The Prevalence and Treatment Costs of Non-Melanoma Skin Cancer in Cluj-Napoca Maxillofacial Center

Background and Objectives: An increasing incidence of non-melanoma skin cancer (NMSC) is noted, as well as an increasing cost of the treatment, with NMSC becoming a public health problem. We aimed to investigate the prevalence and treatment costs of surgically treated NMSC from the Oral and Maxillofacial Surgery Department of Cluj-Napoca County Hospital. Materials and Methods: We retrospectively analyzed the clinical data and the charge data of hospitalization from the informatic system of Cluj-Napoca County Hospital. All patients benefited from standard surgical excision with the reconstruction of the post-excisional defect. A statistical analysis of the costs related to the patients’ features, period and conditions of hospitalization, materials, medication, and paraclinical investigations was performed. Results: Between 2015 and 2019, 133 patients with NMSC were addressed to our department, with basal cell carcinoma (BCC) being four-fold higher than squamous cell carcinoma (SCC). Most NMSC cases were diagnosed in stage I or II, and they benefited from local reconstruction. The treatment costs progressively increased in the last five years, reaching a total cost of EUR ~13.000 in 2019. The treatment cost per episode was higher for SCC compared to BCC, while the total cost of treatment in 5 years was higher for BCC. Low income, immunosuppression, comorbidities, flap reconstruction option, long-lasting surgery, and prolonged hospitalization were associated with an increased cost of the treatment. Conclusion: The prevalence and treatment cost of surgically treated NMSC of the head and neck region increased in the last five years, with high-cost drivers being related to patients and treatment options.

[1]  F. Bassetto,et al.  Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review , 2021, Frontiers in Oncology.

[2]  K. Sultanem,et al.  Prognostic factors of head and neck cutaneous squamous cell carcinoma: a systematic review , 2021, Journal of Otolaryngology - Head & Neck Surgery.

[3]  M. Koziej,et al.  Detailed head localization and incidence of skin cancers , 2021, Scientific Reports.

[4]  T. Hanna,et al.  Impact of the COVID-19 pandemic on skin cancer diagnosis: A population-based study , 2021, PloS one.

[5]  M. Błasińska-Morawiec,et al.  The incidence and clinical analysis of non-melanoma skin cancer , 2021, Scientific Reports.

[6]  A. Jemal,et al.  Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries , 2021, CA: a cancer journal for clinicians.

[7]  J. Califano,et al.  An Analysis of 1-Year Charges for Head and Neck Cancer: Targets for Value-Based Interventions , 2020, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[8]  E. Kasumagić-Halilović,et al.  A Clinical Study of Basal Cell Carcinoma , 2019, Medical archives.

[9]  Samuel J. Lin,et al.  Regional incidence of and reconstructive management patterns in melanoma and nonmelanoma skin cancer of the head and neck: A 3-year analysis in the inpatient setting. , 2019, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[10]  V. Kähäri,et al.  Complement System in Cutaneous Squamous Cell Carcinoma , 2019, International journal of molecular sciences.

[11]  J. Shah,et al.  Changes in the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging of Head and Neck Cancer: Rationale and Implications , 2019, Current Oncology Reports.

[12]  S. Sarker,et al.  Estimating the health care costs of non-melanoma skin cancer in Saskatchewan using physician billing data. , 2019, Current oncology.

[13]  E. Adjei Boakye,et al.  Comparison of the Financial Burden of Survivors of Head and Neck Cancer With Other Cancer Survivors , 2019, JAMA otolaryngology-- head & neck surgery.

[14]  B. Murthy,et al.  A review of ASA physical status – historical perspectives and modern developments , 2019, Anaesthesia.

[15]  A. Costa-Pereira,et al.  Skin cancer healthcare impact: A nation-wide assessment of an administrative database. , 2018, Cancer epidemiology.

[16]  P. Demers,et al.  The economic burden of occupational non-melanoma skin cancer due to solar radiation , 2018, Journal of occupational and environmental hygiene.

[17]  P. Romano,et al.  Hospitalization Rates and Predictors of Rehospitalization Among Individuals With Advanced Cancer in the Year After Diagnosis. , 2017, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  V. Rao,et al.  The Economics of Skin Cancer: An Analysis of Medicare Payment Data , 2016, Plastic and reconstructive surgery. Global open.

[19]  S. Whitaker,et al.  Non-melanoma skin cancer: United Kingdom National Multidisciplinary Guidelines , 2016, The Journal of Laryngology & Otology.

[20]  Grey Giddins,et al.  Statistics , 2016, The Journal of hand surgery, European volume.

[21]  M. Crane,et al.  Estimating the economic costs of skin cancer in New South Wales, Australia , 2015, BMC Public Health.

[22]  A. Marzuka,et al.  Basal Cell Carcinoma: Pathogenesis, Epidemiology, Clinical Features, Diagnosis, Histopathology, and Management , 2015, The Yale journal of biology and medicine.

[23]  K.,et al.  Prevalence and costs of skin cancer treatment in the U.S., 2002-2006 and 2007-2011. , 2015, American journal of preventive medicine.

[24]  L. Iancu,et al.  Epidemiological and pathological aspects of skin cancer in North East of Romania. , 2014, Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi.

[25]  C. Reyes,et al.  Age distribution of patients with advanced non-melanoma skin cancer in the United States , 2013, Archives of Dermatological Research.

[26]  W. Hwang,et al.  Evaluation of AJCC tumor staging for cutaneous squamous cell carcinoma and a proposed alternative tumor staging system. , 2013, JAMA dermatology.

[27]  J. Leonardi-Bee,et al.  A systematic review of worldwide incidence of nonmelanoma skin cancer , 2012, The British journal of dermatology.

[28]  Eric J Feuer,et al.  Projections of the cost of cancer care in the United States: 2010-2020. , 2011, Journal of the National Cancer Institute.

[29]  S. Dalton,et al.  Socioeconomic status and non-melanoma skin cancer: a nationwide cohort study of incidence and survival in Denmark. , 2010, Cancer epidemiology.

[30]  David Howard,et al.  Cancer treatment cost in the United States , 2010, Cancer.

[31]  Corwin M Zigler,et al.  Analysis of national skin cancer expenditures in the United States Medicare population, 2013 , 2019, Journal of the American Academy of Dermatology.

[32]  M. Iglesias,et al.  Oncologic surgery of the eyelid and orbital region. , 2015, Actas dermo-sifiliograficas.

[33]  S. Çelebi̇oğlu,et al.  Reconstruction of periorbital region defects: A retrospective study , 2014, Annals of maxillofacial surgery.

[34]  Martin A Weinstock,et al.  Non-melanoma skin cancer incidence and impact of skin cancer screening on incidence. , 2014, The Journal of investigative dermatology.

[35]  C. Compton,et al.  AJCC Cancer Staging Manual , 2002, Springer New York.