Medical cost in the last one month of life of Taiwanese oral cancer decedents from 2009 to 2011 by hierarchical generalized linear model using a random-intercept model.

<p>*Medical cost of aggressive care in the last one month of life US dollars 2,611±3,329.</p><p>**95% CI, 95% confidence interval.</p><p>Medical cost in the last one month of life of Taiwanese oral cancer decedents from 2009 to 2011 by hierarchical generalized linear model using a random-intercept model.</p

Factors associated with increased or decreased EOL expenditure in oral cancer decedents.

<p>Factors associated with increased or decreased EOL expenditure in oral cancer decedents.</p

Effect of age on survival rates of patients with oral cancer (<i>n</i>=2339).

<p>Effect of age on survival rates of patients with oral cancer (<i>n</i>=2339).</p

Impact of Young Age on the Prognosis for Oral Cancer: A Population-Based Study in Taiwan

<div><p>Background</p><p>Oral cancer leads to a considerable use of health care resources. Wide resection of the tumor and reconstruction with a pedicle flap/ free flap is widely used. This study was conducted to investigate if young age at the time of diagnosis of oral cancer requiring this treatment confers a worse prognosis.</p> <p>Methods</p><p>A total of 2339 patients who underwent resections for oral cancer from 2004 to 2005 were identified from The Taiwan National Health Insurance Research Database. Survival analysis, Cox proportional regression model, propensity scores, and sensitivity test were used to evaluate the association between 5-year survival rates and age.</p> <p>Results</p><p>In the Cox proportional regression model, the older age group (>65 years) had the worst survival rate (hazard ratio [HR], 1.80; 95% confidence interval [CI], 1.45-2.22; P<0.001). When analyzed using the propensity scores, the adjusted 5-year survival rates were also poorer for oral cancer patients with older age (>65 years), compared to those with younger age (<45 years) (P<0.001). In sensitivity test, the adjusted hazard ratio remained no statistically elevated in the younger age group (<45 years).</p> <p>Conclusions</p><p>For those oral cancer patients who underwent wide excision and reconstruction, young age did not confer a worse prognosis using a Cox proportional regression model, propensity scores or sensitivity test. Young oral cancer patients may be treated using general guidelines and do not require more aggressive treatment.</p> </div

The Combined Effect of Individual and Neighborhood Socioeconomic Status on Nasopharyngeal Cancer Survival

<div><p>Background</p><p>The relationship between individual and neighborhood socioeconomic status (SES) and mortality rates in patients with nasopharyngeal carcinoma (NPC) is unknown. This population-based study aimed to examine the association between SES and survival of patients with NPC in Taiwan.</p><p>Materials and Methods</p><p>A population-based follow-up study was conducted of 4691 patients diagnosed with NPC between 2002 and 2006. Each patient was traced to death or for 5 years. Individual SES was defined by enrollee job category. Neighborhood SES was based on household income dichotomized into advantaged and disadvantaged areas. Cox proportional hazards model was used to compare the death-free survival rates between the different SES groups after adjusting for possible confounding factors and risk factors.</p><p>Results</p><p>In NPC patients below the age of 65 years, 5-year overall survival rates were worst for those with low individual SES living in disadvantaged neighborhoods. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score), NPC patients with low individual SES residing in disadvantaged neighborhoods were found to have a 2-fold higher risk of mortality than patients with high individual SES residing in advantaged neighborhoods. We found no significant difference in mortality rates between different SES groups in NPC patients aged 65 and above.</p><p>Conclusions</p><p>Our findings indicate that NPC patients with low individual SES who live in disadvantaged neighborhoods have the higher risk of mortality than their more privileged counterparts. Public health strategies and welfare policies would be well advised to try to offset the inequalities in health care and pay more attention to addressing the needs of this vulnerable group.</p></div

Combined effect of individual SES and neighborhood SES on 5-year overall survival rates in nasopharyngeal cancer patients (n = 4691).

<p>Abbreviation: SES, socioeconomic status.</p

Sociodemographic characteristics by individual and neighborhood socioeconomic status.

*<p>Pearson’s chi-square test.</p

Survival curves by individual-level and neighborhood-level SES for NPC patients aged 65 years and above.

<p>Survival curves by individual-level and neighborhood-level SES for NPC patients aged 65 years and above.</p

Baseline characteristics (n = 4691).

<p>Abbreviation: SES, socioeconomic status.</p

Hazard ratios of individual SES for mortality in advantaged and disadvantaged neighborhoods^*.

<p>Abbreviation: Adjusted HR, adjusted hazard ratio; 95% CI, 95% confidence interval; SES, socioeconomic status.</p>*<p>Adjusted for the patients’ diagnosed age, gender, Charlson Comorbidity Index Score, urbanization and region of residence, adjuvant therapy, and hospital characteristics.</p