Inequities Associated With Advanced Stage at Presentation of Head and Neck Cancer: A Systematic Review.

Autor:	Ioerger P; University of Kansas School of Medicine, Kansas City., Mills K; University of Kansas School of Medicine-Wichita, Wichita., Wagoner SF; University of Kansas Medical Center, Kansas City., Lawrence A; University of Kansas Medical Center, Kansas City., Alapati R; University of Kansas Medical Center, Kansas City., Nallani R; University of Kansas Medical Center, Kansas City., Hamill CS; University of Kansas Medical Center, Kansas City., Adjei Boakye E; Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan.; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan., Sykes KJ; University of Kansas School of Medicine, Kansas City.; Baylor Scott & White Health and Wellness Center, Dallas, Texas.
Jazyk:	angličtina
Zdroj:	JAMA otolaryngology-- head & neck surgery [JAMA Otolaryngol Head Neck Surg] 2024 Aug 01; Vol. 150 (8), pp. 727-740.
DOI:	10.1001/jamaoto.2024.1180
Abstrakt:	Importance: Social determinants of health (SDoH) are defined by a wide range of factors (eg, built environment, economic stability, education level, discrimination, racism, access to health care). Advanced stage at presentation or delayed diagnosis heavily influences health outcomes in patients with head and neck cancer (HNC). While the drivers of advanced-stage presentation come from a multitude of sources, SDoH plays an outsized role. Objective: To systematically review the published literature to identify which SDoH are established as risk factors for delayed diagnosis or advanced stage at presentation among patients with HNC. Evidence Review: In this systematic review, a literature search of PubMed, Web of Science, and Embase was conducted on February 27, 2023, using keywords related to advanced stage at presentation and delayed diagnosis of HNC between 2013 and 2023. Quality assessment was evaluated through the Newcastle-Ottawa Scale. Articles were included if they focused on US-based populations and factors associated with advanced stage at presentation or delayed diagnosis of HNC. Findings: Overall, 50 articles were included for full-text extraction, of which 30 (60%) were database studies. Race was the most commonly reported variable (46 studies [92%]), with Black race (43 studies [93%]) being the most studied racial group showing an increased risk of delay in diagnosis of HNC. Other commonly studied variables that were associated with advanced stage at presentation included sex and gender (41 studies [82%]), insurance status (25 studies [50%]), geographic region (5 studies [10%]), and socioeconomic status (20 studies [40%]). Male sex, lack of insurance, rurality, and low socioeconomic status were all identified as risk factors for advanced stage at presentation. Conclusions and Relevance: This systematic review provides a comprehensive list of factors that were associated with advanced HNC stage at presentation. Future studies should focus on evaluating interventions aimed at addressing the SDoH in communities experiencing disparities to provide a net positive effect on HNC care.
Databáze:	MEDLINE
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