Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Objective: Head and neck squamous cell carcinoma (HNSCC) is associated with disparities in healthcare access and outcomes, influenced by socioeconomic factors. Our study examines the relationship between race and overall survival (OS) in metastatic HNSCC.
Methods: The Surveillance, Epidemiology, and End Results (SEER) 2016 to 2021 database was used to extract adult patients with AJCC 7th ed. T1-4 N0-3 M1 HNSCC. Kaplan-Meier survival analysis and Cox-Proportional Hazards modeling were used to analyze the impact of race on OS at 60 months.
Results: Of the 1,094 patients satisfying inclusion criteria, 700 (64%) were white, 138 (13%) were black, and 256 (23%) were other races. Univariate analysis revealed that black patients were more likely to be younger, have lower income levels, and exhibit lower prevalence of HPV-positive cancer. On Kaplan-Meier analysis, 5-year OS for white, black, and other races was 18.6%, 13.5%, and 21.0%, respectively (p<0.001). Black patients (HR 1.31, 95% CI 1.03-1.66, p=0.026) were associated with worse OS than white patients. Female patients (HR 1.29, 95% CI 1.06-1.57, p=0.013) were associated with worse OS than male patients. When stratified by annual household income >$75,000, black patients (HR 1.61, 95% CI 1.16-2.24, p=0.005) were associated with worse OS than white patients. Female patients (HR 1.33, 95% CI 1.04-1.70, p=0.022) were associated with worse OS than male patients.
Conclusions: In a cohort of adult patients with metastatic HNSCC, black and female patients were associated with worse OS. Even when making >$75,000 annually, black and female patients had lower OS than their white and male counterparts. Despite improved treatment methods, disparities among patients with metastases persist. Further research must be conducted to understand the interplay between these socioeconomic variables and survival likelihood in metastatic HNSCC.