A National Evaluation of Food Insecurity in a Head and Neck Cancer Population

Abstract

Objectives/Hypothesis To determine the food security status of patients with a history of head and neck cancer and compare to other types of cancer. Study Deign A retrospective analysis using the National Health Interview Series. Methods The National Health Interview Series (NHIS) for the calendar years 2014 to 18 was used to elicit food security status (secure, marginally secure/not secure) among adult patients with a history of throat/pharynx head and neck cancer (pHNC), thyroid cancer, and colon cancer. The relationship between food security and the primary site was compared and subanalyses were performed according to sex, race, and ethnicity. Results The study population included 199.0 thousand patients with pHNC, with 17.7% (95% confidence interval, 10.5%–28.1%) of pHNC patients reporting their food security status as marginally secure or not secure. Food insecurity was significantly higher among pHNC patients when compared to thyroid cancer (insecurity 10.7%, [7.7%–14.7%]) and colon cancer patients (10.1%, [7.8%–13.2%]). Among pHNC patients, there was no significant difference in rates of food insecurity when stratified by gender, race, or ethnicity. However, black individuals were more likely to have food insecurity with a history of thyroid or colon cancer (P < .042) and Hispanics were more likely to have food insecurity with a history of thyroid cancer (P = .005). Conclusions Food insecurity disproportionally affects patients with a history of pHNC, though there is less demographic variability when compared to other cancer primary sites. Food security assessments should be part of the tailored approach to survivorship management in head and neck cancer. Level of Evidence 4 Laryngoscope, 131:E1539–E1542, 2021

Emerging Disparities in Prevention and Survival Outcomes for Patients with Head and Neck Cancer and Recommendations for Health Equity

“…While improvement in overall nutritional health has proven to be an important achievement of public health efforts to promote healthy dietary patterns and prevent chronic diseases and cancers, disparities continue to persist among various populations, including rural or geographically isolated, and ethnic minorities [ 66 , 67 ]. A recent study found that patients with a history of throat cancer are more likely to live in areas with food insecurity, especially among Black and Hispanic groups [ 68 ]. Increasing screenings for food insecurity among patients with HNC, especially among patients from disadvantaged groups, is needed to improve equal access to care, which can be further exacerbated by socioeconomic status, income, race and ethnicity, and geographical residence [ 66 ].…”