Oral (mouth) cancer in the Caribbean basin region

The incidence rates of mouth cancer vary from low to high among the countries of Latin America and the Caribbean. According to the Department of Epidemiology, University of São Paulo, Brazil, high incidence rates for oral cancer are found in parts of Latin America and the Caribbean particularly in Brazil, Uruguay and Puerto Rico. The specific risk factors that have been identified are high tobacco smoking, excessive alcohol drinking specially in persons over 50 years old and lifestyle. The large majority of oral cancers have risk factors similar to those occurring in the the upper digestive tract.

The increase in tobacco smoking among females is beginning to and will have a strong impact on the incidence of mouth cancer in the future in the region and around the globe. Oral cancer is the most common cancer in men, and may contribute up to 25% of all new cases of cancer. The American Dental Association (ADA) estimates that this year alone almost 42,000 Americans will be diagnosed with oral and throat cancers. The five (5) year survival rate of those diagnosed is only slightly more than 64 percent? When cancer is detected and treated early, treatment-related health problems are reduced.

The symptoms of mouth or throat cancer can include: a sore or irritation that doesn't go away, red or white patches and pain, tenderness or numbness in mouth or lips; a lump, thickening, rough spot, crust or small eroded area of the mouth or throat; difficulty chewing, swallowing, speaking or moving your tongue or jaw and a change in the way your teeth fit together when you close your mouth.

But more recently, the Human Papilloma Virus (HPV), which is sexually transmitted, has been associated with cancers of the oropharyngeal region that is the part of the throat at the back of the mouth. HPV-positive oropharyngeal cancers are related to the increasing incidence of throat cancers in non-smoking adults. Although HPV-positive oropharyngeal cancers are often diagnosed at a later stage, people with HPV-positive cancers have a lower risk of dying or having recurrence.

In some Latin American and Caribbean countries, lay educational information on oral cancer is scant. Oral cancer is a serious and growing problem in many parts of the developing world but most are preventable. The importance of improving information systems on cancer and the development of tobacco smoking and alcohol cessation programs are stressed. The training of health practitioners in the early detection and treatment of mouth lesions is a major public health goal that could improve survival. But the difficulties encountered by people from the lowest socioeconomic strata in obtaining access to quality and timely primary health care often hinder this objective.

Oral and oropharyngeal cancer is generally described as cancers of the lip, tongue and mouth (oral cavity) and oropharynx (head and neck). When grouped together, it is the sixth (6th) most common cancer in the world. With an estimated half a million cases around the globe and the rising trends reported in some populations, particularly in the young, urgent public health measures are needed to reduce the incidence and mortality of oral and oropharyngeal cancer. When oral cancer and all cancers are detected and treated early, treatment-related health problems are reduced.