Oral oncology · 2026
Early diagnosis and treatment of oral cancer in workers was associated with reduced losses of healthy life expectancy and productivity: real-world evidence from Taiwan during 2010-2019.
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Huang Cheng-Chih, Hsiao Jenn-Ren, Wang Wei-Ming, Wang Fuhmei, Wang Jung-Der
Аннотация
OBJECTIVES: We assessed the expected losses of life expectancy (LE), quality of life (QoL), lifetime employment duration (LED), and lifetime productivity (LP) among workers with oral cancer (OC) in Taiwan.
MATERIALS AND METHODS: We linked five nationwide administrative databases in Taiwan and collected data on 22,908 pathologically verified OC workers from 2010 to 2019. Using a rolling algorithm, we estimated lifetime survival functions to obtain LEs. We abstracted each OC patient's employment status and insured salaries to estimate LEDs and LP. Using the EQ-5D-3L QoL questionnaire repeatedly measured in 383 workers with OC at a single medical center, we multiplied the mean utility by survival rates to calculate quality-adjusted life expectancy (QALE). Finally, these estimates were compared with age-, sex-, and calendar-year-matched referents from vital statistics to estimate expected losses of LE, QALE, LED, and LP among workers with OC.
RESULTS: The earlier the stage, the lower the losses of QALEs and LP, with losses of 12.2 ± 4.3, 13.7 ± 2.5, 17.7 ± 2.3, and 21.4 ± 0.6 QALYs, respectively, for stages I-IV. The LED for stages I-IV were 8.4 ± 0.4, 6.9 ± 0.2, 5.6 ± 0.3, and 3.6 ± 0.2 years, respectively, corresponding with loss-of-LED -0.2 ± 0.4, 1.1 ± 0.2, 2.8 ± 0.3, and 4.4 ± 0.2 years, respectively. The LP for stages I-IV were US$122,929 ± 6440, 98,521 ± 2206, 77,636 ± 4625, and 48,887 ± 2170, respectively, which were equivalent to LP losses of 15.8 ± 4.7%, 31.0 ± 1.5%, 48.6 ± 2.8%, and 65.8 ± 1.6%, respectively.
CONCLUSION: The earlier the stage of OC diagnosis and treatment, the lower the losses of QALE, lifetime employment years, and LP. The above evidence would be useful for improving the incentive to screen among the target population.
MATERIALS AND METHODS: We linked five nationwide administrative databases in Taiwan and collected data on 22,908 pathologically verified OC workers from 2010 to 2019. Using a rolling algorithm, we estimated lifetime survival functions to obtain LEs. We abstracted each OC patient's employment status and insured salaries to estimate LEDs and LP. Using the EQ-5D-3L QoL questionnaire repeatedly measured in 383 workers with OC at a single medical center, we multiplied the mean utility by survival rates to calculate quality-adjusted life expectancy (QALE). Finally, these estimates were compared with age-, sex-, and calendar-year-matched referents from vital statistics to estimate expected losses of LE, QALE, LED, and LP among workers with OC.
RESULTS: The earlier the stage, the lower the losses of QALEs and LP, with losses of 12.2 ± 4.3, 13.7 ± 2.5, 17.7 ± 2.3, and 21.4 ± 0.6 QALYs, respectively, for stages I-IV. The LED for stages I-IV were 8.4 ± 0.4, 6.9 ± 0.2, 5.6 ± 0.3, and 3.6 ± 0.2 years, respectively, corresponding with loss-of-LED -0.2 ± 0.4, 1.1 ± 0.2, 2.8 ± 0.3, and 4.4 ± 0.2 years, respectively. The LP for stages I-IV were US$122,929 ± 6440, 98,521 ± 2206, 77,636 ± 4625, and 48,887 ± 2170, respectively, which were equivalent to LP losses of 15.8 ± 4.7%, 31.0 ± 1.5%, 48.6 ± 2.8%, and 65.8 ± 1.6%, respectively.
CONCLUSION: The earlier the stage of OC diagnosis and treatment, the lower the losses of QALE, lifetime employment years, and LP. The above evidence would be useful for improving the incentive to screen among the target population.