Hello, my name is Marcia, and I’m from Rio de Janeiro, Brazil.
This study presents a randomized clinical trial on early detection of oral cancer in a public health system.
Oral cancer is a major public health problem in many low- and middle-income countries, including Brazil, where the number of cases has been increasing, and it’s already among the four most common cancers in men. Most cases are diagnosed at advanced stages, with high mortality.
This happens despite three key factors:
The disease is largely preventable,
Brazil has the largest number of dentists in the world,
And there is a simple, low-cost (cóst) examination available that can detect (can rapido) the disease early and save lives.
However, oral cancer does not affect everyone in the same way. It mainly affects vulnerable populations, especially men, smokers, Black individuals, and those with low income and low education.
The Brazilian public health system, called SUS, widely known for providing accessible care, offers this examination to people who usually go to the dentist.
But what about those who don’t?
What would happen if we changed the way this exam is offered?
To answer all these questions, a randomized clinical trial was conducted in primary healthcare. The main objective of the study was to compare the performance of different strategies to increase access to preventive oral examination among high-risk populations.
Rio de Janeiro is divided into 10 health areas, and one of these areas was randomly selected. An area comprising 35 primary healthcare units, which were randomly allocated into three groups: Control, Experimental I, and Experimental II.
The sample comprised individuals registered in these units who were aged 35 or older and had an active tobacco-use record in the electronic health system. They were identified in November across all study groups.
In December, the experimental groups received training to standardize procedures, with all stakeholders and health teams.
Throughout 2024, the control group maintained routine care, with opportunistic screening, the current strategy in Brazil.
In the experimental groups, organized screening was implemented, with active invitations to high-risk individuals, who had already been identified, to attend examinations at the units
