- Volume 17 Issue 7
DOI QR Code
Comparing Survival of Oral Cancer Patients Before and After Launching of the Universal Coverage Scheme in Thailand
- Sungwalee, Waraporn (Department of Epidemiology, Faculty of Public Health, Khon Kaen University) ;
- Vatanasapt, Patravoot (Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University) ;
- Suwanrungruang, Krittika (Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University) ;
- Promthet, Supannee (Department of Epidemiology, Faculty of Public Health, Khon Kaen University)
- Published : 2016.07.01
Background: As the treatment modalities for oral cancer have been relatively consistent during the last two-decades, this study was conducted to compare survivals of oral cancer patients in Khon Kaen Province before and after the universal coverage scheme (UC) was launched in Thailand. Materials and Methods: The data were retrieved from the population-based cancer registry of Khon Kaen for oral cancer patients diagnosed during 1992-2001 (pre-UC), and 2004-2012 (post-UC). To compare survival of the two cohorts, Kaplan Meier and log rank tests were employed. Results: Of 1,196 patients, 65% were females and the median age was 65 years. The most common primary sites were lip (31.0%), tongue (29.9%), and buccal mucosa (14.6%). The proportion of early stage cancer increased from 20.4 % in pre-UC to 41.3% in post-UC. The overall 5-year survival rate was 36.5% (95% CI =32.6-40.9) for pre-UC and 32.4% (95% CI = 28.8-36.4) for post-UC. The declining survival was mainly due to an increasing proportion of tongue cancer. However, no survival improvement was demonstrated on subgroup analysis of the tongue cancer patients. Conclusions: After the universal coverage scheme had been launched, early diagnosis increased, but no significant gain in survival for oral cancer patients was achieved.
Survival;oral cancer;universal coverage scheme;Thailand
- Esteban D, Whelan S, Laudico A, Parkin DM (1995). Manual for cancer registry personnel. Lyon, France: IARC Press; 1995 .
- Ferlay J, Soerjomataram I, Ervik M, et al (2016). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBaseNo.11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013 [cited 2016 Jun 1].
- Forman D, Bray F, Brewster DH, et al (2014). editors. Cancer Incidence in Five Continents. S.l.: World Health Organizat, 1435.
- Gatta G, Botta L, Sanchez MJ, et al (2015). Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: The EUROCARE-5 population-based study. Eur J Cancer. 2015.
- Intragumtornchai T, Bunworasate U, Siritanaratkul N, et al (2013). Inferior progression-free survival for Thai patients with diffuse large B-cell lymphoma treated under Universal Coverage Scheme: the impact of rituximab inaccessability. Leuk Lymphoma, 54, 83-9. https://doi.org/10.3109/10428194.2012.698739
- Joseph LJ, Goodman M, Higgins K, et al (2015). Racial disparities in squamous cell carcinoma of the oral tongue among women: a SEER data analysis. Oral Oncol, 51, 586-92. https://doi.org/10.1016/j.oraloncology.2015.03.010
- Maruthappu M, Watkins J, Noor AM, et al (2016). Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990-2010: a longitudinal analysis. Lancet, 25.
- Schwam ZG, Judson BL (2016). Improved prognosis for patients with oral cavity squamous cell carcinoma: Analysis of the National Cancer Database 1998-2006. Oral Oncol, 52, 45-51. https://doi.org/10.1016/j.oraloncology.2015.10.012
- Sermsri N, Boonpipattanapong T, Prechawittayakul P, Sangkhathat S (2014). Influence of payer source on treatment and outcomes in colorectal cancer patients in a university hospital in Thailand. Asian Pac J Cancer Prev, 15, 9015-9. https://doi.org/10.7314/APJCP.2014.15.20.9015
- Sohn M. Globalization of public health law and ethics. Asia Pac J Public Health. 2012 Sep;24(5):851-5. https://doi.org/10.1177/1010539512462501
- Suntorntham S, Chongudomsuk P, Uasiriwan B (2012). Thai health insurance system. Bangkok. Thailand: National Health Security Office.
- Tangcharoensathien V, Prakongsai P, Limwattananon S, Patcharanarumol W, Jongudomsuk P (2009). From targeting to universality: lessons from the health system in thailand. in: townsend p, editor. building decent societies: rethinking the role of social security in development. Hampshire: Palgrave Macmillan, 2009, 310-22.
- Thai Association of Radiation Oncology - THAS Annual Survey - Services, Manpower, and Equipments in Thailand Radiotherapy Centers [Internet]. 2015 [cited 2016 Jun 30].
- Vatanasapt P, Suwanrungruang K, Kamsa-Ard S, Promthet S, Parkin MDM (2011). Epidemiology of oral and pharyngeal cancers in Khon Kaen, Thailand: a high incidence in females. Asian Pac J Cancer Prev, 12, 2505-8.
$\mid$Health and human rights [Internet]. WHO. 2015 [cited 2016 Jun 30]. Available from: http://www.who.int/mediacentre/factsheets/fs323/en/
- WHO (2015). Health in 2015: From MDGs, Millennium Development Goals, to SDGs, Sustainable Development Goals. 1 edition. World Health Organization; 2016. 212 p.
- WHO. Tracking Universal Health Coverage: First Global Monitoring Report. 1 edition. World Health Organization; 2015. 9.
- Wibulpolprasert S (2012). Thailand Health Profile Report 2008-2010 [Internet]. 2012 [cited 2016 May 6]. Available from: http://www.moph.go.th/ops/thp/index.php?option=com_content&task=view&id=176&Itemid=2