Análise da distribuição espacial da casuística de câncer oral no Sul de Minas Gerais

Abstract

The strong influence of socioeconomic aspects on oral cancer (OC) etiology is evidenced by the elevated frequency of advanced stages diagnoses in developing countries. However, studies on the impacts of pesticide exposure or on the influence of socioeconomic aspects on oral cancer incidence in Brazil are rare. Brazil is a country of large dimensions and its multiple geographic regions present different demographic, economic, cultural and health care conditions. Furthermore, its internal social inequality might perform an important role in oral carcinogenesis. Thus, this essay aims to analyze the spatial distribution of OC casuistry in south of Minas Gerais exploring its probable connection with the percentage of establishments that have admitted to use pesticides; with per capita income index; with the percentage of illiteracy and people over 15 years old that have completed middle school; with the life expectancy index and the percentage of people over 60 years old, according to the county where the patients live. In order to do so, this study performed a retrospective analysis of patients’ charts diagnosed with oral cancer from 2003 to 2013 seen at Hospital Bom Pastor, which is located in the city of Varginha in the state of Minas Gerais. The outcomes revealed that among the 286 participant patients included in this study there was a notable predominance of men, smokers, skin discoloration carriers and individuals around seventy years old. There was an increase of oral cancer incidence in the analyzed time, with the tongue and mouth floor being the most frequent locations. A predominance of patients with lesions in advanced stage (III and IV) was discovered. However, the anatomopathological records of compromised margins, vascular and perineural invasion or lymph node metastasis were absent in a significant number of charts. The analysis of the spatial distribution showed that the counties of Pouso Alegre (n=24), Varginha (n=22), Lavras (n=22) and Itajubá (n=18) presented the greatest concentration of oral cancer carriers. The counties in which oral cancer patients lived revealed high percentage of establishments that have admitted to use pesticides – except Itajubá. Pouso Alegre, Varginha, Lavras and Itajubá are exceptions among the 74 counties analyzed because they revealed elevated per capita income index and low percentage of illiterate people and individuals that have not concluded middle school. The other counties in which most of oral cancer patients lived showed high life expectancy index and low proportion of elderly people (over 60 years old) and individuals that have not concluded middle school. This outcome highlights the urgent need to educate and elaborate a georeferenced plan of health resources distribution as a preventive measure for the increase of the referred disease with the aging of this region population.