Who is covered?
The following are covered by the Early Intervention Project in Oral Cancer:
- Users belonging to the risk group: men who smoke, aged 40 years or older and have alcoholic habits
- clients complaining of pain, lesions or changes in the colour or surface of the oral mucosa or unusual swelling of structures of the mouth or upper airways, sensation of oral or perioral numbness
- patients in whom lesions in the oral cavity are identified due to the user's complaint or observation by the family doctor
How do you start the process?
The process is triggered by the family doctor, following 2 possible situations:
- Opportunistic screening of high-risk clients
- clinical diagnosis of malignant or potentially malignant lesions, detected by complaint or observation of the user or referred by a stomatologist or dentist
Screening should be carried out every 2 years in clients belonging to the risk group.
How is it processed?
The clinical diagnosis of potentially malignant or malignant lesions results from an opportunistic screening, observation or complaint of the patient whose importance is confirmed through macroscopic observation carried out by the family doctor.
In any case, whenever the existence of a suspicious lesion is confirmed, a diagnostic referral cheque is issued to an adherent physician accredited for this purpose.
What happens when the lesion is detected by the dentist?
When the suspicion of a malignant lesion is detected by a dentist or stomatologist, the patient should be referred to the family doctor, so that the user's access to a diagnostic check can be operationalized with the utmost urgency.
What is the diagnostic check?
The diagnostic check is used by the adhering physician with the record of the diagnosis/suspected diagnosis. If the biopsy is deemed necessary, the adhering physician collects the biological product, issuing a biopsy check for this purpose.
I have the diagnostic check. What now?
In possession of the diagnostic cheque, the user of the National Health Service must make an appointment with the professional of their choice, provided that it is included in the national list of adherent doctors specific for this purpose.
In each district, there is a group of professionals qualified to perform the differential diagnosis of lesions of the oral cavity.
I had a biopsy under this program. What now?
In possession of the biological product sent by the adhering physician, the laboratory proceeds to carry out the analysis and upload the result to the Oral Health Information System (SISO) platform, within 4 days and to send a detailed report, via email, to the adhering physician. This information is available in SISO, in the profile of the adhering physician and by notification in the Physician Support System (SAM), for consultation by the family doctor.
What could be the various options in the light of the results?
In the face of a result:
- Negative for oral cancer: the adherent doctor and/or family doctor inform the patient
- of potentially malignant lesion: the adherent physician or the family doctor communicates the result to the user, and the family doctor must proceed with the referral of the patient via "consultation on time" (CTH)
- dand oral cancer registered by the laboratory: results in the sending of a message in the SISO to the adherent physician and to the focal points of the Portuguese Institute of Oncology of reference of the patient, as well as, for the latter, to the sending via email of the detailed anatomopathological report. The adhering physician must immediately contact the patient in order to transmit the result of the examination
During the consultation, the adhering physician closes the process of using the biopsy check.
What happens after oral cancer is registered by the laboratory?
The reference Portuguese Institute of Oncology contacts the patient within a maximum period of 24 hours, transmitting the date of the consultation and, if necessary, provides a priority medical-surgical intervention.
The Portuguese Institute of Oncology registers in SISO the type of medical-surgical treatment performed on the patient as well as, within the scope of surveillance, the registration of the date of discharge.
For lesions diagnosed with oral cancer, HPV (Human Papilloma Virus) is also tested with serotyping. The laboratory must upload the results of this research to SISO within a maximum period of 15 days.
What are the objectives of the Early Intervention Project in Oral Cancer?
The objectives are:
- increase survival from oral cancer at 5 years after the diagnosis of oral cancer in individuals belonging to the highest risk group covered by this project, exceeding by 5 percentage points the current value, taking the European average as a reference
- efficiently use all the installed capacity in public and/or private services for the differential diagnosis of potentially malignant lesions, detected by complaint or observation of the user or referred by a stomatologist or dentist
What is oral cancer?
According to the International Classification of Diseases, oral cancer is given to malignant tumors that affect any location in the oral cavity, from the lips to the throat (including the tonsils and pharynx) and most often on the lateral edge of the tongue, floor of the mouth and soft palate.
Source: Directorate-General for Health (DGS)