title: Head and neck cancers in France: an analysis of the hospital medical information system (PMSI) database.
abstract: BACKGROUND
  With 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.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  Even without taking into account the rehabilitation costs, the hospital burden of H&N cancers is considerable.
authors.affiliation: Biostatistic and Epidemiology Department, Institut Gustave Roussy, Villejuif, France.
authors.forename: Jean Lacau
authors.initials: JL
authors.lastname: St Guily
authors.forename: Isabelle
authors.initials: I
authors.lastname: Borget
authors.forename: Alexandre
authors.initials: A
authors.lastname: Vainchtock
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rémy
authors.forename: Claire
authors.initials: C
authors.lastname: Takizawa
mesh_terms: D000367:Age Factors; D005260:Female; D005602:France / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000191:economics / Q000453:epidemiology*; D017721:Hospital Costs; D006751:Hospital Information Systems; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
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