title: Oral/pharyngeal, laryngeal, and lung cancer discharge trends in Department of Veterans Affairs hospitals.
abstract: OBJECTIVE
  This paper describes trends in oral and pharyngeal (O/P) cancer diagnoses in Department of Veterans Affairs (VA) hospitals from 1983 to 1993 and compares these trends to those of laryngeal and lung cancers.
  
  
  METHODS
  The VA patient treatment file was used to identify unique hospital discharges from 1983 to 1993 having ICD-9-CM codes for O/P, laryngeal, and lung cancers. Descriptive statistics were tabulated to determine prevalence and distribution. Trends of change over time were analyzed using regression analyses of the percent rate on year.
  
  
  RESULTS
  Between 1983 and 1993 the annual number of O/P cases among users of VA hospitals decreased from 4,983 to 3,298. Despite overall declines in O/P cancer discharges in VA, cancer of the pharynx, tongue, and salivary gland continues to increase. O/P cancer in younger persons also continues to increase in VA. Overall, laryngeal cancers significantly increased, while no significant change was associated with lung cancer.
  
  
  CONCLUSIONS
  VA needs to evaluate the changes in the patterns of O/P cancer to ascertain whether this represents a shift in care from inpatient to outpatient care. VA should seek further information regarding these trends to better plan, implement, and evaluate programs to provide early diagnosis and treatment targeted to veterans.
authors.affiliation: Dental Service (PP/DEN/160), VA Maryland Health Care System, Perry Point, MD 21902, USA. denise.fedele@med.va.gov
authors.forename: D J
authors.initials: DJ
authors.lastname: Fedele
authors.forename: J A
authors.initials: JA
authors.lastname: Jones
authors.forename: L C
authors.initials: LC
authors.lastname: Niessen
authors.forename: I Y
authors.initials: IY
authors.lastname: Guo
authors.forename: K
authors.initials: K
authors.lastname: Harrison
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology*; D008175:Lung Neoplasms / Q000453:epidemiology*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010610:Pharyngeal Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D012044:Regression Analysis; D012468:Salivary Gland Neoplasms / Q000453:epidemiology; D014062:Tongue Neoplasms / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs