Neighborhood deprivation and clinical outcomes among head and neck cancer patients

Reitzel, Lorraine R.; Nguyen, Nga; Zafereo, Mark; Li, Guojun; Wei, Qingyi; Sturgis, Erich M.

doi:10.1016/j.healthplace.2012.03.005

Cited by 46 publications

(48 citation statements)

References 55 publications

(68 reference statements)

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“…Smokers (HR 1.3), older patients (HR 1.6), more deprived patients and patients in advanced stages of OC cancer in which the tumour has extended beyond the organ or site of origin had significantly poorer survival rates. This result is consistent with the Neighbourhood Deprivation study in the United States [30],which reported a decreased survival rate amongst the most deprived patients between 1996 and 2009. An important factor in this context is the effect of the economic crisis in 2008.…”

Section: Discussionsupporting

confidence: 92%

Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009

et al. 2016

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BackgroundOral cancer is a significant public health problem world-wide and exerts high economic, social, psychological, and physical burdens on patients, their families, and on their primary care providers. We set out to describe the changing trends in incidence and survival rates of oral cancer in Ireland between 1994 and 2009.MethodsNational data on incident oral cancers [ICD 10 codes C01-C06] were obtained from the National Cancer Registry Ireland from 1994 to 2009. We estimated annual percentage change (APC) in oral cancer incidence during 1994–2009 using joinpoint regression software (version 4.2.0.2). The lifetime risk of oral cancer to age 79 was estimated using Irish incidence and population data from 2007 to 2009. Survival rates were also examined using Kaplan-Meier curves and Cox proportional hazard models to explore the influence of several demographic/lifestyle covariates with follow-up to end 2012.ResultsData were obtained on 2,147 oral cancer incident cases. Men accounted for two-thirds of oral cancer cases (n = 1,430). Annual rates in men decreased significantly during 1994–2001 (APC = -4.8 %, 95 % CI: −8.7 to −0.7) and then increased moderately (APC = 2.3 %, 95 % CI: −0.9 to 5.6). In contrast, annual incidence increased significantly in women throughout the study period (APC = 3.2 %, 95 % CI: 1.9 to 4.6). There was an elevated risk of death among oral cancer patients who were: older than 60 years of age; smokers; unemployed or retired; those living in the most deprived areas; and those whose tumour was sited in the base of the tongue. Being married and diagnosed in more recent years were associated with reduced risk of death.ConclusionOral cancer increased significantly in both sexes between 1999 and 2009 in Ireland. Our analyses demonstrate the influence of measured factors such as smoking, time of diagnosis and age on observed trends. Unmeasured factors such as alcohol use, HPV and dietary factors may also be contributing to increased trends. Several of these are modifiable risk factors which are crucial for informing public health policies, and thus more research is needed.

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Section: Discussionsupporting

confidence: 92%

Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009

et al. 2016

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“…It has been well documented that social determinants of health have a strong correlation with prognosis in head and neck cancer. 46–51 Our multivariate models showed that oral health had a significant association with survival independent of education and income. Nonetheless, the overwhelming influence of social determinants of health on oral health is well-established, and a large number of unmeasured or unknown pathways, such as a biological mechanism, could underlie the links between social factors and oral health outcomes, including oral cancer and survival.…”

Section: Discussionmentioning

confidence: 83%

Poor oral health affects survival in head and neck cancer

et al. 2017

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Introduction Poor oral health has emerged as a risk factor for squamous cell carcinoma of the head and neck (HNSCC) but its impact on survival has not been examined. We sought to estimate the impact of oral health indicators on survival in a population-based HNSCC cohort. Materials and Methods Cases (n=1381) and age-, sex- and race-matched controls (n=1396) were participants in the Carolina Head and Neck Cancer Epidemiologic Study (CHANCE). Vital status was determined via linkage with the National Death Index. Survival was considered at 5 years post-diagnosis or study-enrollment for controls. Oral health was assessed using self-reported indicators including frequency of routine dental exams and tooth brushing. We used Kaplan-Meyer analyses and Cox regression to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI). Results Routine dental visits during the preceding 10 years were associated with decreased mortality risk (>10 visits: HR=0.6, 95% CI=0.4–0.8) after adjusting for confounders. This effect was most pronounced for oral cavity cancer—(e.g., >10 visits: HR=0.4, 95% CI=0.2–0.9). Dental visits were also positively associated with survival among controls. No other routine health screening (e.g., eye exams) was associated with survival. Conclusion We found significant associations between markers of oral health and survival among both HNSCC cases and controls. This association was most pronounced for sites closer to the dentition. Oral health may have a direct effect on tumor biology due to the associated immune or inflammatory response. It may also represent a proxy for wellness or unmeasured social determinants of health.

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“…Colorectal and lung cancer risks increase with area deprivation at district level in Bavaria (Kuznetsov et al 2011). Reitzel et al (2012) reports that poorer survival can be predicted by neighborhood economic deprivation among oropharyngeal patients.…”

Section: Discussionmentioning

confidence: 99%

Area Deprivation and Liver Cancer Prevalence in Shenzhen, China: A Spatial Approach Based on Social Indicators

Wang

Tan

et al. 2016

Soc Indic Res

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Cancer has become an alarming threat to human health and well-being worldwide. Examining the social determinants of cancer prevalence should effectively inform the practices and strategies on cancer treatment and prevention. However, rather few studies have conducted in this regard for developing countries. This paper attempts to characterize the association between area deprivation and liver cancer prevalence using a case of Shenzhen, China. Data from 2009 to 2011 provided by Shenzhen's Health Information Center are used to calculate the incidence rate of liver cancer at district level. An area deprivation index (ADI) at district level is established by integrating 13 indicators of 5 domains (income, employment, education, housing and demography). The weight for each indicator is determined by two typical subjective methods (AHP and fuzzy AHP) and two common objective methods (Entropy and Coefficient Variation). Quantitative comparisons indicate that the four methods are highly consistent though they assign different weight to the indicators. Spatial lag regression identifies significantly positive linear relationships between ADIs and liver cancer incidence rate from 2009 and 2010. It suggests that greater possibility of liver cancer prevalence would be expected in districts of higher social deprivation. The results also denote that the obtained relationships are insensitive to weight determination method and temporal dimension. Our study demonstrates that spatial autocorrelation should be incorporated for better understanding the association between area deprivation and liver cancer prevalence at district level. This paper provides some new insights into social indicators research.

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Neighborhood deprivation and clinical outcomes among head and neck cancer patients

Cited by 46 publications

References 55 publications

Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009

Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009

Poor oral health affects survival in head and neck cancer

Area Deprivation and Liver Cancer Prevalence in Shenzhen, China: A Spatial Approach Based on Social Indicators

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