Comparing Survival of Oral Cancer Patients Before and After Launching of the Universal Coverage Scheme in Thailand

Background: As the treatment modalities for oral cancer have been relatively consistent during the last two decades, this study was conducted to compare survivals of oral cancer patients in Khon Kaen Province before and after the universal coverage scheme (UC) was launched in Thailand. Materials and Methods: The data were retrieved from the populationbased cancer registry of Khon Kaen for oral cancer patients diagnosed during 19922001 (preUC), and 20042012 (postUC). To compare survival of the two cohorts, Kaplan Meier and log rank tests were employed. Results: Of 1,196 patients, 65% were females and the median age was 65 years. The most common primary sites were lip (31.0%), tongue (29.9%), and buccal mucosa (14.6%). The proportion of early stage cancer increased from 20.4 % in preUC to 41.3% in postUC. The overall 5year survival rate was 36.5% (95% CI 32.640.9) for preUC and 32.4% (95% CI 28.836.4) for postUC. The declining survival was mainly due to an increasing proportion of tongue cancer. However, no survival improvement was demonstrated on subgroup analysis of the tongue cancer patients. Conclusions: After the universal coverage scheme had been launched, early diagnosis increased, but no significant gain in survival for oral cancer patients was achieved.