Changes in gingival cancer: burden of hospitalization and epidemiological evolution from 2001 to 2023 in Spain. a...

Gingival squamous cell carcinoma represents approximately 10% of oral cavity carcinomas. The Spanish Hospital Activity Registry (RAE) covers > 90% of the Spanish population and provides updated epidemiological data. This study aims to describe the epidemiological evolution of gingival cancer in Spain from 2001 to 2023 by analysing sex distribution, age groups, anatomical location (maxilla vs. mandible) and hospitalization costs.

This was a retrospective cohort study using RAE data from January 1, 2001, to December 31, 2023. We selected hospital admissions with primary or secondary diagnoses of gingival malignancy (ICD-9 code 143 and ICD-10 code C03), treatment, or regional spread related to the tumour. We selected only the first admission for each patient during the study period. Variables analysed: sex, age, location (maxilla/mandible), and economic cost adjusted to the 2023 Consumer Price Index.

A total of 7,327 admissions were identified, corresponding to 5,623 patients. The number of cases increased from 198 in 2001 to 315 in 2023 (+ 59.1%). The male: female ratio shifted from 1.3:1 (2001) to 0.8:1 (2023), with a female predominance consolidated after 2015. The mean age at diagnosis was greater in women (71.1 years) than in men (65.3 years), p < 0.001. When the location was specified, 63% were mandibular, and 37% were maxillary. The mean cost per admission rose from €7,007 to €13,114. The total hospital cost increased from €1.67 million (2001) to €4.69 million (2023), representing a 180% increase.

RAE is a valuable data source for monitoring cancer trends in Spain. Since 2015, there has been a sustained shift toward female predominance in the incidence of gingival cancer, with a greater diagnostic age in women. The economic burden of gingival cancer hospitalization has increased substantially, with both higher case numbers and increased costs per patient.