PLoS ONE (Jan 2023)

The Brazilian National Oral Health Policy and oral cancer mortality trends: An autoregressive integrated moving average (ARIMA) model.

  • Elisa Miranda Costa,
  • Elisa Santos Magalhães Rodrigues,
  • Francenilde Silva de Sousa,
  • Felipe Bezerra Pimentel,
  • Mariana Borges Sodré Lopes,
  • João Ricardo Nickenig Vissoci,
  • Erika Barbara Abreu Fonseca Thomaz

DOI
https://doi.org/10.1371/journal.pone.0291609
Journal volume & issue
Vol. 18, no. 9
p. e0291609

Abstract

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ObjectiveThis study analyzes the effect of the Brazilian National Oral Health Policy (NOHP) on oral cancer mortality rates (OCMR).MethodThis is an ecological study with secondary oral cancer death data, using interrupted time series analysis (ARIMA, Autoregressive Integrated Moving Average). Annual death data were collected from the Mortality Information System (1996-2019). The outcome was the OCMR, standardized by gender and age We considered the NOHP, categorized as "0" (before its implementation), from 1996 to 2004, and "1 to 15", from 2005 to 2019. ARIMA modeling was carried out for temporal analysis, and regression coefficient estimation (RC).ResultsThe Brazilian NOHP implementation was associated with an increase in OCMR in the North region (CR = 0.16; p = 0.022) and with a decrease in the Southeast region (CR = -0.04; pConclusionThe Brazilian NOHP is not being effective in reducing the OCMR. The trends behaved differently in the Brazilian territory, highlighting health inequities. We recommend that the NOHP strengthen the oral health care network, incorporating oral cancer as a notifiable disease, adopting strategies for prevention, screening, and providing opportunities for early treatment of the disease.