Skip to main content

Advertisement

Log in

Economic burden of head and neck cancer

A literature review

  • Original Papers
  • Published:
The European Journal of Health Economics, formerly: HEPAC Aims and scope Submit manuscript

Abstract

This literature review presents the economics of head and neck cancer (HNC), the world's sixth most common neoplasm. HNC economics is complicated by the involvement of multiple body sites, multiple medical specialties, and multiple treatment modalities. Economic analyses of HNC published in English between 1990 and 2002 were identified from electronic data sources. Additional studies were identified manually from bibliographies of retrieved articles. Study characteristics and findings were analyzed. We identified 51 studies that reported original cost data. Most were cost-identification or cost-comparison studies; only one evaluated cost-effectiveness. Few assessed the overall economic burden of HNC or cost effectiveness of current treatments, thus making appropriate comparisons impossible. Systematic measurement of the cost of HNC and its treatment in existing practice settings would be valuable. Inclusion of economic components in clinical trials and the conduct of retrospective or prospective observational studies, such as patient registries, would yield important new information.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Arnold DJ, Funk GF, Karnell LH, Chen AH, Hoffman HT, Ricks JM et al (2000) Laryngeal cancer cost analysis: association of case-mix and treatment characteristics with medical charges. Laryngoscope 110:1–7

    CAS  Google Scholar 

  2. Aviv JE, Sataloff RT, Cohen M, Spitzer J, Ma G, Bhayani R et al (2001) Cost-effectiveness of two types of dysphagia care in head and neck cancer: a preliminary report. Ear Nose Throat J 80:553–6:558

    Google Scholar 

  3. Bennett CL, Lane D, Stinson T, Glatzel M, Buntzel J (2001) Economic analysis of amifostine as adjunctive support for patients with advanced head and neck cancer: preliminary results from a randomized phase II clinical trial from Germany. Cancer Invest 19:107–113

    Article  CAS  PubMed  Google Scholar 

  4. Benninger MS, Enrique RR, Nichols RD (1993) Symptom-directed selective endoscopy and cost containment for evaluation of head and neck cancer. Head Neck 15:532–536

    CAS  PubMed  Google Scholar 

  5. Bentkover SH, Grande DM, Soto H, Kozlicak BA, Guillaume D, Girouard S (2002) Excision of head and neck basal cell carcinoma with a rapid, cross-sectional, frozen-section technique. Arch Facial Plast Surg 4:114–119

    PubMed  Google Scholar 

  6. Blackwell KE, Azizzadeh B, Ayala C, Rawnsley JD (2002) Octogenarian free flap reconstruction: Complications and cost of therapy. Otolaryngol Head Neck Surg 126:301–306

    Article  PubMed  Google Scholar 

  7. Blair EA, Callender DL (1994) Head and neck cancer. The problem. Clin Plast Surg 21:1–7

    CAS  PubMed  Google Scholar 

  8. Bongers V, Hobbelink MG, van Rijk PP, Hordijk GJ (2002) Cost-effectiveness of dual-head 18F-fluorodeoxyglucose PET for the detection of recurrent laryngeal cancer. Cancer Biother Radiopharm 17:303–306

    Article  PubMed  Google Scholar 

  9. Bonomi A, Palmer C, Ajax M, Peeples P, Jackson S (1999) Cost of managing mucositis and xerostomia in head and neck cancer patients undergoing chemoradiotherapy (CRT) or radiation (RT). Value in Health 2:197

    Google Scholar 

  10. Brandenburg JH (2001) Laser cordotomy versus radiotherapy: an objective cost analysis. Ann Otol Rhinol Laryngol 110:312–318

    CAS  PubMed  Google Scholar 

  11. Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL et al (2001) Harrison's principles of internal medicine, 15th edn. McGraw-Hill: New York

  12. Brown ML, Hodgson TA, Rice DP (1993) Economic impact of cancer in the United States. In: Schottenfeld D, Fraumeni J (eds). Cancer epidemiology and prevention. Oxford University Press: New York

    Google Scholar 

  13. Brown ML, Riley GF, Schussler N, Etzioni R (2002) Estimating health care costs related to cancer treatment from SEER-Medicare data. Med Care 40 [8 Suppl]:IV-17

  14. Chen AY, Callender D, Mansyur C, Reyna KM, Limitone E, Goepfert H (2000) The impact of clinical pathways on the practice of head and neck oncologic surgery: the University of Texas M. D. Anderson Cancer Center Experience. Arch Otolaryngol Head Neck Surg 126:322–326

    CAS  PubMed  Google Scholar 

  15. Chiesa F, Mauri S, Tradati N, Calabrese L, Giugliano G, Ansarin M et al (1999) Surfing prognostic factors in head and neck cancer at the millennium. Oral Oncol 35:590–596

    Article  CAS  PubMed  Google Scholar 

  16. Cohen J, Stock M, Andersen P, Everts E (1997) Critical pathways for head and neck surgery. Development and implementation. Arch Otolaryngol Head Neck Surg 123:11–14

    CAS  PubMed  Google Scholar 

  17. Cohen J, Stock M, Chan B, Meininger M, Wax M, Andersen P et al (2000) Microvascular reconstruction and tracheotomy are significant determinants of resource utilization in head and neck surgery. Arch Otolaryngol Head Neck Surg 126:947–949

    CAS  PubMed  Google Scholar 

  18. Coyle D, Drummond MF (1997) Costs of conventional radical radiotherapy versus continuous hyperfractionated accelerated radiotherapy (CHART) in the treatment of patients with head and neck cancer or carcinoma of the bronchus. Medical Research Council CHART Steering Committee. Clin Oncol (R Coll Radiol) 9:313–321

    Google Scholar 

  19. Cragle SP, Brandenburg JH (1993) Laser cordectomy or radiotherapy: cure rates, communication, and cost. Otolaryngol Head Neck Surg 108:648–654

    CAS  PubMed  Google Scholar 

  20. Cronin K, Lee B, Wang D (2001) Cost of treatment for squamous cell carcinoma of the head and neck in the United States. Value Health 4:94

    Article  Google Scholar 

  21. Dickinson KD, Myers TJ (1990) Cost savings in cancer care from the selection of effective versus ineffective initial chemotherapy. Prog Clin Biol Res 339:465–476

    CAS  PubMed  Google Scholar 

  22. DiNardo LJ, Lin J, Karageorge LS, Powers CN (2000) Accuracy, utility, and cost of frozen section margins in head and neck cancer surgery. Laryngoscope 110 (10 Pt 1):1773–1776

    CAS  PubMed  Google Scholar 

  23. Ferlay J, Bray F, Pisani P, Parkin DM (2001). GLOBOCAN 2000: cancer incidence, mortality and prevalence worldwide. IARC CancerBase no. 5. IARC: Lyon

  24. Foote RL, Buskirk SJ, Grado GL, Bonner JA (1997) Has radiotherapy become too expensive to be considered a treatment option for early glottic cancer? Head Neck 19:692–700

    CAS  PubMed  Google Scholar 

  25. Funk GF, Hoffman HT, Karnell LH, Ricks JM, Zimmerman MB, Corbae DP et al (1998) Cost-identification analysis in oral cavity cancer management. Otolaryngol Head Neck Surg 118:211–220

    CAS  PubMed  Google Scholar 

  26. Funk GF, Karnell LH, Whitehead S, Paulino A, Ricks J, Smith RB (2002) Free tissue transfer versus pedicled flap cost in head and neck cancer. Otolaryngol Head Neck Surg 127:205–212

    Article  PubMed  Google Scholar 

  27. Gendron KM, Lai SY, Weinstein GS, Chalian AA, Husbands JM, Wolf PF et al (2002) Clinical care pathway for head and neck cancer: a valuable tool for decreasing resource utilization. Arch Otolaryngol Head Neck Surg 128:258–262

    PubMed  Google Scholar 

  28. Gregoire V, Hamoir M, Rosier JF, Counoy H, Eeckhoudt L, Neymark N et al (1999) Cost-minimization analysis of treatment options for T1N0 glottic squamous cell carcinoma: comparison between external radiotherapy, laser microsurgery and partial laryngectomy. Radiother Oncol 53:1–13

    CAS  PubMed  Google Scholar 

  29. Heinz TR, Cowper PA, Levin LS (1999) Microsurgery costs and outcome. Plast Reconstr Surg 104:89–96

    CAS  PubMed  Google Scholar 

  30. Hollenbeak CS, Lowe VJ, Stack BC Jr (2001) The cost-effectiveness of fluorodeoxyglucose 18-F positron emission tomography in the N0 neck. Cancer 92:2341–2348

    Article  CAS  PubMed  Google Scholar 

  31. Husbands JM, Weber RS, Karpati RL, Weinstein GS, Chalian AA, Goldberg AN et al (1999) Clinical care pathways: decreasing resource utilization in head and neck surgical patients. Otolaryngol Head Neck Surg 121:755–759

    CAS  PubMed  Google Scholar 

  32. Jacobson J, Lang K, Menzin J, Earle C (2002) The health economic cost of squamous cell cancer of the head and neck in the elderly. American Society of Clinical Oncology Annual Meeting 2002

  33. Kroll SS, Evans GR, Goldberg D, Wang BG, Reece GP, Miller MJ et al (1997) A comparison of resource costs for head and neck reconstruction with free and pectoralis major flaps. Plast Reconstr Surg 99:1282–1286

    CAS  PubMed  Google Scholar 

  34. Leon X, Quer M, Orus C, Lopez-Pousa A, Pericay C, Vega M (2000) How much does it cost to preserve a larynx? An economic study. Eur Arch Otorhinolaryngol 257:72–76

    CAS  PubMed  Google Scholar 

  35. Lowry JC (1990) Maxillofacial surgery: the economic aspect. Br J Oral Maxillofac Surg 28:16–19

    CAS  PubMed  Google Scholar 

  36. McCrory AL, Magnuson JS (2002) Free tissue transfer versus pedicled flap in head and neck reconstruction. Laryngoscope 112:2161–2165

    PubMed  Google Scholar 

  37. Miller MJ, Swartz WM, Miller RH, Harvey JM (1991) Cost analysis of microsurgical reconstruction in the head and neck. J Surg Oncol 46:230–234

    CAS  PubMed  Google Scholar 

  38. Myers EN, Wagner RL, Johnson JT (1994) Microlaryngoscopic surgery for T1 glottic lesions: a cost-effective option. Ann Otol Rhinol Laryngol 103:28–30

    CAS  PubMed  Google Scholar 

  39. Owen JB, Grigsby PW, Caldwell TM, Konski AA, Johnson DJ, Demas WF et al (2001) Can costs be measured and predicted by modeling within a cooperative clinical trials group? Economic methodologic pilot studies of the radiation therapy oncology group (RTOG) studies 90-03 and 91-04. Int J Radiat Oncol Biol Phys 49:633–639

    Article  CAS  PubMed  Google Scholar 

  40. Peterman A, Cella D, Glandon G, Dobrez D, Yount S (2001) Mucositis in head and neck cancer: economic and quality-of-life outcomes. J Natl Cancer Inst Monogr 29:45–51

    PubMed  Google Scholar 

  41. Petruzzelli GJ, Brockenbrough JM, Vandevender D, Creech SD (2002) The influence of reconstructive modality on cost of care in head and neck oncologic surgery. Arch Otolaryngol Head Neck Surg 128:1377–1380

    PubMed  Google Scholar 

  42. Poulsen M, Denham J, Spry N, Lamb D, Peters L, Krawitz H et al (1999) Acute toxicity and cost analysis of a phase III randomized trial of accelerated and conventional radiotherapy for squamous carcinoma of the head and neck: a Trans-Tasman Radiation Oncology Group study. Australas Radiol 43:487–494

    Article  CAS  PubMed  Google Scholar 

  43. Ruff LK, Volmer T, Nowak D, Meyer A (2000) The economic impact of smoking in Germany. Eur Respir J 16:385–390

    Article  CAS  PubMed  Google Scholar 

  44. Sagar SM, McKenna G, Nolan MC (1994) A clinical audit of glottic cancer in Nova Scotia: a paradigm for effectiveness research. Clin Oncol (R Coll Radiol) 6:14–23

    Google Scholar 

  45. Schuller DE, Bier-Laning CM, Sharma PK, Siegle RJ, Pellegrini AE, Karanfilov B et al (1998) Tissue-conserving surgery for prognosis, treatment, and function preservation. Laryngoscope 108:1599–1604

    CAS  PubMed  Google Scholar 

  46. Sculpher MJ, Sargeant IR, Loizou LA, Thorpe SM, Spencer GM, Bown SG (1995) A cost analysis of Nd:YAG laser ablation versus endoscopic intubation for the palliation of malignant dysphagia. Eur J Cancer 31A:1640–1646

    Article  CAS  PubMed  Google Scholar 

  47. Sturgis EM, Gianoli GJ, Miller RH, Fisher JW (2000) Avoiding transfusion in head and neck surgery: feasibility study of erythropoietin. Laryngoscope 110:51–57

    CAS  PubMed  Google Scholar 

  48. Tan L, Greener CC, Seikaly H, Rassekh CH, Calhoun KH (1999) Role of screening chest computed tomography in patients with advanced head and neck cancer. Otolaryngol Head Neck Surg 120:689–692

    CAS  PubMed  Google Scholar 

  49. Thoma A, Veltri K, Archibald S, Jackson S, Young JE (1999) Microsurgical reconstruction of the through-and-through defect in head and neck cancer: is it worth it? J Reconstr Microsurg 15:401–408

    CAS  PubMed  Google Scholar 

  50. Tsue TT, Desyatnikova SS, Deleyiannis FW, Futran ND, Stack BC Jr, Weymuller EA Jr et al (1997) Comparison of cost and function in reconstruction of the posterior oral cavity and oropharynx. Free vs pedicled soft tissue transfer. Arch Otolaryngol Head Neck Surg 123:731–737

    CAS  PubMed  Google Scholar 

  51. Valk PE, Pounds TR, Tesar RD, Hopkins DM, Haseman MK (1996) Cost-effectiveness of PET imaging in clinical oncology. Nucl Med Biol 23:737–743

    Article  CAS  PubMed  Google Scholar 

  52. Van Agthoven M, van Ineveld BM, de Boer MF, Leemans CR, Knegt PP, Snow GB et al (2001) The costs of head and neck oncology: primary tumours, recurrent tumours and long-term follow-up. Eur J Cancer 37:2204–2211

    Article  PubMed  Google Scholar 

  53. Virgo KS, Paniello RC, Johnson FE (1998) Costs of posttreatment surveillance for patients with upper aerodigestive tract cancer. Arch Otolaryngol Head Neck Surg 124:564–572

    CAS  PubMed  Google Scholar 

  54. Vokes EE, Weichselbaum RR, Lippman SM, Hong WK (1993) Head and neck cancer. N Engl J Med 328:184–194

    CAS  PubMed  Google Scholar 

  55. Zavras A, Andreopoulos N, Katsikeris N, Zavras D, Cartsos V, Vamvakidis A (2002) Oral cancer treatment costs in Greece and the effect of advanced disease. BMC Public Health 19:12

    Article  Google Scholar 

Download references

Acknowledgements

This research has been funded in part by Pharmacia Corporation (Milan, Italy). The authors do not perceive any conflict of interest relative to the content of this manuscript and their status either as employees of Pharmacia (M.T.) or as independent researchers whose work has been financially supported by Pharmacia (J.M.L., M.F.B., C.L.P.).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marco Turini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, J.M., Turini, M., Botteman, M.F. et al. Economic burden of head and neck cancer. HEPAC 5, 70–80 (2004). https://doi.org/10.1007/s10198-003-0204-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-003-0204-3

Keywords

Navigation