4 research outputs found
The cost of anal cancer in England: Retrospective hospital data analysis and Markov model
Background: Anal cancer requires a multidisciplinary approach to treatment with often complex interventions. Little is known regarding the associated costs and resource use. Methods: Patient records were extracted from a national hospital database to estimate the number of patients treated for anal cancer in England. Identified resource use was linked to published UK cost estimates to quantify the reimbursement of treatment through the Payment by Results system. A mathematical model was developed simultaneously to validate findings and to calculate the average 10-year cost of treating a squamous cell anal carcinoma case from diagnosis. The model utilised data from the Association of Coloproctology of Great Britain and Ireland's anal cancer position statement. Results: On average, 1,564 patients were admitted to hospital and 389 attended an outpatient facility per year. The average annual cost per inpatient and outpatient ranged from Ā£4,562-Ā£5,230 and Ā£1,146-Ā£1,335, respectively. Based on the model estimates, the inflated cost per case was between Ā£16,470-Ā£16,652. Results were most sensitive to the mode of admission for primary treatment and the costs of staging/diagnosis (inflated range: Ā£14,309-Ā£23,264). Conclusions: Despite limitations in the available data, these results indicate that the cost of treating anal cancer is significant. Further observational work is required in order to verify these findings.</p
The cost of anal cancer in England: retrospective hospital data analysis and Markov model
BACKGROUND: Anal cancer requires a multidisciplinary approach to treatment with often complex interventions. Little is known regarding the associated costs and resource use. METHODS: Patient records were extracted from a national hospital database to estimate the number of patients treated for anal cancer in England. Identified resource use was linked to published UK cost estimates to quantify the reimbursement of treatment through the Payment by Results system. A mathematical model was developed simultaneously to validate findings and to calculate the average 10-year cost of treating a squamous cell anal carcinoma case from diagnosis. The model utilised data from the Association of Coloproctology of Great Britain and Ireland's anal cancer position statement. RESULTS: On average, 1,564 patients were admitted to hospital and 389 attended an outpatient facility per year. The average annual cost per inpatient and outpatient ranged from Ā£4,562-Ā£5,230 and Ā£1,146-Ā£1,335, respectively. Based on the model estimates, the inflated cost per case was between Ā£16,470-Ā£16,652. Results were most sensitive to the mode of admission for primary treatment and the costs of staging/diagnosis (inflated range: Ā£14,309-Ā£23,264). CONCLUSIONS: Despite limitations in the available data, these results indicate that the cost of treating anal cancer is significant. Further observational work is required in order to verify these findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2458-14-1123) contains supplementary material, which is available to authorized users
Prevalence of human papillomavirus in head and neck cancers in European populations: a meta-analysis
Pregnancy and neonatal outcomes of COVID -19: coreporting of common outcomes from PAN-COVID and AAP-SONPM registries
Objective
Few large cohort studies have reported data on maternal, fetal, perinatal and neonatal outcomes associated with severe acute respiratory syndrome coronavirus 2 (SARSāCoVā2) infection in pregnancy. We report the outcome of infected pregnancies from a collaboration formed early during the pandemic between the investigators of two registries, the UK and Global Pregnancy and Neonatal outcomes in COVIDā19 (PANāCOVID) study and the American Academy of Pediatrics (AAP) Section on NeonatalāPerinatal Medicine (SONPM) National Perinatal COVIDā19 Registry.
Methods
This was an analysis of data from the PANāCOVID registry (1 January to 25 July 2020), which includes pregnancies with suspected or confirmed maternal SARSāCoVā2 infection at any stage in pregnancy, and the AAPāSONPM National Perinatal COVIDā19 registry (4 April to 8 August 2020), which includes pregnancies with positive maternal testing for SARSāCoVā2 from 14ādays before delivery to 3ādays after delivery. The registries collected data on maternal, fetal, perinatal and neonatal outcomes. The PANāCOVID results are presented overall for pregnancies with suspected or confirmed SARSāCoVā2 infection and separately in those with confirmed infection.
Results
We report on 4005 pregnant women with suspected or confirmed SARSāCoVā2 infection (1606 from PANāCOVID and 2399 from AAPāSONPM). For obstetric outcomes, in PANāCOVID overall and in those with confirmed infection in PANāCOVID and AAPāSONPM, respectively, maternal death occurred in 0.5%, 0.5% and 0.2% of cases, early neonatal death in 0.2%, 0.3% and 0.3% of cases and stillbirth in 0.5%, 0.6% and 0.4% of cases. Delivery was preterm (<ā37āweeks' gestation) in 12.0% of all women in PANāCOVID, in 16.1% of those women with confirmed infection in PANāCOVID and in 15.7% of women in AAPāSONPM. Extreme preterm delivery (<ā27āweeks' gestation) occurred in 0.5% of cases in PANāCOVID and 0.3% in AAPāSONPM. Neonatal SARSāCoVā2 infection was reported in 0.9% of all deliveries in PANāCOVID overall, in 2.0% in those with confirmed infection in PANāCOVID and in 1.8% in AAPāSONPM; the proportions of neonates tested were 9.5%, 20.7% and 87.2%, respectively. The rates of a smallāforāgestationalāage (SGA) neonate were 8.2% in PANāCOVID overall, 9.7% in those with confirmed infection and 9.6% in AAPāSONPM. Mean gestationalāageāadjusted birthāweight Zāscores were ā0.03 in PANāCOVID and ā0.18 in AAPāSONPM.
Conclusions
The findings from the UK and USA registries of pregnancies with SARSāCoVā2 infection were remarkably concordant. Preterm delivery affected a higher proportion of women than expected based on historical and contemporaneous national data. The proportions of pregnancies affected by stillbirth, a SGA infant or early neonatal death were comparable to those in historical and contemporaneous UK and USA data. Although maternal death was uncommon, the rate was higher than expected based on UK and USA population data, which is likely explained by underascertainment of women affected by milder or asymptomatic infection in pregnancy in the PANāCOVID study, although not in the AAPāSONPM study. The data presented support strong guidance for enhanced precautions to prevent SARSāCoVā2 infection in pregnancy, particularly in the context of increased risks of preterm delivery and maternal mortality, and for priority vaccination of pregnant women and women planning pregnancy. Copyright Ā© 2021 ISUOG. Published by John Wiley & Sons Ltd