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Tumor Location and Referral Sources as Determinants of Late-Stage Oral Cancer Diagnosis in a Portuguese Cohort
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Advisor(s)
Abstract(s)
Background: Most cases of oral cancer at the time of diagnosis are already locally advanced, which is associated with a worse prognosis. This study aimed (1) to identify tumor characteristics and risk factors associated with late-stage oral cancer diagnosis in the Portuguese population and (2) to develop population- and provider-oriented early detection strategies, particularly focused on recognizing potentially malignant disorders, to enhance timely diagnosis and improve patient outcomes.
Methods: A retrospective study of 151 patients with oral cancer treated in a Portuguese tertiary hospital between January 2015 and April 2023 was conducted. Information regarding sociodemographic variables, habits, tumor location and form of presentation, referral sources, and stage of the disease at initial diagnosis was analyzed.
Results: The majority of patients were male, and the mean age at diagnosis was 65 years. Most were diagnosed at stage IV (51.7%, n = 75), and most of these were referred by the emergency department (46.7%, n = 35). Family physicians made the earliest referrals. Patients referred by dentists were diagnosed at more advanced stages of disease by comparison. The anatomical sites with the highest percentage of locally advanced disease were the lower gingiva, retromolar trigone, and upper gingiva.
Conclusions: Late-stage oral squamous cell carcinoma was the most common diagnosis, particularly for lesions in the gingiva and retromolar trigone, and was more frequent among cases referred through emergency departments, reflecting gaps in early detection. Targeted surveillance, improved professional training, and public awareness are essential to promote earlier diagnosis.
Description
Keywords
Early diagnosis Gingival squamous cell carcinoma Oral cancer detection Oral cancer referral Oral squamous cell carcinoma Risk factors Tumor characteristics
Pedagogical Context
Citation
Cunha Coutinho J, Cruz E Silva L, São João R, et al. (November 03, 2025) Tumor Location and Referral Sources as Determinants of Late-Stage Oral Cancer Diagnosis in a Portuguese Cohort. Cureus 17(11): e95982. doi:10.7759/cureus.95982