Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data

Abstract

AbstractObjectivesThis study compared prevalence, incidence, mortality rates, treatment costs, and risk factors for oral and oropharyngeal cancer (OC/OPC) between two large cohorts of adults in 2012–2019.MethodsMedicaid and commercial claims data were from the IBM Watson Health MarketScan Database. Logistic regression analyses estimated incidence and risk factors for OC/OPC. Mortality was calculated by merging deceased individuals’ Medicaid files with those of the existing cancer cohort. Costs were calculated by summing costs of outpatient and inpatient services.ResultsThe prevalence of OC/OPC in the Medicaid cohort decreased each year (129.8 cases per 100,000 enrollees in 2012 to 88.5 in 2019); commercial enrollees showed a lower and more stable prevalence (64.7 per 100,000 in 2012 and 2019). Incidence trended downward in both cohorts, with higher incidence in the Medicaid (51.4–37.6 cases per 100,000) than in the commercial cohort (31.9–31.0 per 100,000). OC/OPC mortality rates decreased in the Medicaid cohort during 2012–2014 but increased in the commercial cohort. Total OC/OPC treatment costs were higher for commercial enrollees by an average of $8.6 million during 2016–2019. In both cohorts, incidence of OC/OPC was higher among adults who were older, male, white, used tobacco or alcohol, or had prior HIV/AIDS diagnosis, and lower among those who had seen a dentist within the prior year.ConclusionsMedicaid enrollees experienced higher OC/OPC incidence, prevalence, and mortality compared with commercially insured adults. Having seen a dentist within the prior year was associated with a lower risk of OC/OPC diagnosis.