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The economic burden of oral squamous cell carcinoma in Australia.

OBJECTIVES
The financial burden of treatment for oral squamous cell carcinoma in Australia has never been reported and there is a paucity of international data. Here we report the direct costs of treatment of surgically resectable oral cancer in a tertiary public hospital in Australia over a 15 year period.


MATERIALS AND METHODS
Pathology department records, records of hospital attendance and hospital finance department records were interrogated to determine the direct costs of inpatient and outpatient treatment. Costs were adjusted using the total health price index so that all costs were equivalent to costings for the 2016/2017 financial year.


RESULTS
113 cases were identified as suitable for inclusion. Complete inpatient and outpatient hospital attendance and costing data for treatment and subsequent two-year follow-up was available for 29 cases. The average total cost over the two-year period was $92,958AUD (median $102,722, range $11,662-$181,512). On average, 92.8% of costs were incurred in the first year post-diagnosis. Inpatient costs, outpatient costs and total costs increased with increasing pathological cancer stage. Both 1 and 2 year-post diagnosis overall cost for patients with Stage 4 oral cavity cancer were more than two times greater than for patients with Stage 1 oral cancer.


CONCLUSION
It is well documented that patients diagnosed at an earlier stage will have better survival outcomes and it is assumed that the economic burden of their treatment will be less. We have shown that there is a direct correlation between cancer stage and cancer treatment cost. The findings provide clear economic support for oral cancer screening initiatives to detect earlier stage cancers, and the need to investigate novel techniques and technologies to detect oral squamous cell carcinoma early and reduce recurrence and mortality rates. This article is protected by copyright. All rights reserved.