The burden of hospitalizations for head and neck neoplasm in Spain (1997-2008): An epidemiologic study.

Abstract

Background: Cancers of the head and neck currently figure as the 6th most important cause of cancer globally. They are strongly associated with tobacco and alcohol consumption, but recent studies showed the presence of HPV in patients with these types of cancer. The incidence of cancers of the head and neck potentially attributable to HPV has increased in the last years. This study aims to provide population-based estimates of the burden of hospitalisation for head & neck neoplasm in Spain that may be useful when cost-effectiveness models are developed to evaluate the impact of HPV vaccination in Spain. Methods: Epidemiological retrospective survey to assess the burden of hospitalisation for head and neck neoplasm in the general population in Spain during the 1997-2008 period. Differences in proportions were assessed by the Chi-square test. ANOVA was used for multiple comparisons. The post hoc Bonferroni correction was used to adjust statistical significance for multiple comparisons. Poisson regression was used to assess differences in the hospitalisation rate during the study period in all the age groups. Results: A total of 199,304 hospital discharges for head and neck malignant neoplasm were recorded during the 12-years of study: 55,475 (46,560 males and 8,915 females) corresponded to oral cavity; 46,699 (45,020 males and 1,679 females) to pharynx and 97,139 (93,374 males and 3,765 females) to larynx malignant neoplasms. Hospitalization rates increased significantly with age. Overall hospitalization rates in men were more than 10-fold higher than in women. Rates decreased significantly in men during the study period but increased significantly in women in all locations. Conclusions: Although a slight decrease has been observed in hospitalization rates due to head and neck neoplasm in the last years in men, they still generate a substantial morbidity and mortality, especially in adults over 50 years of age.