Implementation-focused consensus recommendations for oral cavity cancer prevention and early detection in Latin America and the Caribbean: A Delphi study

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BACKGROUND: Oral cavity cancer represents a public health challenge in Latin America and the Caribbean (LAC), where exposure to modifiable risk factors such as tobacco and alcohol remains high and inequalities in access to health services contribute to delayed diagnosis and poor outcomes. This study aimed to develop consensus-based recommendations to strengthen the prevention and early detection of oral cavity cancer and oral potentially malignant disorders in LAC. METHODS: A multi-phase study using a Delphi approach was conducted. An initial qualitative survey with regional experts identified barriers, facilitators, and priority actions for oral cavity cancer prevention and early detection. Preliminary recommendations were refined through feasibility assessment by international advisors and subsequently evaluated in a quantitative Delphi round using a Likert scale. RESULTS: Twenty-four experts from 12 LAC countries participated in the Delphi process, including research investigators, clinicians, and health service managers. The panel had a mean age of 49.4 (SD 10.3) years and included 41.7 % women. Seven recommendations achieved consensus, addressing key domains of oral cavity cancer control including primary prevention interventions, screening of high-risk individuals, establishment of structured referral pathways, improved surveillance systems, and expansion of access to diagnostic services in underserved populations. High levels of agreement were observed across all recommendations. CONCLUSIONS: These consensus-based recommendations provide a regionally informed framework to guide oral cavity cancer prevention and early detection strategies in LAC. Strengthening coordinated actions across the continuum of care, including primary prevention, screening, referral, and diagnostic capacity, may contribute to reducing diagnostic delays and improving outcomes in the region.

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