Oral cancer treatment costs in Greece and the effect of advanced disease.
BACKGROUND
The main purpose of the study was to quantify the direct costs of oral cancer treatment to the healthcare system of Greece. Another aim was to identify factors that affect costs and potential cost reduction items. More specifically, we examined the relationship between stage of disease, modality of treatment and total direct costs.


METHODS
The medical records and clinic files of the Oral and Maxillofacial Clinic of the Athens General Hospital "Genimatas" were abstracted to investigate clinical treatment characteristics, including length of hospitalization, modes of treatment, stage of disease etc. Records of 95 patients with oral squamous cell carcinoma (OSSC), with at least six months of follow-up, were examined. The clinical data was then used to calculate actual direct costs, based on 2001 market values.


RESULTS
The mean total direct costs for OSSC treatment estimated at euro 8,450 or approximately US$ 7,450. Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05). Multi-modality treatment applied mainly to patients in stages III and IV was the factor that affected the cost. Disease stage was also associated with the total duration of hospitalization (p < 0.05).


CONCLUSIONS
The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life.
Health Policy & Epidemiology,Harvard School of Dental Medicine, 118 Longwood Avenue, Boston, MA 02115, USA. zavras@hms.harvard.edu
Athanasios
A
Zavras
Nikos
N
Andreopoulos
Nikos
N
Katsikeris
Dimitrios
D
Zavras
Vassiliki
V
Cartsos
Athanasios
A
Vamvakidis
D002294:Carcinoma, Squamous Cell / Q000191:economics* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000191:economics; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D006115:Greece; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research; D017721:Hospital Costs; D006769:Hospitals, General / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009062:Mouth Neoplasms / Q000191:economics* / Q000503:physiopathology / Q000628:therapy*; D009313:National Health Programs / Q000191:economics; D009367:Neoplasm Staging / Q000145:classification / Q000191:economics*