Racial disparity and prognosis in patients with mouth and oropharynx cancer in Brazil

L. Ramos, Adriano Referino da Silva Sobrinho, L. Ribeiro, A. V. Martins-de-Barros, H. Mauricio, Stefânia Jerônimo Ferreira, M. V. Carvalho
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Abstract

Background Oral and oropharyngeal cancer (OPC) is an important cause of morbidity and mortality worldwide. Populations in situations of social vulnerability tend to have higher incidences of cancer, a higher proportion of late diagnosis, greater difficulties in accessing health services, and, consequently, worse prognosis. The aim of this study was to evaluate the relationship between race/skin color and OPC prognosis in Brazil. Material and Methods This is a cross-sectional epidemiological study using OPC data from the National Cancer Institute between the years 2000 and 2019. The selected variables were: gender, race/skin color, age, education, smoking and alcohol consumption, stage of the disease and disease status at the end of the 1st treatment. Results 154,214 cases were recorded. Black men, in the 6th decade of life, were the most affected population. Blacks had a lower level of education when compared to non-blacks (p<0.001). Blacks were more exposed to smoking and alcohol consumption (p<0.001). At the time of diagnosis, the black population was at the most advanced stage when compared to non-blacks (p<0.001). At the end of the 1st treatment, more black patients had disease in progression, as well as more black patients died (p<0.001). Conclusions Blacks had a worse prognosis for OPC in Brazil. Despite the limitations, these results are important to elucidate the scenario of health disparities in relation to the race/skin color of the Brazilian population. Key words:Head and neck, oncology, cancer, oral cavity, oropharynx.
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巴西口腔癌和口咽癌患者的种族差异和预后
口腔和口咽癌(OPC)是世界范围内发病率和死亡率的重要原因。处于社会弱势地位的人口往往有较高的癌症发病率,较晚诊断的比例较高,获得保健服务的困难较大,因此预后较差。本研究的目的是评估种族/肤色与巴西OPC预后之间的关系。这是一项横断面流行病学研究,使用了美国国家癌症研究所2000年至2019年的OPC数据。选择的变量包括:性别、种族/肤色、年龄、教育程度、吸烟和饮酒、疾病阶段和第一次治疗结束时的疾病状况。结果共记录病例154214例。60岁的黑人男性是受影响最大的人群。与非黑人相比,黑人的教育水平较低(p<0.001)。黑人更容易吸烟和饮酒(p<0.001)。在诊断时,与非黑人相比,黑人人群处于最晚期(p<0.001)。在第一次治疗结束时,更多的黑人患者出现疾病进展,更多的黑人患者死亡(p<0.001)。结论:巴西黑人OPC预后较差。尽管存在局限性,但这些结果对于阐明与巴西人口的种族/肤色有关的健康差异情况非常重要。关键词:头颈部,肿瘤,癌症,口腔,口咽。
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