Racial and ethnic disparities in paranasal sinus malignancies

Abstract

Background: Racial and ethnic disparities in cancer outcomes have been demonstrated for several different malignancies. In this study we aimed to quantify disease-specific survival (DSS) and the 5-year conditional disease-specific survival (CDSS, the change in life expectancy with increasing survivorship) for paranasal sinus cancer by race and ethnicity. Methods: Patients with sinus cancer between 1973 and 2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by race and ethnicity. Cox regression models of DSS were generated controlling for stage, age, race, and ethnicity. CDSS was calculated using Cox models. Logistic regression was conducted to identify risk factors for younger age at diagnosis, late-stage at diagnosis, and likelihood of receiving surgical intervention when recommended. Results:The analysis included a total of 5202 patients. DSS was significantly different when stratified by race (p < 0.01). Compared with White patients, Black patients (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.13-1.45; p < 0.001) and American Indian/Alaskan Natives (HR, 1.94; 95% CI, 1.37-2.74, p < 0.001) exhibited increased mortality when controlling for other factors.Black patients had worse CDSS for regional and distant staged cancer compared with other races; American Indian/Alaskan Native patients had worse CDSS for cancers of all stages. Hispanic patients were more likely to present with advanced disease (odds ratio [OR], 1.47; 95% CI, 1.07-2.07; p = 0.020). American Indian/Alaskan Native patients were less likely than White patients to receive surgical intervention when recommended (OR, 0.42; 95% CI, 0.21-0.04; p = 0.024). Nonwhite patients were more likely to be diagnosed at a younger age.Variations in racial and ethnic disparities were observed over time. Conclusion: Race and ethnicity significantly impact paranasal sinus cancer outcome metrics. Disparities in outcomes are likely multifactorial.

Quality of life in sinonasal tumors: an up-to-date review

“…A systemic review carried out by Papadopoulou et al, (2021), showed the anatomic variations among these groups that is of paramount importance, especially in the context of predicting certain pitfalls and complications when managing sinonasal tumors through endoscopic or surgical means [65]. Thereby, accessing, and distinguishing ethnicity when accessing QOL is crucial due to differences in anatomic variation, genetic and environmental factors [66]. This is especially important as sinonasal tumors are more common in Asia and Africa than in the Western countries [5].…”

Impact of Medicaid Expansion on Rhinologic Cancer Presentation, Treatment, and Outcomes

“…To our knowledge, this finding has not been previously reported, but is important to note, as minority demographics are known to be disproportionately uninsured and account for over half of the uninsured population in the United States, even after enactment of the ACA 14 . Similarly, previous research using the SEER database established a relationship between race and ethnicity and paranasal sinus cancer outcomes 15 . Sharma et al identified, for example, that Black patients with advanced stage paranasal sinus cancer exhibited worse conditional disease‐specific survival compared to other races.…”

“…14 Similarly, previous research using the SEER database established a relationship between race and ethnicity and paranasal sinus cancer outcomes. 15 Sharma et al identified, for example, that Black patients with advanced stage paranasal sinus cancer exhibited worse conditional disease-specific survival compared to other races. Our results suggest that advanced stage disease is not only more deadly, but also disproportionately prevalent, among racial minorities.…”

Year in review: 2021 IFAR article summary

“…Farrell et al 31 analyzed patients with sinonasal squamous cell carcinoma from the National Cancer Database and demonstrated that multimodality therapy that includes surgical management is associated with improved overall survival, and that when followed by surgical intervention, patients undergoing induction chemotherapy had similar survival outcomes to those with primary surgery with or without adjuvant therapy. Sharma et al 32 showed that race and ethnicity impact sinus cancer outcomes.…”