Ethnicity and Clinical Outcomes in Head and Neck Cancer: an Analysis of the SEER Database

Abstract

Background We evaluated the differences within various ethnic groups diagnosed with head and neck cancer in the USA with a specific focus on the clinical outcomes of patients of Hispanic ethnicity. Material/Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to examine the clinical outcomes of patients with head and neck cancer by ethnicity, region of origin, place of birth, treatment modality, primary location, age, gender, and SEER tumor stage. Results For all patients, African American race conferred the worst prognosis for head and neck cancer (1.41; CI 1.361-1.454), while non-US born Hispanics had the best prognosis (0.74; 0.684-0.804). US born Hispanics (0.86; CI 0.823-0.892) had a significantly better prognosis than Whites (ref.). Conclusion The Hispanic population appears to have a better prognosis compared to their Caucasian peers while both do better than Blacks across all stages and in local and regional disease subsets. Furthermore, non-US born Hispanics had a better prognosis than US born Hispanics. The cause of this disparity is unclear and warrants further investigation.

Demographic predictors of head and neck cancer survival differ in the elderly

“…Despite this background, elderly cancer patients are rarely the focus of research or included in clinical trials . In HNSCC, age and other demographic factors have been identified as prognostic . However, it is not known how these factors and their impact may differ within the growing population of elderly HNSCC patients.…”

“…Demographically, HNSCC patients are predominately white, male, and from lower socioeconomic strata . The established demographic prognostic factors in HNSCC, including insurance status, income level, and race, are thought to be markers for low socioeconomic status . These demographics may mediate increased comorbidity prevalence, delays in diagnosis, and decreased initiation or completion of ideal treatment.…”

“…7 In HNSCC, age and other demographic factors have been identified as prognostic. [8][9][10][11] However, it is not known how these factors and their impact may differ within the growing population of elderly HNSCC patients.…”

“…10,12 The established demographic prognostic factors in HNSCC, including insurance status, income level, and race, are thought to be markers for low socioeconomic status. [8][9][10][11][12][13] These demographics may mediate increased comorbidity prevalence, delays in diagnosis, and decreased initiation or completion of ideal treatment. Social support, especially from marriage, is also associated with earlier stage of presentation, more complete and timely treatment, and ultimately improved prognosis.…”

Urban and rural differences in outcomes of head and neck cancer

“…9,10 HNC mortality has been further linked to age, sex, ethnicity, marital status, and other socioeconomic determinants. [11][12][13] Notably, recent studies have also evaluated the impact of geography on cancer outcomes by assessing the relationship between urban-rural residence and cancer survival. [14][15][16][17][18][19] The majority of research on urban-rural disparities has focused on breast, lung, and colorectal malignancies, 14,15,19 with relatively few studies assessing the impact of rurality on HNC outcomes.…”