Oral pharyngeal laryngeal and lung cancer discharge trends in Department of Veterans Affairs Hospitals

OBJECTIVE:

This paper describes trends in oral and pharyngeal (O/P) cancer diagnoses in Department of Veterans Affairs (VA) hospitals from 1983 to 1993 and compares these trends to those of laryngeal and lung cancers.

METHODS:

The VA patient treatment file was used to identify unique hospital discharges from 1983 to 1993 having ICD-9-CM codes for O/P, laryngeal, and lung cancers. Descriptive statistics were tabulated to determine prevalence and distribution. Trends of change over time were analyzed using regression analyses of the percent rate on year.

RESULTS:

Between 1983 and 1993 the annual number of O/P cases among users of VA hospitals decreased from 4,983 to 3,298. Despite overall declines in O/P cancer discharges in VA, cancer of the pharynx, tongue, and salivary gland continues to increase. O/P cancer in younger persons also continues to increase in VA. Overall, laryngeal cancers significantly increased, while no significant change was associated with lung cancer.

CONCLUSIONS:

VA needs to evaluate the changes in the patterns of O/P cancer to ascertain whether this represents a shift in care from inpatient to outpatient care. VA should seek further information regarding these trends to better plan, implement, and evaluate programs to provide early diagnosis and treatment targeted to veterans.