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Clinical and economic burden of head and neck cancer : a nationwide retrospective cohort study from France

Abstract : Objectives: To evaluate the clinical and economic burden of head and neck squamous cell carcinoma (HNSCC) in France. Methods: All 53,255 incident adult patients discharged with a first diagnosis of HNSCC in 2010–2012 were identified from the 2008–2013 French National Hospital Discharge (PMSI) database. We conducted a retrospective longitudinal analysis of prognosis and direct costs attributable to HNSCC. Results: Direct medical costs attributable to HNSCC care amounted to 665 million euros in 2012 in France. The majority (62%) of incident patients were 64 years old or less at HNSCC diagnosis and incurred 1.3-fold higher mean direct costs as compared to elderly patients (41,909 vs 32,221 euros over 3 years, respectively; p<0.001). HNSCC stage at initial treatment was the major driver of mean (SD) direct costs over 3 years (p<0.001): 19,819 (23,150) euros in 31% patients diagnosed at early stage; 46,791 (34,841) euros in 60% patients diagnosed at locally advanced stage; and 43,377 (33,953) euros in 9% patients diagnosed with distant metastasis. About half patients died over 3 years at a median (IQR) age of 63 (56–75) years resulting in 10.9 years-of-life lost on average per incident patient. Conclusion: The present study suggests that the clinical and economic burden of HNSCC is substantial in France.
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Antoine Schernberg, Luis Sagaon-Teyssier, Michaël Schwarzinger, Sylvain Baillot, Mélina Bec, et al.. Clinical and economic burden of head and neck cancer : a nationwide retrospective cohort study from France. ClinicoEconomics and Outcomes Research, 2019, 11, pp.441-451. ⟨10.2147/CEOR.S198312⟩. ⟨hal-02271446⟩

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