Background: Oral cancer is among the most prevalent malignant neoplasms in Brazil and worldwide and is strongly associated with modifiable risk factors, particularly tobacco and alcohol use. Despite being a simple and low-cost procedure, clinical oral examination often fails to ensure early diagnosis, with many cases still identified at advanced stages, resulting in poor prognosis. In this context, strategies aimed at strengthening referral pathways from Primary Health Care (PHC) to specialized services—supported by electronic platforms and teledentistry—have emerged as promising approaches to improve early detection and quality of care. Objective: To report the experience of implementing and using an electronic platform to facilitate referrals of oral lesions suspected of malignancy from PHC in the state of São Paulo, Brazil, and to describe the clinical, sociodemographic, and care-related profile of patients diagnosed with oral cancer. Methods: This cross-sectional study with retrospective data collection was conducted at Barretos Cancer Hospital (BCH), within the Oral Cancer Prevention Department, between January 2021 and May 2025. Electronic referral records submitted by PHC dentists from 18 municipalities within the Barretos Regional Health Department (DRS-V) and neighboring areas were analyzed. Dentists were trained to use a standardized electronic referral form developed on the REDCap® platform, which included clinical criteria and image submission. Following initial triage at BCH, eligible patients were scheduled for in-person dental evaluation and biopsy when indicated, with diagnostic confirmation by histopathological examination. Sociodemographic, clinical, and care flow variables were analyzed descriptively. Results: Between January 2021 and May 2025, 341 electronic referrals of suspected oral lesions were registered. Of these, 102 patients (29.9%) underwent biopsy. Oral cancer was confirmed in 55 cases (53.9%) by histopathology; additionally, 16 cases (15.7%) were diagnosed as oral potentially malignant disorders, 30 cases (29.5%) as benign lesions, and 1 case (0.9%) as cancer diagnosed by imaging examination. Among patients with confirmed cancer and available age data (n = 56), the mean age was 66.5 ± 10.3 years (median: 66; range: 42–87), with a predominance of males (87.5%). Regarding tumor staging, 30.36% of cases were classified as T3, 25.0% as T4, 25.0% as T2, and 19.64% as T1. The most frequent anatomical sites were the tongue (39.29%), lower lip (16.07%), and floor of the mouth (14.29%). Concerning risk factors, 41.07% of patients reported combined tobacco and alcohol use, 39.29% tobacco use only, 10.71% alcohol use only, and 8.93% reported no exposure. The municipalities with the highest number of referrals were Guaira, Olímpia, Severinia, and Barretos. Conclusion: The implementation of an electronic referral platform for suspected oral lesions proved to be a feasible and effective strategy for organizing care pathways between PHC and specialized services. This approach enabled the identification of a substantial number of oral cancer cases and oral potentially malignant disorders. The integration of professional training, standardized transmission of clinical information and images, and structured counter-referral processes strengthens early diagnosis and may support the expansion of oral cancer prevention and control strategies within the public health system.

Referrals - Prevention of Oral Cancer HA Barretos