(0676) Lost Productivity Due to Head and Neck Cancer Mortality in the United States

Introduction: Head and neck cancer (HNC) rates are rising, and survival remains poor. HPV has been associated with this HNC increase and fortunately is associated with improved survival. Given these trends and that more than 20% of cases occur in patients younger than 55, there is a potentially significant societal economic cost when lives are lost due to HNC. We present the first study examining loss of productivity due to HNC in the US.

Methods: A cross-sectional study of patient records of HNC diagnosis between 2014 and 2018 resulting in death was extracted from the NCDB. Life expectancy was extracted from the CDC. Macro and microeconomic data and Medicaid adoption data were extracted from the Bureau of Economic Analysis, Bureau of Labor Statistics, and the Kaiser Family Foundation. Descriptive statistics, calculations of years of life lost, years of productive life lost, present value of future lost productivity (PVFLP), and comparative statistics were performed.

Results: In total, 71,951 patient records were extracted. Male sex comprised 52,943 (73%) of records and the average age at diagnosis was 67 (SD = 12). Most cancers diagnosed were lip, oral cavity, and pharynx (n = 58,527, 81.3%), were stage IV (n = 39,032, 54.2%), and were moderately or poorly differentiated (n = 38,064, 61.9%). On average, patients lost 7.9 years of life (SD = 12) compared to the US life expectancy and 3.5 years of productive life (SD = 12). The mean PVFLP per life lost was $1,678,245.90 (SD = 1,459,614.60). PVFLP differed significantly by region (p = 0.02), with the South having the highest mean loss ($1,592,426.30, SD = 1,300,148.17).

Conclusions: The average economic loss per life lost to HNC in the US is over $1.6 million. The economic impact is likely to be even more substantial when taking into account individuals who are disabled but alive due to cancer treatment. This compelling statistic underscores the significance of preventative counseling for HNC, emphasizing the value of initiatives such as HPV vaccination and measures to mitigate risk factors like smoking.