Elsevier

Journal of Voice

Volume 34, Issue 1, January 2020, Pages 100-104
Journal of Voice

Trends in the Incidence and Treatment of Benign Vocal Fold Lesions in Korea, 2006–2015: A Nationwide Population-based Study

https://doi.org/10.1016/j.jvoice.2018.08.005Get rights and content

Summary

Objective

The aim of this study was to determine the prevalence and demographics of benign vocal fold lesions (BVFL) and trends in its treatment in Korea based on data collected from the National Health Insurance Service database.

Material and Methods

Data for patients diagnosed with BVFL (ICM-10 codes J381, J382, J384) from 2006 to 2015 were selected for analysis. Patient characteristics, including sex, age, income, area of residence, and comorbidity, were analyzed. Treatment was divided into surgical management and conservative management using operation codes.

Results

The prevalence and incidence of BVFL increased from 7.07% and 5.29%, respectively, in 2006 to 12.47% and 7.98% in 2015. Compared with the non-BVFL population, patients with BVFL were more likely to be female, reside in an urban area, and have gastroesophageal reflux disease. There was no significant change in the incidence of surgical treatment during the study period (around 6000 per year); however, the surgical treatment rate decreased from 19.29% to 8.38%. The probability of undergoing surgical treatment for BVFL was higher in men, those aged 50–59 years, and those in the lowest quartile for income, except for the medical aid group.

Conclusion

In Korea, there was an increase in the number of patients diagnosed with BVFL and a decrease in the operation rate for this condition between 2006 and 2015. Diagnosis of BVFL varied significantly based on income and sex; however, the only variable affecting the operation rate was patient age.

Section snippets

INTRODUCTION

Benign vocal fold lesions (BVFL) are frequently encountered in otorhinolaryngology clinics. These lesions are the most common cause of voice problems after acute laryngitis caused by transient upper respiratory infection. BVFL include vocal nodules, vocal polyps, intracordal cysts, and Reinke's edema. The prevalence of BVFL has been reported to be 2.5%–7.7% in previous national epidemiologic studies in the United States and South Korea.1, 2, 3, 4, 5, 6, 7 In South Korea, the prevalence data

Data source and study population

The NHIS shared claims database was used in this study. The NHIS is an obligatory health insurance system that presently provides cover for approximately 50 million Koreans. Health insurance policyholders and their dependents who reside in Korea are eligible for this service. Health insurance policyholders include both employees and self-employed persons, so most of the residents in South Korea are included in the NHIS. Medical aid beneficiaries and persons eligible for medical care on the

Changes in the prevalence and incidence of BVFL in Korea

The prevalence of BVFL in Korea increased by 1.7-fold from 7.07% to 12.47% during the 10-year study period. The incidence of BVFL increased by 1.5-fold from 5.29% to 7.98% during this time. Figure 1 shows the trends in prevalence and incidence from 2006 to 2015. Both the incidence and prevalence peaked in 2014.

The prevalence of BVFL increased in all age groups from 2006 to 2014. The teenage group showed the largest increase (2.51-fold) during these years. The lowest increase in prevalence

DISCUSSION

This population-based study reviewed the nationwide prevalence of BVFL and the trends in the surgical treatment of this disorder between 2006 and 2015. There have been a few reports on the prevalence of BVFL1, 2, 3, 4, 5, 6, 7; however, as far as we know, this study is the first to analyze trends in the prevalence of BVFL, changes in its incidence at a population-based nationwide level, and surgical treatment of this condition.

Our findings indicate that the prevalence and incidence of BVFL have

CONCLUSION

This population-based nationwide study in Korea demonstrated that the prevalence and incidence rates for BVFL increased between 2006 and 2015. The prevalence rate was higher in women than in men and was associated with age, income level, and presence of gastroesophageal reflux disease. The number of surgical treatments performed did not change during the study period. However, there was a decrease in the rate of surgical treatment for BVFL during this time. The observed changes may be explained

DISCLOSURES

Authors have no conflicts of interest to report.

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This work was supported by grants from the Korean Society of Otorhinolaryngology Head and Neck Surgery 2016 (grant number 2016-1) by grants from the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (grant number: NRF-2017R1D1A1B03034399)

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