Oral Cancer Management Outcomes and Their Association With the Oral Health-Related Quality of Life in Resource-Limited Settings: A Prospective Cohort Study

Abstract

OBJECTIVE: The management of oral cancer (OC), particularly in developing countries, presents significant challenges. This study aimed to identify the challenges faced by patients with OC in resource-limited settings and evaluate their impact on the Oral Health-Related QOL (OHRQoL). MATERIALS AND METHODS: A prospective cohort study was conducted among Congolese participants using clinical data and an Oral Health Impact Profile (OHIP-14) questionnaire. Predictor variables included treatment methods and clinical characteristics. Main outcome variables included the challenges (delayed treatment, lack of information, access to health care, and perception of OC) and QOL. The χ2 tests and analysis of variance were used to compare the study groups, with a significance level set at P<0.05. RESULTS: Of 827 participants, 459 were OC patients, and 368 were healthy controls. The cohort was predominantly male (>60%). Over 60% of OC patients reported delayed treatment, 78% had not disclosed their diagnosis, and 72% were uninformed about their disease. Among the few (22%) who were informed, 89% refused treatment. The mean OHIP-14 total score was significantly higher in OC patients (with therapy: 19.18±6.05; without therapy: 25.67±5.56) than in healthy controls (11.76±4.58; P<0.005). Delayed or refusal of treatment, lack of information, and negative perceptions of OC were all significantly associated with worse OHRQoL. CONCLUSION: Multiple factors contribute to the challenges in managing OC in resource-limited settings. Patients who had delayed or refused treatment, lacked information, and had a negative perception of OC exhibited significantly worse OHRQoL than healthy participants.