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ANALYSIS OF THE PROFILE OF PATIENTS WITH ORAL CAVITY
NEOPLASIA
Lara Isabella Souza Santos1
Geiza de Oliveira Alves2
Lorena de Souza Ferreira3
Cynthia Palmeira Eleutério4
Alex do Nascimento Chaves Lima5
Graziela Dias6
Juliana Alves Soares7
Cândida Ferreira de Carvalho Alves8
Dayara de Souza Ramos9
Lucas de Andrade Huber10
Ana Rúbia Rockenbach11
José Elson Amaral dos Santos12
Diego Barbosa Rocha13
Wesley Silva Teixeira14
1 Universidade Estadual de Montes Claros
2 Faculdade Anhanguera
3 Universidade Estadual de Montes Claros
4 Universidade Estadual de Montes Claros
5 Faculdade Anhanguera
6 Faculdade Anhanguera
7 Faculdade Anhanguera
8 Faculdade Anhanguera
9 Universidade Estadual de Montes Claros
10 Universidade Estadual de Montes Claros
11 Universidade Estadual de Montes Claros
12 Faculdade de Saúde e Humanidades Ibituruna
13 Faculdades Unidas do Norte de Minas Gerais
14 Universidade Estadual de Montes Claros
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Lucas Gabriel Pimenta Resende15
Maria Eduarda Silva Rodrigues16
Abstract: Objective: To describe the prole of patients with oral cavity cancer from 2015 to 2019 in
Montes Claros, Minas Gerais State, Brazil. Methods: this is a descriptive study with a quantitative
approach using data from patients living in Montes Claros, Minas Gerais, Brazil, diagnosed with
oral cavity neoplasia in the hospital records of the José Alencar Gomes da Silva National Cancer
Institute (INCA). Results and discussion: In the historical series analyzed, 312 cases of oral cavity
neoplasia were identied among patients living in the analyzed region. Conclusion: the patients who
were diagnosed with oral cavity cancer were mostly men aged between 50 and 69 years, and the
association between the concomitant use of tobacco and alcoholic beverages was present in the vast
majority of cases. Eorts are needed by health professionals and managers for early diagnosis through
educational and primary prevention actions.
Keywords: Cancer. Oral neoplasms. Prevention.
15 Universidade Estadual de Montes Claros
16 Universidade Estadual de Montes Claros
INTRODUCTION
Oral cavity cancer is considered an important public health problem, with more than 24
million new cases of the disease estimated in the world in 20301. In the world ranking, Brazil has the
eighth highest incidence of this neoplasm1, with 15,210 new cases of the disease expected for each
year of the 2020-2022 triennium, representing an estimated risk of 10.70 and 3.71 new cases per 100
thousand inhabitants, respectively, for Brazilian men and women (INCA, 2019).
Although the disease is more frequent in individuals from the fourth decade of life, it tends to
increase its incidence in young adults (Hussein AA et al, 2017). The most common histological type
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– squamous cell carcinoma (SCC) – is of multifactorial etiology, and is frequently related, to varying
degrees, to tobacco and alcohol consumption, exposure to biological agents, especially the human
papillomavirus (HPV), associated or not with genetic susceptibility, in cases of oral cavity cancer in
young adults (Vargas LS et al, 2017).
Based on the nding that oral cancer is a public health problem, it is important to know its
magnitude in Brazil, with regard to the geographic distribution with stratication by age and gender,
as a basis to support its control. The dissemination of statistical data is necessary both to know the
national picture and to encourage health professionals to work in the prevention and diagnosis of oral
cancer (Tavares C et al, 2016).
Taking into account the growth and aging of the population, as well as industrialization and
urbanization, aggravated by inadequate coverage of health services, it is evident that there is a need
to change the strategy for controlling non-communicable diseases, combining preventive actions to
promote and protect health and diagnostic measures, especially those of early diagnosis and therapy
(D’Cruz et al, 2018). Thus, the present study sought to describe the prole of patients with oral cavity
cancer from 2015 to 2019 in Montes Claros, Minas Gerais State, Brazil.
MATERIALS AND METHODS
A descriptive study with a quantitative approach was conducted. Clinical data of patients
diagnosed with oral cavity cancer in the hospital records database of the José Alencar Gomes da Silva
National Cancer Institute (INCA) were analyzed.
Hospital Cancer Registries (HCR) gather information on patients treated at the hospital
where they received diagnosis and/or treatment for cancer; they serve as a subsidy for reection on the
performance of the clinical team; assist in administrative planning; in addition to serving as a mirror
of the patient’s condition, the measures taken and his survival. With legal support, the implementation
and maintenance of a HCR are used as a criterion for the accreditation of a hospital in the Brazilian
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Oncology Care Network, so that all Brazilian states have at least one hospital qualied in oncology
(INCA, 2012).
The study was carried out during the months of January and February 2024. It should be
noted that the data for the years 2015 to 2019 were evaluated because they are the most current
available in the INCA secondary database.
The eligibility criteria were available in the database, and incomplete records were excluded.
A data collection instrument developed by the authors was used with the following variables: year,
use of tobacco or tobacco products, family history, alcoholism, sex, age, color, histological type, TNM
staging, and primary location.
Since the analyzed data are available in a public database, it was not necessary to request
authorization from a Research Ethics Committee, according to resolution number 466 of December
12, 20121 (Brasil, 2013).
FINDINGS
In the analysis from 2015 to 2019, 312 diagnoses of oral cavity cancer were recorded in
the municipality investigated. 17.2% of the individuals were female, while 82.8% were men, the
predominant age was between 50 and 69 years (55.6%), and the family history of cancer was negative
in 37.7% of the cases. 48.4% of the patients used tobacco and tobacco products, and the combined
use of tobacco and alcoholic beverages was present in 83.4 of the records. Regarding the clinical-
pathological variables, a signicant rate corresponded to squamous cell carcinoma (97.4%), with the
TNM staging classied as 4 A (46.4%) more frequently and with primary location in the tongue or
base of the tongue (51.7%) (Table 1).
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Table 1. Descriptive analysis of the sociodemographic and clinical characteristics of patients with oral
cavity cancer, Montes Claros, Minas Gerais, Brazil (n=312).
Legend: Cir: surgery, Qt: chemotherapy, Rxt: radiotherapy.
DISCUSSION
In this study, the prole of patients with oral cavity neoplasm was evaluated, in this sense,
a well-known pattern was identied in the literature regarding this type of cancer, thus, there was a
signicant association between age, alcohol and tobacco consumption, in addition to a well-dened
Var iable N% total
Gender
Male 258 82,8
Female 54 17,2
Age group
30-59 139 44,9
50-69 173 55,6
History of smoking
Former consumer 56 64,3
Never 26 29,8
Current 548,4
Family history of cancer
No 117 37,7
Yes 195 79,3
Combined use of tobacco and alcohol
Yes 260 83,4
No 52 16,6
Detailed primary location
Base of the tongue 161 51,7
Other 151 48,3
Histological type
Squamous cell carcinoma 303 97,4
Other 92,6
TNM Staging
A4 144 46,4
Other 168 53,6
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location at the base of the tongue.
The main sign of this type of cancer is the appearance of mouth ulcers that do not heal
within a week. Other signs are supercial ulcerations less than 2 cm in diameter and painless, which
may or may not bleed, and whitish or reddish spots and plaques on the lips or oral mucosa. Diculty
speaking, chewing, and swallowing, in addition to marked weight loss, pain, and the presence of
cervical lymph node enlargement are signs of advanced oral cancer (MS, 2024).
In 1976, Krolls, Homan16 published an analysis of 14,253 cases of squamous cell carcinomas,
nding 42% on the lips, 22% on the tongue, 17% on the oor of the mouth, 6% on the gums, 5% on the
palate and 2% on the jugal mucosa. As for gender, 93% correspond to males and only 7% to females.
Regarding race, 92.6% were Caucasian and 5.2% melanoderma. Regarding age, 86.8% of the cases
were between the fth and ninth decades of life.
Squamous cell carcinoma of the oral cavity is the result of the interrelationship of three
factors: the agent, the host, and the environment. Thus, a considerable number of factors related to the
human host and the environment in which it lives may be related to the predisposition to malignant
neoplasms (Garrafa, 1977). Two points should be emphasized in relation to risk factors: rst, the same
factor may be a risk factor for several diseases and second, that several risk factors may be involved in
the genesis of the same disease, constituting multiple causal agents. The study of risk factors, isolated
or combined, has allowed the establishment of cause-eect relationships between them and certain
types of cancer (MS, 2024).
Most cancer cases (80%) are related to the environment, in which we nd a large number
of risk factors. The environment is understood as the environment in general (water, land and air),
the occupational environment (chemical industries and the like), the consumption environment
(food, medicines), the social and cultural environment (lifestyle and lifestyle habits) (MS, 2024). For
Tommasi (1982), whatever the cause of cancer, especially in the mouth, it begins on previous lesions
caused by local causes associated with general causes. These lesions are considered cancerous.
The histopathological classication of oral cancer has been shown to be an important tool
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to try to explain the biological behavior of oral tumors. Thus, in 1941, Broders (1941) proposed a
histopathological grading of four grades, based on the degree of cell dierentiation of neoplastic cells,
with grade I up to 75% of dierentiated cells, grade II 75 to 50% of dierentiated cells, grade III of 50
to 25% of dierentiated cells, and grade IV of 25 to 0% of dierentiation. In 2005, based on Broders’
principles, the WHO proposed the classication most used today, consisting of three categories: poorly
dierentiated cells - predominance of immature cells, numerous typical and atypical mitoses, and
minimal keratinization; moderately dierentiated cells - a certain degree of nuclear pleomorphism
and mitotic activity and little keratinization; and well-dierentiated cells - tissue architecture similar
to the normal pattern of the squamous epithelium (Broders, 1941).
The most frequent malignant neoplasm of the oral cavity is squamous cell carcinoma, also
known as squamous cell carcinoma or squamous cell carcinoma, which is responsible for 90 to 95%
of oral cancer cases. Among the less frequent are: melanoma, lymphoma, and Kaposi’s sarcoma.
(Kaposi, 2020). Squamous cell carcinoma can develop anywhere in the mouth. The most common
sites are the tongue, lower lip, and oral oor, the latter two being related to a worse prognosis due to
the frequent presence of cervical metastases. Its incidence varies in dierent regions of Brazil and the
world, making it important to know its epidemiological and pathogenic prole in order to guide public
health actions in the prevention of this disease (Brener et al, 2007).
The problem involving oral cavity tumors is considered a public health problem in Brazil and
in several countries around the world, implying the recognition that early diagnosis and emergency care
represent a form of prevention and a means of increasing survival, where dentists play a fundamental
role, not only in making the diagnosis, but also in making the diagnosis. but also for the preservation
of cases. Thus, the primary intervention of physicians and dentists in prevention programs, including
educational lectures regarding risk factors and the importance of oral cavity self-examination with
the participation of the community and the media, is extremely important in the control of oral cancer
(Bercht, 1998).
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CONCLUSION
The clinical information included in the hospital records database of the José Alencar Gomes
da Silva National Cancer Institute (INCA) about patients diagnosed with oral cavity cancer living in
Montes Claros, Minas Gerais, indicate male individuals with a predominant age between 50 and 69
years and no positive family history of cancer.
The combined use of alcohol and tobacco was present to a large extent, the cancer clinic
was advanced in the degree of carcinogenesis. In this context, it is pointed out that eorts by health
professionals and managers are needed for early diagnosis through educational and primary prevention
actions.
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