Racial and ethnic disparities in nasopharyngeal cancer with an emphasis among Asian Americans

Wang, Qian; Xie, Hui; Li, Yannan; Theodoropoulos, Nicholas; Zhang, Yaning; Jiang, Changchuan; Wen, Chi Pang; Rozek, Laura S.; Boffetta, Paolo

doi:10.1002/ijc.34154

Cited by 12 publications

(3 citation statements)

References 39 publications

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“…Married patients may receive more encouragement from their families and are more likely to engage in healthy behaviors and actively seek treatment. Some studies have shown that racial differences have a signi cant impact on the prognosis of NPSCC [19] [20] , which aligns with our ndings. This may be attributed to variations in diet and health behaviors, such as the consumption of salted or pickled foods and tobacco use [21,22,23] .…”

Section: Discussionsupporting

confidence: 92%

Developing a nomogram model and prognostic analysis of nasopharyngeal squamous cell carcinoma patients: a population-based study

Liu,

Wang

2023

J Cancer Res Clin Oncol

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BackgroundNasopharyngeal squamous cell carcinoma (NPSCC) is a common histo-logical subtype of nasopharyngeal cancer with a generally poor prognosis. The aim of this study is to identify factors affecting the survival prognosis of NPSCC patients and develop a specialized nomogram model. MethodsWe extracted clinical data of 1235 diagnosed cases of NPSCC from the SEER database using SEER*Stat software. Univariate and multivariate Cox proportional hazards regression analyses were conducted to explore clinical factors that impact the prognosis of NPSCC patients. Based on signi cant independent factors, we developed a nomogram to predict the 1, 3, and 5 years overall survival rates. The discriminative and predictive abilities of the nomogram were evaluated using C-index, calibration curve, area under the curve (AUC), and receiver operating characteristic curve. We evaluated the clinical value of the nomogram using decision curve analysis (DCA) and clinical impact curve (CIC). ResultsWe performed a cohort analysis on 846 patients with nasopharyngeal cancer in the training cohort.Multivariate Cox regression analysis revealed age, race, marital status, primary tumor, radiation therapy, chemotherapy, SJCC stage, primary tumor size, Lung metastasis and brain metastasis as independent prognostic factors for NPSCC patients, which we used to construct the nomogram prediction model. The C-index of the training cohort was 0.737. The ROC curve analysis indicated that the AUC of the OS rate at 1, 3, and 5 years in the training cohort was > 0.75. The calibration curves of the two cohorts showed good consistency between the predicted and observed results. DCA and CIC demonstrated that the nomogram prediction model had good clinical bene ts. ConclusionsThe nomogram risk prediction model for NPSCC patient survival prognosis, constructed in this study, has exhibited excellent predictive capability. This model can be employed for swift and precise assessment of individualized survival prognosis. It can offer valuable guidance to clinical physicians in diagnosing and treating NPSCC patients.

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Section: Discussionsupporting

confidence: 92%

Developing a nomogram model and prognostic analysis of nasopharyngeal squamous cell carcinoma patients: a population-based study

Liu,

Wang

2023

J Cancer Res Clin Oncol

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“…For oral cavity cancer, there is a higher incidence in Native American and Asian American/Pacific Islander populations [ 29 ]. Laotian individuals have 18.04 times higher risk of developing this nasopharyngeal carcinoma than non-Hispanic White individuals [ 34 ]. Compared to White patients, American Indian patients had a greater risk of alcohol abuse (68% vs 42%), current smoking (67% vs 49%), living more than 1 h away from a cancer center (81% vs 30%), and delayed presentation with stages III and IV HNC (74% vs 55%) [ 35 ].…”

Section: Healthcare Disparities Across Otolaryngology Subspecialitiesmentioning

confidence: 99%

Healthcare Disparities in Otolaryngology

Batool

Burks

Bergmark

2023

Curr Otorhinolaryngol Rep

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Purpose of Review The purpose of this review is to summarize some of the recent research studies on healthcare disparities across various subspecialties within otolaryngology. This review also highlights the impact of COVID-19 pandemic on disparities and proposes potential interventions to mitigate disparities. Recent Findings Significant healthcare disparities in care and treatment outcomes have been reported across all areas of otolaryngology. Notable differences in survival, disease recurrence, and overall mortality have been noted based on race, ethnicity, socioeconomic status (SES), insurance status, etc. This is most well-researched in head and neck cancer (HNC) within otolaryngology. Summary Healthcare disparities have been identified by numerous research studies within otolaryngology for many vulnerable groups that include racial and ethnic minority groups, low-income populations, and individuals from rural areas among many others. These populations continue to experience suboptimal access to timely, quality otolaryngologic care that exacerbate disparities in health outcomes.

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“…By integrating variables identified to have a significant impact on outcome, nomograms are excellent visualization tools for the estimation of survival rates, but also identify the critical parameters responsible for survival (15). Reported studies examining into some specific subgroups of NPC, including some tumor stage (16)(17)(18)(19)(20)(21)(22), patient age (20,(23)(24)(25)(26), histologic type (27)(28)(29) and even race (30)(31)(32), in a wide scope based on the Surveillance, Epidemiology, and End Results (SEER) data, have shown the potential and ability to provide a better reference for clinical decisions (16,21,23). However, few studies have specifically focused on LA-NPC patients as a group using the SEER data.…”

Section: Introductionmentioning

confidence: 99%

An overall survival predictive nomogram to identify high-risk patients among locoregionally advanced nasopharyngeal carcinoma: Developed based on the SEER database and validated institutionally

et al. 2023

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ObjectiveLocoregionally advanced nasopharyngeal carcinoma (LA-NPC) patients, even at the same stage, have different prognoses. We aim to construct a prognostic nomogram for predicting the overall survival (OS) to identify the high-risk LA-NPC patients.Materials and methodsHistologically diagnosed WHO type II and type III LA-NPC patients in the Surveillance, Epidemiology, and End Results (SEER) database were enrolled as the training cohort (n= 421), and LA-NPC patients from Shantou University Medical College Cancer Hospital (SUMCCH) served as the external validation cohort (n= 763). Variables were determined in the training cohort through Cox regression to form a prognostic OS nomogram, which was verified in the validation cohort, and compared with traditional clinical staging using the concordance index (C-index), Kaplan–Meier curves, calibration curves and decision curve analysis (DCA). Patients with scores higher than the specific cut-off value determined by the nomogram were defined as high-risk patients. Subgroup analyses and high-risk group determinants were explored.ResultsOur nomogram had a higher C-index than the traditional clinical staging method (0.67 vs. 0.60, p<0.001). Good agreement between the nomogram-predicted and actual survival were shown in the calibration curves and DCA, indicating a clinical benefit of the nomogram. High-risk patients identified by our nomogram had worse prognosis than the other groups, with a 5-year overall survival (OS) of 60.4%. Elderly patients at advanced stage and without chemotherapy had a tendency for high risk than the other patients.ConclusionsOur OS predictive nomogram for LA-NPC patients is reliable to identify high-risk patients.

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Racial and ethnic disparities in nasopharyngeal cancer with an emphasis among Asian Americans

Cited by 12 publications

References 39 publications

Developing a nomogram model and prognostic analysis of nasopharyngeal squamous cell carcinoma patients: a population-based study

Developing a nomogram model and prognostic analysis of nasopharyngeal squamous cell carcinoma patients: a population-based study

Healthcare Disparities in Otolaryngology

An overall survival predictive nomogram to identify high-risk patients among locoregionally advanced nasopharyngeal carcinoma: Developed based on the SEER database and validated institutionally

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