Influence of Educational Level, Stage, and Histological Type on Survival of Oral Cancer in a Brazilian Population

Abstract

The mortality rate associated with oral cancer is estimated at approximately 12,300 deaths per year, and the survival rate is only 40% to 50% for diagnosed patients and is closely related to the duration of time between disease perception and its diagnosis and treatment. Socioeconomic risk factors are determinants of the incidence and mortality related to oral cancer. We conducted a retrospective, cross-sectional study of 573 records of patients with oral cancer at Haroldo Juaçaba Hospital – Cancer Institute of Ceará from 2000 to 2009 to evaluate the influence of socioeconomic factors on survival and epidemiological behavior of this neoplasia in a Brazilian population. In this study, patients with oral cancer were males greater than 60 years of age, presented squamous cell carcinoma in the floor of mouth and were characterized by low education levels. A total of 573 lesions were found in oral cavities. Cox proportional hazards regression model showed that the histological type, tumor stage, and low degree of education significantly influenced survival. A lower patient survival rate was correlated with a more advanced stage of disease and a worse prognosis. Squamous cell carcinoma is associated with a higher mortality when compared with other histological types of malign neoplasia.

Role of Inflammatory Markers in Prognosis of Oral Squamous Cell Carcinoma

“…It was also observed, similar to the present study, that patients with low education and high immunoexpression for TNF-α showed a worse survival rate, in addition to greater staging and use of surgery associated with radiotherapy and chemotherapy as a treatment of choice (Krishnan et al, 2014). In previous studies, patients with stage III and IV tumours expressed more TNF-α; in the researchers' country, patients with advanced disease stage are patients with a low level of education (Ferreira et al, 2012;Dantas et al, 2016).…”

“…This tumour growth results in a greater tumour staging that is linked to worse prognosis and higher mortality (Iamaroon et al, 2004). A previous study conducted by this group of researchers (Dantas et al, 2016) also observed that schooling directly influences patient survival. Oral cancer is related to low education, which may be partly due to poor access to disease information in general, including the diagnosis and treatment of oral cancer (Atununes et al, 2001).…”

Smoking History Decreases Survival in Patients with Squamous Cell Carcinoma of the Mouth: A Retrospective Study with 15 Years of Follow-up

“…Although smoking generates a risk factor for oral SCC that is purely biological, it is known that the risk of developing oral cancer is increased in individuals with low education levels, low occupational classes and low incomes (Conway et al, 2008). Oral SCC is a type of cancer that has a relationship with social status, showing a worse prognosis in patients with lower socioeconomic status (Dantas et al, 2016).…”

“…Survival was calculated as the time from the treatment start date (day, month and year) to the date of death (day, month and year) in number of weeks for statistical analysis (Dantas et al, 2016).…”

Histórico de Consumo de Álcool como Fator Preditivo de Sobrevida em Pacientes com Carcinoma de Células Escamosas de Boca e Orofaringe: Follow-up de 15 Anos

“…A sobrevida foi obtida por meio da diferença entre a data do início do tratamento (dia, mês e ano) e a data do óbito (dia, mês e ano) utilizando para fins de análise estatística a quantidade de semanas entre essas datas 9 .…”