Prevalence and organization problems of medical care to patients with precanceral oral cavity mucosa diseases (on the Tomsk Region example)

Abstract

Introduction. Nowadays discussed and actual issues of modern oncology are the diagnostics problems and care organization for patients with oral mucosa and lips precancerous diseases.Study purposes – to analyze the prevalence, structure, and primary diagnosis quality of oral mucosa and lips precancerous diseases and to identify the organizing medical care problems for the adult population with the oral cavity precancerous diseases in residents of Tomsk city and Tomsk Region.Materials and methods. For the period 2014–2019 1,664 patients were examined and treated for oral mucosa and lips diseases. The main complaints and medical history were clarified in all patients, according to the recommendations of the World Health Organization, assessed the state of the oral mucosa and lips according to the visual inspection data. To assess the primary diagnosis quality of an oral mucosa disease, we analyzed the data from a dental patient’s medical record, dentist’s referrals, and anamnesis data.Results. In the general oral mucosa and lips pathology structure almost a quarter (25.7 %) of patients were diagnosed with precancerous diseases – leukoplakia (12.5 %), lichen planus (10.8 %), viral papillomas (2.0 %) and Manganotti cheilitis (0.4 %). Malignant neoplasms of the oral cavity at different stages was established in 8.3 % of cases. A retrospective errors analysis revealed that in 100 % of leukoplakia, lichen planus, candidiasis and stomatitis cases the disease form was not indicated. In 22 % cases out of the total number of oral leukoplakia patients, the diagnosis was made mistakenly. In 12 cases of malignant neoplasm underdiagnoses, lichen planus and oral mucosa candidiasis prevailed. In half of the cases of the mistakenly diagnosed oral leukoplakia (10.2 %), oral cavity squamous cell carcinoma was detected. The average waiting time for the oncologist»s appointment was 44.3 ± 10 days.Conclusion. The results indicate a high prevalence of precancerous pathology in the oral mucosa structure diseases(25.7 %) and a long wait for specialized medical care.