The association between the socioeconomic status and systemic comorbidities in patients with oral cancers: a retrospective study in Guangxi Province

Abstract

Background

It is unclear whether and how the prevalence of systemic comorbidities in oral cancer patients would change with socioeconomic development.

Materials and methods

A retrospective study of association between socioeconomy and prevalence of systemic comorbidities in oral cancer patients from 2003 to 2017 was performed in Guangxi Province, a southwestern part of China. According to the Union for International Cancer Control (UICC) classification, 2814 patients with squamous cell carcinoma (SCC) of the lip, oral cavity, and oropharynx and 423 patients with ameloblastoma were collected and assigned to the oral cancer group and control group, respectively. Then, comparisons between the socioeconomy and healthcare expenditure in Guangxi Province, the whole China, and the USA were carried out.

Results

The prevalence of systemic comorbidities in oral cancer patients increased from 0.820% in 2003 to 32.302% in 2017, which was significantly higher than that in non-cancer patients(P < 0.001) and was positively correlated with the increase in gross regional product (GRP) (r = 0.911, P < 0.001) and per capita GRP (r = 0.910, P < 0.001) of Guangxi Province. In addition, the prevalence of cardiovascular diseases has the largest correlation coefficient with GRP(r = 0.957, P < 0.001) and per capita GRP(r = 0.959, P < 0.001). And the prevalence of endocrine diseases increased by 13.402% and exhibited the most significant increase in 15 years. The per capita health care expenditure of Guangxi Province and whole China was nearly equal (P = 0.353). Although the health care expenditure of Guangxi Province had been increasing year by year, its proportion in GRP remains far below that of the USA.

Conclusions

With socioeconomic growth, oral cancer patients in Guangxi Province are more common to comorbid with systemic diseases. Cardiovascular and endocrine diseases may be the most susceptible systemic comorbidities in oral cancer patients to the socioeconomic status. In order to control the prevalence of systemic diseases, the government of Guangxi Province may need to expend more budgets in the health care.

Clinical relevance

Clinicians need to pay more attention to the detection of systemic comorbidities and the concept of multidisciplinary collaboration. Instructing oral cancer patients to treat and control systemic comorbidities is also an indispensable part in the treatment of oral cancer.

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Abbreviations

SCC:

Squamous cell carcinoma

UICC:

Union for International Cancer Control

GDP:

Gross domestic product

GRP:

Gross regional product

NBS:

National Bureau of Statistics of China

PPP:

Purchasing power parity

WHO:

World Health Organization

χ2 test:

Chi-square test

ANOVA:

Analysis of variance

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Acknowledgements

We thank our collaborators at the Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University for their contribution to the collection of the data used for this study.

Financial disclosures

This work was supported by National Natural Science Foundation of China (81360403), Natural Science Foundation of Guangxi Province (2019GXNSFAA185054), and the Medical and Health Appropriate Technology Development and Promotion Project of Guangxi Province (S2018067) to Feixin Liang.

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Contributions

Zhuoqian Zhou participated in the design of the study, carried out the data analysis, interpreted the data and drafted and revised the manuscript. Qinchao Tang assisted with interpretation of study results and revising of the manuscript. Xueru Chen assisted with interpretation of study results and revising of the manuscript. Tao Yu assisted with the data analysis and revising of the manuscript. Wanqian Huang coordinated the data collection and assisted with revising the manuscript. Feixin Liang conceived and directed the study, interpreted the data and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Feixin Liang.

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The Ethics Committee of Guangxi Medical University approved the present study.

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Cite this article

Zhou, Z., Tang, Q., Chen, X. et al. The association between the socioeconomic status and systemic comorbidities in patients with oral cancers: a retrospective study in Guangxi Province. Clin Oral Invest (2020). https://doi.org/10.1007/s00784-020-03405-2

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Keywords

  • Socioeconomic status
  • Comorbidity
  • Oral cancer
  • Health care expenditure