Economic and human impact of late diagnosis of oral cancer inBrazil’s Unified Health System (SUS)

Abstract

Oral cancer in Brazil's Unified Health System (SUS) represents a major challenge, with 60% of cases diagnosed at late stages, increasing treatment costs by 500% from stage I (R$ 5,100) to stage IV (R$ 25,600) and reducing 5-year survival from 80% to 20%. This study reviewed 21 international studies and SUS data (2019-2024), identifying three critical factors: (1) barriers to early detection, with only 35% of primary care units conducting active screening; (2) regional disparities, such as a 120-day average diagnostic delay in the North versus 45 days in the Southeast; and (3) structural gaps in the healthcare network, with only 20% of units having trained dentists. Successful initiatives like the Boca Saudável (“Healthy Mouth”) Program (state of Rio Grande do Sul) demonstrate that professional training and fast-track referral protocols can reduce diagnostic time by up to 40%. Evidence-based strategies, including teledentistry for remote regions, targeted risk-group campaigns (smokers and older adults), and strict enforcement of legal treatment deadlines are urgently needed to reverse this scenario. A multisectoral commitment to early diagnosis is essential to improve outcomes and optimize SUS resources.