Intersectional analysis of the social vulnerability of individuals with differences in the time between oral cancer diagnosis and treatment: a cross-sectional study, Brazil, 2011-2020

Objective To investigate association between the sociodemographic profiles of individuals with oral cancer in Brazil and the time interval between diagnosis and initiation of treatment. Methods This was a cross-sectional study of reported oral cancer cases in Brazil from 2011 to 2020, using data from the Cancer Hospital Registry Information System of the Brazilian National Cancer Institute (Sis-RHC/INCA). Sociodemographic profiles were identified using two-step cluster analysis, and associations were estimated using multinomial logistic regression, with odds ratios (OR) and 95% confidence intervals (95%CI). Results The sample included 25,169 cases diagnosed between 2011 and 2020, which defined four distinct profiles: A) married men aged 40-79, White, with less than 8 years of schooling, from the Southern region; B) married men aged 40-79, Black, with 8 years of schooling, from the Northeast region; C) married men aged 40-79, Black, with less than 8 years of schooling, from the Northeast region; D) widowed women aged 40-79, Black, with less than 8 years of schooling, from the Southeast region. Compared to profile D, profile A showed 61.5% lower odds of starting treatment ≥91 days after diagnosis (OR 0.38; 95%CI 0.26; 0.55), profile B showed 50.0% lower odds (OR 0.50; 95%CI 0.32; 0.77), and profile C showed 35.4% lower odds (OR 0.64; 95%CI 0.45; 0.92). Conclusion Significant differences exist in the time to treatment initiation for oral cancer across distinct sociodemographic groups.