Effect of socioeconomic status on survival in patients with head and neck cancer

Weizman, Baruch; Golan, Nili; Ronen, Ohad

doi:10.1002/hed.26788

Cited by 12 publications

(11 citation statements)

References 22 publications

(57 reference statements)

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“…22 Multiple studies have commented on the importance of socioeconomic status in determining oncologic outcomes. 23,24 Our study adds to evidence about socioeconomic status disparities in OPSCC by identifying lower education and income as potent and independent factors associated with adverse long-term PROs across multiple domains. The association between socioeconomic status and long-term patient-reported QOL is poorly characterized in OPSCC, although it has been reported before.…”

Section: Discussionmentioning

confidence: 68%

Long-term Patient-Reported Outcomes in a Population-Based Cohort Following Radiotherapy vs Surgery for Oropharyngeal Cancer

Dohopolski

Diao

Hutcheson

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceOncologic outcomes are similar for patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with primary surgery or radiotherapy. However, comparative differences in long-term patient-reported outcomes (PROs) between modalities are less well established.ObjectiveTo determine the association between primary surgery or radiotherapy and long-term PROs.Design, Setting, and ParticipantsThis cross-sectional study used the Texas Cancer Registry to identify survivors of OPSCC treated definitively with primary radiotherapy or surgery between January 1, 2006, and December 31, 2016. Patients were surveyed in October 2020 and April 2021.ExposuresPrimary radiotherapy and surgery for OPSCC.Main Outcomes and MeasuresPatients completed a questionnaire that included demographic and treatment information, the MD Anderson Symptom Inventory–Head and Neck (MDASI-HN) module, the Neck Dissection Impairment Index (NDII), and the Effectiveness of Auditory Rehabilitation (EAR) scale. Multivariable linear regression models were performed to evaluate the association of treatment (surgery vs radiotherapy) with PROs while controlling for additional variables.ResultsQuestionnaires were mailed to 1600 survivors of OPSCC identified from the Texas Cancer Registry, with 400 responding (25% response rate), of whom 183 (46.2%) were 8 to 15 years from their initial diagnosis. The final analysis included 396 patients (aged ≤57 years, 190 [48.0%]; aged &gt;57 years, 206 [52.0%]; female, 72 [18.2%]; male, 324 [81.8%]). After multivariable adjustment, no significant differences were found between surgery and radiotherapy outcomes as measured by the MDASI-HN (β, −0.1; 95% CI, −0.7 to 0.6), NDII (β, −1.7; 95% CI, −6.7 to 3.4), and EAR (β, −0.9; 95% CI −7.7 to 5.8). In contrast, less education, lower household income, and feeding tube use were associated with significantly worse MDASI-HN, NDII, and EAR scores, while concurrent chemotherapy with radiotherapy was associated with worse MDASI-HN and EAR scores.Conclusions and RelevanceThis population-based cohort study found no associations between long-term PROs and primary radiotherapy or surgery for OPSCC. Lower socioeconomic status, feeding tube use, and concurrent chemotherapy were associated with worse long-term PROs. Further efforts should focus on the mechanism, prevention, and rehabilitation of these long-term treatment toxicities. The long-term outcomes of concurrent chemotherapy should be validated and may inform treatment decision making.

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Section: Discussionmentioning

confidence: 68%

Long-term Patient-Reported Outcomes in a Population-Based Cohort Following Radiotherapy vs Surgery for Oropharyngeal Cancer

Dohopolski

Diao

Hutcheson

et al. 2023

JAMA Otolaryngol Head Neck Surg

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“…Higher socioeconomic status has been shown to be associated with improved overall survival and outcomes in head and neck cancer previously. 20 These findings highlight the need for further research and efforts to diminish disparities and improve equitable care for all patients with head and neck cancers.…”

Section: Discussionmentioning

confidence: 96%

Survival outcomes for patients with T3N0M0 squamous cell carcinoma of the glottis treated with definitive radiation alone versus chemoradiation

et al. 2022

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Background Given the poor lymphatics of the glottis, we evaluated omission of chemotherapy in patients treated definitely for T3N0M0 squamous cell carcinoma (SCC) of the glottis. Methods We performed survival analysis of patients with T3N0M0 SCC of the glottis identified in the National Cancer Database treated with radiation alone versus chemoradiation. Results A total of 3785 patients were identified. Patients age ≥70 and those with comorbidities were less likely to receive chemotherapy (odds ratio [OR] 0.30, 95% CI [0.25–0.37] and 0.48 [0.31–0.76], respectively). Five‐year OS was lower in patients treated with radiation versus chemoradiation (33.8% [30.3%–37.2%] vs. 58.0% [55.8%–60.0%]). In patients <70 with no comorbidities this difference persisted (51.0% [44.5%–57.0%] versus 66.7% [64.0%–69.3%]). Conclusion Overall survival was higher in patients treated with chemoradiation compared to radiation alone, even when controlling for age and comorbidities. Radiotherapy with chemotherapy omission is not appropriate in patients with T3N0M0 SCC of the glottis.

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“…In the past few decades, few studies have investigated the association between SES and HNC survival ( 14–17 ). Area-level measures of SES include neighborhood disadvantages (e.g., poverty, local health-related businesses, household crowding, etc.…”

Section: Introductionmentioning

confidence: 99%

The Intersectionality between Race, Ethnicity, and Residential-Level Socioeconomic Status in Disparities of Head and Neck Cancer Outcomes: A SEER Study

Karanth

Akinyemiju

Walker

et al. 2023

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Head and Neck cancer (HNC) mortality differs by race, ethnicity, and socioeconomic status (SES). However, it is unclear whether the relationship between race/ethnicity and HNC-specific mortality varies according to the residence-level SES. Methods: Data from the Surveillance, Epidemiology, and End Results database included participants with primary HNC between 2006-2017 (followed through 2018) to assess the joint association of race/ethnicity and census-tract level SES Yost-index groups (quintiles) with all-cause and HNC-specific mortalities. Relative survival rates at one/five/ten years were calculated. Multivariable Cox proportional hazard regression models estimated hazard-ratios and 95% confidence intervals for all-cause mortality, and Fine-Gray subdistribution hazard models for HNC-specific mortality. Cumulative incidence curves for HNC-specific deaths were estimated. Results 76,095 patients were included in the analysis: 63.2% were <65 years, 73.4% male, and 11.3% non-Hispanic (NH) Black. Most patients (58.3%) were diagnosed at regional or distant stages and 20.6% died of HNC. The five-year relative survival rate increased with SES group, with 51.6% in the lowest SES group, and 74.1% in the highest SES group. NH-Black patients had higher risk of all-cause and HNC-specific mortality than NH-White patients, regardless of the SES group. NH-Asian/Pacific Islander and Hispanic patients had higher risk of HNC-specific mortality in some SES groups. Conclusions NH-Black patients of all SES strata had significantly worse outcomes. Other factors, such as healthcare quality, may be associated with persistent disparities.

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Effect of socioeconomic status on survival in patients with head and neck cancer

Cited by 12 publications

References 22 publications

Long-term Patient-Reported Outcomes in a Population-Based Cohort Following Radiotherapy vs Surgery for Oropharyngeal Cancer

Long-term Patient-Reported Outcomes in a Population-Based Cohort Following Radiotherapy vs Surgery for Oropharyngeal Cancer

Survival outcomes for patients with T3N0M0 squamous cell carcinoma of the glottis treated with definitive radiation alone versus chemoradiation

The Intersectionality between Race, Ethnicity, and Residential-Level Socioeconomic Status in Disparities of Head and Neck Cancer Outcomes: A SEER Study

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