Race, not socioeconomic disparities, correlates with survival in human papillomavirus-negative oropharyngeal cancer: A retrospective study
| Autor: | Ryan L. Freedman, Steven S. Chang, Haley Sibley, Amy M. Williams |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Comorbidity Kaplan-Meier Estimate 03 medical and health sciences 0302 clinical medicine Medicine Humans 030223 otorhinolaryngology Socioeconomic status Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Proportional hazards model Head and neck cancer Papillomavirus Infections Racial Groups Human Papillomavirus Negative Cancer Retrospective cohort study Middle Aged medicine.disease Oropharyngeal Neoplasms Otorhinolaryngology Socioeconomic Factors 030220 oncology & carcinogenesis Female Analysis of variance business Demography Forecasting |
| Zdroj: | American journal of otolaryngology. 42(1) |
| ISSN: | 1532-818X |
| Popis: | Investigate the impact of black versus white race, socioeconomic status (SES), and comorbidity burden on oropharyngeal cancer (OPC) survival.This study retrospectively analyzed patients diagnosed between 1991 and 2012 at an urban tertiary care center with a high volume of head and neck cancer referrals. Data gathered included demographics, human papilloma virus (HPV) status, follow-up time, comorbidities, smoking history, and overall survival. SES was extrapolated from the 2000 and 2010 censuses. Analysis of variance, chi-square tests, multivariable Cox proportional hazards models, Cox proportional hazards regression, Kaplan Meier curves and the log-rank test were utilized.Of 208 charts reviewed, 192 patients met inclusion criteria. Black patients had significantly (p 0.001) poorer survival at 1, 2, and 5 years than white patients (5-year survival: 32% vs 64%); this discrepancy persisted in only HPV-negative disease (20% vs 50%). In the HPV-negative subgroup, there was no racial difference in treatment modality received, Charlson Comorbidity Index, and proportion receiving inadequate, noncurative or no treatment. Univariate analysis identified significant differences in median household income, education level, and stage at presentation between black and white subgroups. Multivariate analysis identified white race and HPV-positive status as independent predictors of overall survival, but SES and stage at presentation were not.SES did not explain the greater survival in HPV-negative white versus black patients. This indicates that race is an independent predictor of survival; future studies should examine more accurate indicators of SES and genetic differences in tumors of black and white patients. |
| Databáze: | OpenAIRE |
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