Head and neck squamous cell carcinoma epidemiology at diagnosis: A description of public and private health care systems in Brazil regarding tumor location, staging and risk factors

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Abstract

Objectives

There is a limited number of updated epidemiological Brazilian data on head and neck squamous cell carcinoma (HNSCC). This study aimed to describe demographic and clinical characteristics of HNSCC patients from Brazilian public and private systems.

Methods

This is a retrospective observational study that included patients diagnosed with HNSCC from Brazilian public and private settings from 2016 to 2018. As for the public scenario, data were drawn from the public hospital national cancer registry database. As for the private sector, the data were extracted from medical records of patients from Oncoclinicas, a large Brazilian oncology group.

Results

A total of 37,121 patients were included in the study, with 36,914 from the public and 207 from the private system. Patients in the public sector were younger than those in the private sector, with medians ages of 61.2 and 66.9 years, respectively. In both cohorts, a predominance of men with a history of tobacco and alcohol consumption and an advanced locoregional stage at diagnosis was observed. The main site of the primary tumor was the oropharynx in the private sector and oral cavity in the public sector. Among patients with oropharyngeal cancer, only those in the private sector were tested for HPV, with the majority being positive.

Conclusions

This real-world data study provides epidemiologic characteristics of patients with HNSCC in two different Brazilian healthcare settings, presenting relevant insights into possible opportunities for improvements in the patient's journey with HNSCC.

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头颈部鳞状细胞癌诊断时的流行病学:巴西公共和私营医疗系统在肿瘤位置、分期和风险因素方面的描述
目的巴西关于头颈部鳞状细胞癌(HNSCC)的最新流行病学数据数量有限。本研究旨在描述巴西公立和私立系统中HNSCC患者的人口统计学和临床特征。方法这是一项回顾性观察研究,纳入了2016年至2018年巴西公立和私立系统中确诊为HNSCC的患者。公共机构的数据来自公立医院国家癌症登记数据库。至于私营机构,数据来自巴西大型肿瘤集团Oncoclinicas的患者病历。结果共有37121名患者被纳入研究,其中36914名来自公立机构,207名来自私营机构。公立医院的患者比私立医院的患者年轻,年龄中位数分别为 61.2 岁和 66.9 岁。在这两组患者中,男性居多,且均有烟酒消费史,确诊时均处于局部晚期。私立医院的原发肿瘤主要位于口咽部,公立医院的原发肿瘤主要位于口腔。在口咽癌患者中,只有私立医院的患者接受了人乳头瘤病毒检测,而且大多数患者的检测结果呈阳性。结论:这项真实世界数据研究提供了巴西两种不同医疗环境中 HNSCC 患者的流行病学特征,为改善 HNSCC 患者的就医过程提供了可能的机会。
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