Abstract
BackgroundWith 16,005 new cases and 5,406 related deaths in 2005, France is particularly concerned by Head and Neck (H&N) cancers. In addition to tobacco and alcohol, Human Papillomavirus (HPV) has been reported as a risk factor for H&N cancers. The literature on the burden of these cancers in Europe is scarce. This study was performed to assess the medical and economical burden of hospitalisations for H&N cancers in France.MethodsThe French national hospital database (PMSI), in which admissions to public and private hospitals are recorded, was retrospectively analysed to assess the annual number of patients hospitalised for H&N cancers and associated hospital costs from the healthcare payer perspective. ICD-10 codes (16 codes classified as oral cavity, oropharynx, pharynx, salivary glands and larynx) were used to extract admissions for these cancers. Hospital stays, chemotherapy and radiotherapy sessions were extracted to assess patients' management. Costs of admissions were obtained from French official tariffs.ResultsIn 2007, there were 36 268 patients hospitalised for H&N cancers, of whom 81% were men, corresponding to 60 200 hospital stays and 287 846 sessions of chemo- or radio-therapy. Oropharynx cancer was the most frequent (28% of patients), followed by oral cavity cancer (25% of patients). The peak of frequency was observed in the 55-59 years age group. Patients were mainly treated in medicine (48%) and surgery (23%) units. Mean annual cost per patient ranged from €2 764 to €7 673 leading to a total hospital cost of €323 millions in 2007 (including hospitalization and expensive drugs). With 26% of H&N cancers attributable to HPV infections, 9 430 patients were hospitalized due to HPV-related H&N cancers, representing €138 million in 2007.ConclusionEven without taking into account the rehabilitation costs, the hospital burden of H&N cancers is considerable.
Highlights
With 16,005 new cases and 5,406 related deaths in 2005, France is concerned by Head and Neck (H&N) cancers
Head and neck cancer refers to a group of cancers originating from the upper aerodigestive tract, including oral cavity, oropharynx, pharynx other than oropharynx, larynx, salivary glands, and other sites located in the head and neck area
The RSS is integrated into a Diagnosis Related Group (DRG) used for classification of hospital stays
Summary
With 16,005 new cases and 5,406 related deaths in 2005, France is concerned by Head and Neck (H&N) cancers. In Europe, head and neck cancer (H&N) accounted for approximately 143 000 new cancers in 2007 and were responsible of more than 68 000 deaths [1]. They have broadly varying rates of incidence and mortality around the world. Head and neck cancers are strongly associated with environmental and lifestyle risk factors. Alcohol consumption is frequently associated with tobacco use as a co-factor in oncogenic risk, especially in oral cavity and hypopharynx cancers
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