National and Subnational Plans for Primary Prevention and Early Detection of Oral and Oropharyngeal Cancer: A Scoping Review

This scoping review aims to map primary prevention and early detection strategies for oral and oropharyngeal cancer (O/OC) across Cancer Plans and Plans of Non-communicable Diseases from all World Health Organization Member States. Following PRISMA-ScR guidelines, a comprehensive search was performed on key organization websites, including The International Cancer Control Partnership, National Comprehensive Cancer Control Program and European Partnership for Action Against Cancer, until March 2023. A total of 194 countries were assessed, divided into 264 Self-governing political entities (SGPE) and similar entities (territories, tribes, among others). Out of 264 SGPE and similar, 124 (47%) presented documents that addressed O/OC to risk factors and preventive strategies for O/OC. Southeast Asia had the highest percentage of SGPE and similar (81.8%), mentioning risk factors and preventive strategies for O/OC in their Plans, followed by America (63.5%). The Western Pacific and Eastern Mediterranean regions had the lowest coverage, 24.2% and 23.8%, respectively. Tobacco use was the most discussed risk factor for O/OC on primary prevention Plans (63.7%), followed by HPV infection (54%) and alcohol consumption (35.5%). The most common strategy for early detection was the opportunistic examination, recommended by 29% of SGPE and similar, followed by screening in high-risk individuals (14.5%), self-examination (5.6%), and population-based screening (2.4%). Despite the high incidence of O/OC in many countries, most cancer plans did not approach primary prevention and early detection for O/OC, and a great diversity of preventive strategies was observed among the Plans.