Prevention and Early Detection of Oral Cancer: Screening in Risk Populations

Objective: To evaluate a viability of a program for prevention and early diagnosis of oral cancer directed to groups considered at risk for this disease, such as chronic smokers and alcoholics. Method: The program was conducted between June 2000 and July 2002 with patients of the University Hospital of the Medical School of the University of Sao Paulo (HCFMUSP) and communitarian support groups, structured in the form of periodic lectures, oral exam for those who had interest, and, if necessary, referral for complementary exams and treatment. Results: 509 people were examined, of which 215 (42.2%) were males and 59.7% were Whites with mean age of 49.8 years. From these, 131 presented a fundamental lesion in the mouth and were referred to School of Dentistry of the University of Sao Paulo (FOUSP) for a complimentary exam. From the 48 (38.7%) patients that attended the University outpatient service, 11 were subjected to biopsy. Results of the biopsies were hyperkeratosis in 3 cases, papillomatous hyperplasia in 2, fibrous hyperplasia in 3, mild dysplasia in 1, adenocarcinoma in 1 and epidermoid carcinoma in 1. Based on the results of exfoliative cytology, 5 patients had diagnosis of Papanicolau class I and 11 of Papanicolau class II. Conclusion: The large number of fundamental lesions diagnosed demonstrates that periodic oral exam of high-risk patients is of paramount importance. However, the method proposed in this study, involving the transport of specific teams for screening of patients, appeared to be too demanding and costly to be effectively incorporated in public health attention services. On the other hand, permanent attention services together with periodic informative campaigns to the population were considered the methods with better results for the early diagnosis of oral cancer.