Head and neck cancers in France: an analysis of the hospital medical information system (PMSI) database

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.

Clinical and epidemiological characteristics of patients in the head and neck surgery department of a university hospital

“…9,[26][27][28] This was corroborated in the present study, in which 79.68% of the individuals affected by this type of cancer were male.…”

Overview of the predictive value of quantitative 18 FDG PET in head and neck cancer treated with chemoradiotherapy

“…The American Joint Committee on Cancer (AJCC) staging is gen-erally used to estimate the prognosis and guide therapy (Edge and Compton, 2010). Radio-chemotherapy is a standard treatment of unresectable and/or locally advanced Head and Neck Cancers (Pignon et al, 2000;St Guily et al, 2010). Despite this treatment, the prognosis remains worst and loco-regional recurrence may occur in up to 40% patients, mostly within the first 2-years after treatment (Chajon et al, 2013).…”

Upper aero digestive tract cancers: epidemiological and histopathological aspects in Togo

“…Our data are lower than those of occidental countries and Maghreb but higher than those reported in Nigeria by Amusa and al (45.4% of ENT cancers) and in Burkina Faso by Ouoba and al (48.8% of ENT and cervico-facial cancers). [3][4][5][6] These disparities should be due to the size of study populations; the considered period of study, the unequal repartition of cancer through the world, the absence of registers of cancers in our sub-Saharan countries and also to available diagnostic. The notion of chronic smoking was found in 26.4% of the patients in our series.…”