrevida foi realizada via modelo estendido de Cox. Resultados: Dos 12.606 pacientes estudados, 79,5% apresentavam-se no estádio III e IV e 77% eram do sexo masculino. A sobrevida global em cinco anos foi estimada em 34,1% (IC95% 33,3­34,9) e os seguintes fatores foram associados à menor sobrevida: estádio III (1,75; IC95% 1,20-2,56), estádio IV (1,91; IC95% 1,69-2,16) aos 12 meses; apresentar comorbidade durante o tratamento (5,21; IC95% 2,87-9,40) no 1º mês, apresentar internações durante o tratamento (HR=1,24; IC95% 1,06 -1,46). Pacientes que a modalidade de tratamento realizou cirurgia apresentaram menor risco ao óbito (0,04; IC95% 0,03-0,05), assim como a combinação de radioterapia e quimioterapia (0,22; IC95% 0,18-0,27) e radioterapia exclusiva (0,83; IC95% 0,69-0,99) quando comparados aos pacientes com tratamento quimioterápico exclusivo no 1º mês de acompanhamento. Conclusão: O diagnóstico tardio da neoplasia, apresentar comorbidade e pacientes que foram internados e receberam apenas quimioterapia como tratamento oncológico foram os fatores relacionados à pior sobrevida dos pacientes com câncer de boca.

Introduction: Cancer control is a major public health challenge. Oral cancer is defined as being a multifactorial disease resulting from the interaction of etiological factors, such as smoking and alcohol consumption, which affect cell control and repair processes. It has a high incidence in the world, a high morbidity rate and a low five-year period survival rate. Depending on its location, oral cancer is asymptomatic in its early stages, which may result in the late detection of more advanced stages of the disease. Early diagnosis reduces complications arising from treatment, and thus prevents aesthetic and functional sequels, in addition to contributing to increased patient survival and chance of healing. Objective: To analyze survival rate in oral cancer patients who underwent treatment under the Brazilian Unified Health System (SUS) in the 2005-2009 period. Methodology: Retrospective cohort analytical observational study using the National Oncology Database by deterministic-probabilistic matching of health information system outpatient (SIS), hospital (SIH) and mortality (SIM) data. Overall survival probabilities were estimated by the time elapsed between the date of the first treatment from 2005 to 2009 up to patients' death or five-year follow-up. The Kaplan-Meier method and the log-rank test were used to estimate survival rate. Survival factors were analyzed using the extended Cox model. Results: Of the 12,606 patients studied, 79.5% were in stages III and IV and 77% were male. The overall survival probability was estimated to be 34.1% (95% CI 33.3-34.9) and the main events were attributed to the lowest survival probability: stage III (1.75, 95% CI, 1.20 -2.54), stage IV (1.91, 95% CI, 1.69-2.16) at 12 months; comorbidity occurring during treatment (5.2; 95% CI 2.87-9.40) in the first month, hospitalization during treatment (HR = 1.24; 95% CI 1.01-1.38), surgical treatment of patients with a lower risk of death (0.04; 95% CI 0,03-0.05), combined radiotherapy and chemotherapy treatment (0.22; 95% CI 0.18-0.27) and exclusive radiotherapy (0.83; 95% CI 0.69-0.99) when compared to patients with exclusive chemotherapy in the first month of follow-up. Conclusion: Late diagnosis of neoplasia with associated comorbidity, patient hospitalization and exclusive oncochemotherapy were factors related to worse survival of oral cancer patients.

Tendencias de la mortalidad por cáncer oral y el efecto de las políticas públicas de prevención en América Latina / Trends in oral cancer mortality and the effect of preventive policies across Latin America

OBJETIVO: Describir las tendencias de la mortalidad por cáncer oral entre 2000 y 2017 por sexos en 20 países de América Latina, e identificar los efectos de las políticas implementadas para controlar de los factores de riesgo. MATERIALES Y MÉTODOS: Se realizó un estudio ecólogico que evaluó la relación entre las tasas estandarizadas por edad de mortalidad por cáncer oral según el sexo, la prevalencia de tabaquismo y consumo de alcohol y la implementación de las políticas públicas de control. RESULTADOS: Los hombres de Cuba y Brasil muestran las más altas tasas de mortalidad en la región. Los descensos más importantes se presentan en los hombres de Brasil y en las mujeres de Panamá. Son pocas las tendencias al aumento, aunque éstas se evidencian especialmente entre las mujeres. La implementación de las medidas de control de factores de riesgo, en cuanto a tabaco, alcohol, infecciones virales, programas de detección temprana y tratamiento, muestra avances desiguales entre los países. Se observó una mayor relación entre la mortalidad por cáncer oral con el consumo de tabaco en los contextos de menor implementación de las políticas, y el consumo de alcohol en los escenarios de mayor avance. CONCLUSIÓN: La mortalidad por cáncer oral afecta especialmente a los hombres de la región, lo que se puede asociar a la distribución de los factores etiológicos y avances desiguales de los países en la implementación de las medidas preventivas. Se requiere profundizar en investigación subnacional de seguimiento, y fortalecer la prevención y tratamiento con estrategias validas para cada contexto.

OBJECTIVE: To describe the trends in oral cancer mortality between 2000 and 2017 by sex in 20 countries in Latin America, and identify the effects of the policies that were implemented to control associated risk factors. MATERIALS AND METHODS: An ecological study was conducted to evaluate the relationship between age-standardized rates of oral cancer mortality by sex, the prevalence of smoking and alcohol consumption, and the implementation of public control policies. RESULTS: Men in Cuba and Brazil show the highest mortality rates in the region. The most important decreases occurred among Brazilian men and Panamanian women. There are only a few cases of increasing trends, although these are especially evident among women. The implementation of risk factor control measures, in terms of tobacco, alcohol, viral infections, early detection programs and treatment, have progressed unevenly in different countries. A strong relationship was observed between oral cancer mortality and tobacco consumption in countries with limited policy implementation; and with alcohol consumption in countries with advanced implementation. CONCLUSION: Oral cancer mortality especially affects men in the region, which can be associated with the distribution of etiological factors and unequal advances in countries in the implementation of preventive measures. It is necessary to further develop subnational follow-up research and strengthen prevention and treatment measures with valid strategies, adapted for each context.

Prevention and control of neoplasms associated with HPV in high-risk groups in Mexico City: The Condesa Study / Prevención y control de neoplasias asociadas a VPH en grupos de alto riesgo de la Ciudad de México: el Estudio Condesa

Abstract: Objective: To evaluate the effectiveness of a combined strategy of human papillomavirus virus (HPV) vaccination and high-risk HPV screening to reduce the occurrence of anogenital and oropharyngeal neoplasms among men who have sex with men, people with HIV, homeless people, transgender women, female sex workers and rape victims. Materials and methods: This mixed methods study evaluates the effectiveness of a combined vaccination-screening strategy to reduce HPV prevalence/incidence and occurrence of cervical intraepithelial neoplasms grade 2+ and/or anal intraepithelial neoplasms grade 2+, using Kaplan-Meier. The time-to-event method will evaluate time from positive results for specific anogenital HPV to incidence of anogenital lesions containing that HPV type. Results: People vaccinated against HPV and screened for HPV as a primary test will have lower prevalence and incidence of HPV infection and consequently lower frequency of HPV-related anogenital and oropharyngeal lesions. Conclusions: This study will generate scientific evidence on effectiveness of a combined vaccination-screening strategy to reduce the burden of HPV-associated neoplasms.

Resumen: Objetivo: Evaluar la efectividad de una estrategia combinada de vacunación contra el virus de papiloma humano (VPH) y tamizaje de VPH de alto riesgo para reducir neoplasias anogenitales y orofaringeas entre hombres que tienen sexo con hombres, personas con VIH, personas en situación de calle, mujeres transgénero, trabajadoras sexuales y víctimas de violación. Material y métodos: Este estudio evaluará la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la ocurrencia de neoplasias intraepiteliales cervicales grado 2+ o neoplasias intraepiteliales anales grado NIA2+ utilizando Kaplan-Meier. Se evaluará tiempo de resultados positivos para tipos específicos de VPH anogenital a incidencia de lesiones anogenitales con ese tipo de VPH. Resultados: Las personas vacunadas contra VPH y con tamizaje de VPH tendrán menor prevalencia e incidencia de infecciones por VPH y por ende menor frecuencia de lesiones anogenitales y orofaringeas relacionadas con VPH. Conclusiones: Este estudio generará evidencia científica sobre la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la carga de neoplasias asociadas al VPH.

Grado de conocimiento de la población acerca del cáncer bucal y su prevención / Degree of knowledge of the population about oral cancer and its prevention

El propósito de este estudio fue determinar el grado de conocimiento que poseen las personas que concurren a una campaña de prevención de Cáncer bucal, en relación a: mucosas orales sanas, lesiones cancerizables y factores de riesgo que pueden desencadenar este tipo de patologías, como así también identificar prácticas de auto-cuidado que realizan para prevenirlas. La muestra estuvo compuesta por 80 personas encuestadas en la capital de la provincia de Córdoba, Argentina, en una zona de residencia de universitarios, en diciembre del 2014, en el marco de la campaña de prevención del cáncer de boca. Se aplicó una encuesta modificada de JC Quintana Díaz y col. Los resultados más relevantes obtenidos fueron: respecto del conocimiento de la existencia del cáncer bucal, un 63,8% conocía de su presencia y se obtuvieron similares porcentajes referentes a anormalidades en las mucosas, tales como tener "fuegos" o llagas en la boca o lesiones de abultamientos, siendo la mayor lesión anormal reconocida el hecho de tener manchas en la boca (90%). El conocimiento sobre los factores de riesgo en general fue insuficiente. Los factores más registrados como promotores del cáncer bucal fueron: el cigarrillo 88,80%, la exposición solar 56%, y el alcohol 47%, habiendo encontrado un gran desconocimiento de factores como el virus del VPH 70%. El 56% de los entrevistados presentó alguna vez una lesión bucal, el 46% se examinaba entre una y dos veces al año y el 17% se examinaba tres o más veces al año. Entendiéndose por examinarse a mirarse el interior de la boca frente a un espejo con luz artificial. De los resultados obtenidos concluimos que, aun teniendo en cuenta el nivel de escolaridad alto de la muestra, el grado de conocimiento de la población sobre factores de riesgo en relación al cáncer oral es insuficiente (AU)

The purpose of this study was to determine the degree of knowledge possessed by people who attend a prevention campaign for oral cancer, in relation to; healthy oral mucous membranes, cancerous lesions and risk factors that can trigger this type of pathologies, as well as identify self-care practices that are carried out to prevent them. The sample consisted of 80 people surveyed in the capital of the province of Córdoba Argentina, in an area of residence of university students, in December 2014 as part of the mouth cancer prevention campaign. A modified survey was applied by JC Quintana Díaz et al. The most relevant results, obtained, were; Regarding the knowledge of the existence of oral cancer, 63.8% were aware of its presence and similar percentages were obtained regarding mucosal abnormalities such as having "fires" or sores in the mouth or bulging lesions, the largest lesion being Abnormal recognized the fact of having spots in the mouth (90%). The knowledge about the risk factors in general was insufficient. The most registered factors as promoters of oral cancer were the 88.80% cigarette, 56% solar exposure and 47% alcohol, having found a great ignorance of factors such as the HPV virus 70%. 56% of those interviewed had a buccal lesion at some time, 46% were examined once or twice a year and 17% were examined three or more times a year. Understanding by examining yourself to look inside the mouth in front of a mirror with artificial light. From the results obtained we conclude that; even taking into account the high level of schooling of the sample, the degree of knowledge of the population about risk factors in relation to oral cancer is insufficient (AU)

Informe de campaña: Lucha contra el cáncer bucal: Diciembre 2017 / Campaign report: Fight against oral cancer: December 2017

El lunes 5 de diciembre se celebra el "Día Nacional de Lucha Contra el Cáncer Bucal", declarado por decreto Nº 955/16 del Poder Ejecutivo Nacional. La propuesta de implementar dicho evento, para la difusión de esta patología, resulta un hecho inédito a nivel Nacional y Provincial. Por tal motivo, desde la Subgerencia de Odontología en Hospitales, dependiente de la Dirección General de Hospitales del Ministerio de Salud CABA, conjuntamente con la Dirección Nacional de Salud Bucodental del Ministerio de Salud de la Nación, se realizaron diversas actividades de Promoción y Prevención del Cáncer Bucal promoviendo el diagnóstico precoz, las medidas de prevención y de control de esta patología. Se describen los recursos humanos y físicos utilizados en la campaña, y los resultados obtenidos

Mortality for oral Cancer in Minas Gerais, Brazil, from 1996 to 2012 / Mortalidade por Câncer de boca em Minas Gerais, Brazil, de 1996 a 2012 / La mortalidad en Cáncer de boca en Minas Gerais, Brasil, 1996 a 2012

Aim: To investigate the spatial-temporal distribution of mortality from oral cancer in Minas Gerais between 1996 and 2012. Methods: The analysis of the growth trend rates of the series was made by Moving Average. Results: In the period there were 8.675 deaths from mouth cancer and these were identified in all the regions of the state. Being, 6,974 (80,4%) men and 1,701 (19,6%) women. Regarding the crude rate, we observed a tendency of growing of mortality from this cancer type. This phenomenon was also observed when executed the weighting by sex, especially for males and over 60 years old. Was rejected the null hypothesis of stationary of mortality series for oral cancer in Minas Gerais during the period. Conclusion: Moving Average weighted by age and gender allowed to observe an increase in the mortality rate in all age groups and for both sexes especially men and older than 60 years.

Objetivo: Investigar a distribuição espaço-temporal da taxa de mortalidade por câncer de boca do estado de Minas Gerais entre 1996 e 2012. Métodos: A Média Móvel foi utilizada para analisar a tendência de crescimento da taxa. Resultados: No período estudado ocorreram 8.675 óbitos por câncer de boca e estes foram identificados em todas as microrregiões do estado. Sendo, 6.974 (80,4%) homens e 1.701(19,6%) mulheres. Houve tendência de crescimento da taxa bruta de mortalidade por este tipo de câncer. Este fenômeno também foi observado quando executado a ponderação por sexo, principalmente para o sexo masculino e indivíduos acima dos 60 anos. Foi rejeitada hipótese de nulidade de estacionariedade da mortalidade por câncer de boca em Minas Gerais no período estudado com elevação da taxa de 2,22 em 1996 para 3,87 em 2012. Conclusão: Observou-se o crescimento da taxa nas faixas etárias estudadas, em homens e acima de 60 anos.

Objetivo: Investigar la distribución espacial y temporal de la mortalidad por cáncer oral en el estado de Minas Gerais entre 1996 y 2012. Métodos: El promedio móvil se utilizó para analizar la tendencia de la tasa de crecimiento. Resultados: En el período hubo 8.675 muertes por cáncer de boca y éstos fueron identificados en todas las regiones del estado. Y, 6.974 (80,6%) eran hombres y 1.701 (19,6%) mujeres. Con respecto a la tasa bruta, se observa una tendencia creciente en la mortalidad por este tipo de cáncer y cuando se ejecuta la ponderación por sexo, especialmente para los varones y más de 60. Rechazó la hipótesis nula de estacionariedad de la mortalidad por cáncer oral en Minas Gerais durante el período. Conclusión: Promedio ponderado por edad y sexo Mobile ha observado tasa de crecimiento en los grupos de edad y en los hombres y por encima de 60 años.