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

Autor:	Karanth SD; Cancer Control & Population Sciences, UF Health Cancer Center, University of Florida, Gainesville, Florida.; Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida., Akinyemiju T; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina., Walker CJ; Department of Behavioral Sciences, College of Medicine, University of Kentucky, Lexington, Kentucky., Yang D; Department of Epidemiology, University of Florida College of Public Health and Health, Professions, Gainesville, Florida., Migliorati CA; College of Dentistry, University of Florida, Gainesville, Florida., Yoon HS; Cancer Control & Population Sciences, UF Health Cancer Center, University of Florida, Gainesville, Florida.; Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida., Hong YR; Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida., Washington CJ; Department of Epidemiology, University of Florida College of Public Health and Health, Professions, Gainesville, Florida., Lattimore C; Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida., Fredenburg KM; Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida., Braithwaite D; Cancer Control & Population Sciences, UF Health Cancer Center, University of Florida, Gainesville, Florida.; Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida.; Department of Epidemiology, University of Florida College of Public Health and Health, Professions, Gainesville, Florida.
Jazyk:	angličtina
Zdroj:	Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2023 Apr 03; Vol. 32 (4), pp. 516-523.
DOI:	10.1158/1055-9965.EPI-22-1167
Abstrakt:	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 and 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 1, 5, and 10 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. Impact: The study highlights the persistence of significant racial disparities in HNC survival across socioeconomic categories. There is need to consider additional factors underlying these disparities. (©2023 The Authors; Published by the American Association for Cancer Research.)
Databáze:	MEDLINE
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