Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men

Carroll, William R.; Kohler, Connie L.; Carter, Vivian L.; Hannon, Lonnie; Skipper, Joni B.; Rosenthal, Eben L.

doi:10.1002/hed.21125

Cited by 21 publications

(27 citation statements)

References 22 publications

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“…Encouragement and support of spouses and family members was commonly associated with timely help‐seeking behaviour . While this is in line with non‐gender‐specific reviews , this factor appeared to be distinctly gender‐specific.…”

Section: Discussionsupporting

confidence: 71%

“…Psychosocial barriers to help-seeking Knowledge and awareness of cancer symptoms were associated with men's help-seeking behaviour, with a low level of cancer awareness or knowledge associated with delayed help-seeking for cancer symptoms in 12 studies [6,[31][32][33][34][35][36][37][38][39][40][41]. This barrier was found across a range of cancer samples, including prostate [34,36,41], testicular [6,32,38], male breast [35], and head and neck [33] cancer. Low level of risk perception was also found to be a barrier in one study [40].…”

Section: Qualitative Synthesismentioning

confidence: 99%

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Psychosocial factors that influence men's help‐seeking for cancer symptoms: a systematic synthesis of mixed methods research

et al. 2015

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Objective: Effectiveness of cancer control partly depends upon early identification and treatment. Men appear to be more likely to delay help-seeking for symptoms, resulting in later diagnosis. This review aims to provide a mixed research synthesis of the psychosocial barriers to and facilitators of help-seeking for cancer symptoms among men.Methods: Systematic methods were followed, including a predefined research question and search strategy. Searches retrieved 7131 international records from online databases: MEDLINE (n = 3011), PubMed (n = 471), SCOPUS (n = 896), Informit (n = 131), PsychINFO (n = 347), and Web of Science (n = 2275). Forty studies were eligible for inclusion in the review (25 qualitative studies, 11 quantitative studies, and 4 mixed-method studies).Results: There was strong observational evidence for several psychosocial barriers to men's helpseeking behaviour: low cancer knowledge and inaccurate symptom interpretation, embarrassment and fear, and conformity to masculine gender role norms. The strongest facilitating factor associated with men's help-seeking behaviour was encouragement and support of spouses and family members. The majority of research was qualitative and used small samples, making generalisations to the wider population difficult.Conclusions: Men's help-seeking for cancer symptoms is influenced by several psychosocial factors, which, in part, may be gender-specific. Health promotion initiatives to improve help-seeking behaviour among men should aim to increase cancer knowledge, reduce embarrassment and fear, address social norms deterring timely help-seeking, and acknowledge informal help-seeking with spouses and family members. Increasing the theoretical grounding of research could aid cohesion across the research area and the design of effective health promotion interventions.

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Section: Discussionsupporting

confidence: 71%

Section: Qualitative Synthesismentioning

confidence: 99%

Psychosocial factors that influence men's help‐seeking for cancer symptoms: a systematic synthesis of mixed methods research

et al. 2015

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“…15,16 The effect size (OR, 1.71) and associated 95% CI (0.84-3.58) for the difference in timely initiation of PORT between the races are consistent with those of prior research 16 and likely reflect a clinically meaningful difference. In addition to experiencing delayed initiation of PORT, significant racial differences in timely HNSCC care exist along with other aspects of the cancer care continuum, including time from symptom onset to consultation, 3 diagnosis to treatment, 5,28 and overall treatment time. 15 Delays in timely care are a source of preventable mortality and a contributor to racial disparities in outcomes.…”

Section: Discussionmentioning

confidence: 99%

Association of Care Processes With Timely, Equitable Postoperative Radiotherapy in Patients With Surgically Treated Head and Neck Squamous Cell Carcinoma

Janz

Kim

Hill

et al. 2018

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Delays in initiation of postoperative radiotherapy (PORT) after surgery for head and neck squamous cell carcinoma (HNSCC) are common, predominantly affect racial minorities, and are associated with decreased survival. Details regarding the care processes that contribute to timely, equitable PORT remain unknown. OBJECTIVE To determine care processes associated with timely, equitable PORT. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included patients 18 years or older undergoing surgery for HNSCC at the Medical University of South Carolina (MUSC), Charleston, followed by PORT (at MUSC or elsewhere) with or without chemotherapy from January 1, 2014, through December 31, 2016. Data were analyzed from September 15, 2017, through June 28, 2018. MAIN OUTCOMES AND MEASURES The main outcome measure was the proportion of timely, guideline-adherent initiation of PORT (≤6 weeks postoperatively). Secondary outcome measures included care processes associated with timely PORT. The association between process variables with timely PORT was explored using multivariable logistic regression analysis. Effect modification of the association between receipt of care processes and timely PORT by race was explored using interaction effects. RESULTS A total of 197 patients were included in the analysis; they were predominantly white (157 [79.7%]) and male (136 [69.0%]) with a mean age of 59 years (range, 28-89 years). Overall, 89 patients (45.2%) experienced a delay initiating PORT. African American patients had a 13.5% absolute increase in the rate of delayed PORT relative to white patients (21 of 37 [56.8%] vs 68 of 157 [43.3%]). The adjusted multivariable regression showed that the following care processes were associated with timely PORT: preoperative radiotherapy consultation (odds ratio [OR], 8.94; 95% CI, 1.64-65.53), PORT at MUSC (OR, 6.21; 95% CI, 1.85-24.75), pathology report within 7 postoperative days (OR, 4.14; 95% CI, 1.21-15.86), time from surgery to PORT referral of no longer than 10 days (OR, 12.14; 95% CI, 3.14-63.00), time from PORT referral to consultation of no longer than 10 days (OR, 10.76; 95% CI, 3.01-49.70), and time from PORT consultation to its start of no longer than 21 days (OR, 4.80; 95% CI 1.41-18.44). Analysis of interactions revealed no statistically significant differences between African American and white patients in receipt of key processes associated with timely PORT. CONCLUSIONS AND RELEVANCE Specific care processes are associated with guideline-adherent initiation of PORT. Novel strategies appear to be needed to ensure that these processes are performed for all patients with HNSCC, thereby facilitating timely, equitable PORT.

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“…Despite advances in treatment, the overall five-year survival rate has briefly improved in recent years, but the incidence of oral cavity and pharynx cancers continue increasing. In addition, African-American males have suffered the highest incidence of HNSCC and the lowest survival compared to any racial/ethnic group (33). It urgently needs an effective, non-toxic and affordable novel pharmacological agent or drug to prevent development of HNSCC.…”

Section: Discussionmentioning

confidence: 99%

Combination Effects of Salvianolic Acid B with Low-Dose Celecoxib on Inhibition of Head and Neck Squamous Cell Carcinoma Growth In vitro and In vivo

Zhao

Hao

et al. 2010

Cancer Prevention Research

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Head and neck squamous cell carcinoma (HNSCC) development is closely associated with inflammation. Cyclooxygenase-2 (COX-2) is an important mediator of inflammation. Therefore, celecoxib, a selective inhibitor of COX-2, was hailed as a promising chemopreventive agent for HNSCC. Dose-dependent cardiac toxicity limits long-term use of celecoxib, but it seems likely that this may be diminished by lowering its dose. We found that salvianolic acid B (Sal-B), isolated from Salvia miltiorrhiza Bge, can effectively suppress COX-2 expression and induce apoptosis in a variety of cancer cell lines. In this study, we report that combination of Sal-B with low-dose celecoxib results in a more pronounced anticancer effect in HNSCC than either agent alone. The combination effects were assessed in four HNSCC cell lines (JHU-06, JHU-011, JHU-013, and JHU-022) by evaluating cell viability, proliferation, and tumor xenograft growth. Cell viability and proliferation were significantly inhibited by both the combined and single-agent treatments. However, the combination treatment significantly enhanced anticancer efficacy in JHU-013 and JHU-022 cell lines compared with the single treatment regimens. A half-dose of daily Sal-B (40 mg/kg/d) and celecoxib (2.5 mg/kg/d) significantly inhibited JHU-013 xenograft growth relative to mice treated with a full dose of Sal-B or celecoxib alone. The combination was associated with profound inhibition of COX-2 and enhanced induction of apoptosis. Taken together, these results strongly suggest that combination of Sal-B, a multifunctional anticancer agent, with low-dose celecoxib holds potential as a new preventive strategy in targeting inflammatory-associated tumor development. Cancer Prev Res; 3(6); 787-96. ©2010 AACR.

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Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men

Cited by 21 publications

References 22 publications

Psychosocial factors that influence men's help‐seeking for cancer symptoms: a systematic synthesis of mixed methods research

Psychosocial factors that influence men's help‐seeking for cancer symptoms: a systematic synthesis of mixed methods research

Association of Care Processes With Timely, Equitable Postoperative Radiotherapy in Patients With Surgically Treated Head and Neck Squamous Cell Carcinoma

Combination Effects of Salvianolic Acid B with Low-Dose Celecoxib on Inhibition of Head and Neck Squamous Cell Carcinoma Growth In vitro and In vivo

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