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.
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.
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.
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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Squamous cell carcinoma
Union for International Cancer Control
Gross domestic product
Gross regional product
National Bureau of Statistics of China
Purchasing power parity
World Health Organization
- χ2 test:
Analysis of variance
Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55(2):74–108. https://doi.org/10.3322/canjclin.55.2.74
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424. https://doi.org/10.3322/caac.21492
Neville BW, Day TA (2002) Oral cancer and precancerous lesions. CA Cancer J Clin 52(4):195–215. https://doi.org/10.3322/canjclin.52.4.195
Healy CM, Moran GP (2019) The microbiome and oral cancer: more questions than answers. Oral Oncol 89:30–33. https://doi.org/10.1016/j.oraloncology.2018.12.003
Brierley JD, Gospodarowicz MK, Wittekind C (2017) TNM classification of malignant tumours--8th edition. John Wiley & Sons, Inc, Oxford
Sarris EG, Harrington KJ, Saif MW, Syrigos KN (2014) Multimodal treatment strategies for elderly patients with head and neck cancer. Cancer Treat Rev 40(3):465–475. https://doi.org/10.1016/j.ctrv.2013.10.007
Dimovska EO, Clibbon JJ, Moncrieff MD, Heaton MJ, Figus A (2016) Microsurgical reconstructions for head and neck cancers in elderly aged >80 years: an analysis of surgical outcomes and quality of life. Ann Surg Oncol 23(5):1684–1692. https://doi.org/10.1245/s10434-015-5049-3
National Center for Cardiovascular Diseases, China (2017) Report on Cardiovascular Diseases in China 2017. Encyclopedia of China Publishing House, Beijing. http://www.nccd.org.cn/News/Columns/Index/1089. Accessed 10 May 2020
Ma RCW (2018) Epidemiology of diabetes and diabetic complications in China. Diabetologia 61(6):1249–1260. https://doi.org/10.1007/s00125-018-4557-7
Weng JP, Bi Y (2015) Epidemiological status of chronic diabetic complications in China. Chin Med J 128(24):3267–3269. https://doi.org/10.4103/0366-6999.171350
Zhou M, Astell-Burt T, Bi Y, Feng X, Jiang Y, Li Y, Page A, Wang L, Xu Y, Wang L, Zhao W, Ning G (2015) Geographical variation in diabetes prevalence and detection in China: multilevel spatial analysis of 98,058 adults. Diabetes Care 38(1):72–81. https://doi.org/10.2337/dc14-1100
Kasper DL, Braunwald E, Hauser S, Longo D, Jameson JL, Fauci AS (2004) Harrison's Principles of Intrenal Medicine, 16th edition. McGraw-Hill Professional, New York
Wang S, Wang Z, Peng L, Zhang X, Li J, Yang Y, Hu B, Ning S, Zhang B, Han J, Song Y, Sun G, Nie Z (2018) Gender, age, and concomitant diseases of melanosis coli in China: a multicenter study of 6,090 cases. PeerJ 6:e4483. https://doi.org/10.7717/peerj.4483
Robert S, House JS (1996) SES differentials in health by age and alternative indicators of SES. J Aging Health 8(3):359–388. https://doi.org/10.1177/089826439600800304
Marmot M (2002) The influence of income on health: views of an epidemiologist. Health Aff (Millwood) 21(2):31–46. https://doi.org/10.1377/hlthaff.21.2.31
Geiss LS, Wang J, Cheng YJ, Thompson TJ, Barker L, Li Y, Albright AL, Gregg EW (2014) Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980-2012. JAMA 312(12):1218–1226. https://doi.org/10.1001/jama.2014.11494
Ford ES, Li C, Zhao G, Pearson WS, Capewell S (2009) Trends in the prevalence of low risk factor burden for cardiovascular disease among United States adults. Circulation 120(13):1181–1188. https://doi.org/10.1161/CIRCULATIONAHA.108.835728
Rigotti NA, Wakefield M (2012) Real people, real stories: a new mass media campaign that could help smokers quit. Ann Intern Med 157(12):907–909. https://doi.org/10.7326/0003-4819-156-1-201201010-00541
Tsoukalas TH, Glantz SA (2003) Development and destruction of the first state funded anti-smoking campaign in the USA. Tob Control 12(2):214–220. https://doi.org/10.1136/tc.12.2.214
McCoy D, Kembhavi G, Patel J, Luintel A (2009) The Bill & Melinda Gates Foundation's grant-making programme for global health. Lancet (London, England) 373(9675):1645–1653. https://doi.org/10.1016/s0140-6736(09)60571-7
De Maeseneer J, van Weel C, Egilman D, Mfenyana K, Kaufman A, Sewankambo N, Flinkenflogel M (2008) Funding for primary health care in developing countries. BMJ (Clinical research ed) 336(7643):518–519. https://doi.org/10.1136/bmj.39496.444271.80
Zhu Z, Zhu X, Lu C, Zhang W, Xie H, Liu C, Ma J, Meng Q, Zhu W, Yu H, Liu Y, Meng C, Cui H, Jia M, Ye L, Wu C, Li X (2000) Tabulation on the 2000 Population census of the People's Republic of China. Census Office of the State Council, Department of population and employment statistics, National Bureau of Statistics of China. http://www.stats.gov.cn/tjsj/pcsj/rkpc/5rp/index.htm. Accessed 10 May 2020
Ma J, Zhang W, Feng N, Yan J, Zhao Y, Li X, Meng Q, Peng Y, Hu Y, Cui H, Zhang Z, Ye L, Liu Y, Li R, Li Z, Yang J, Chen X, Wu C, Xu L, Xu T, Guo D, Liang E (2010) Tabulation on the 2010 Population census of the People's Republic of China. Census Office of the State Council, Department of population and employment statistics, National Bureau of Statistics of China. http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm. Accessed 10 May 2020
Department of Ageing and Life Course, World Health Organization (2015) China Country Assessment Report on Ageing and Health. World Health Organization, Geneva. https://www.who.int/ageing/publications/china-country-assessment/en/. Accessed 10 May 2020
Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q, Li Y, Zhao Z, Qin X, Jin D, Zhou M, Tang X, Hu Y, Wang L (2017) Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA 317(24):2515–2523. https://doi.org/10.1001/jama.2017.7596
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.
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.
Ethics approval and consent to participate
The Ethics Committee of Guangxi Medical University approved the present study.
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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
- Socioeconomic status
- Oral cancer
- Health care expenditure