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Access to Preventive Care Services and Stage at Diagnosis in Head and Neck Cancer


Farquhar, Douglas R.; Lenze, Nicholas R.; Masood, Maheer M.; Divaris, Kimon; Tasoulas, Jason; Blumberg, Jeffrey; Lumley, Catherine; Patel, Samip N.; Hackman, Trevor; & Weissler, Mark Christian, et al. (2020). Access to Preventive Care Services and Stage at Diagnosis in Head and Neck Cancer. Head & Neck, 42(10), 2841-2851.


BACKGROUND: Decreased access to preventive care services has been proposed as a mechanism for the association between low socioeconomic status (SES) and advanced stage at diagnosis in patients with head and neck squamous cell carcinoma (HNSCC).
METHODS: Retrospective analysis of patients diagnosed with HNSCC in North Carolina between 2002 and 2006.
RESULTS: A total of 1108 patients with HNSCC were included in the study. In the multivariable analysis, use of annual routine dental services (OR 0.7, 95% CI 0.5-0.9) and colonoscopy in the past 10 years (OR 0.7, 95% CI 0.5-0.9) were associated with lower odds of advanced T stage at diagnosis. Having no insurance (OR 1.8, 95% CI 1.1-2.9), an income <$20 000 (OR 1.6 95% CI 1.03-2.6), and >10 pack-years tobacco use (OR 1.5, 95% CI 1.04-2.2) were associated with advanced T stage at diagnosis.
CONCLUSION: Use of preventive care services and SES independently predict stage at diagnosis in HNSCC.


Reference Type

Journal Article

Article Type


Year Published


Journal Title

Head & Neck


Farquhar, Douglas R.
Lenze, Nicholas R.
Masood, Maheer M.
Divaris, Kimon
Tasoulas, Jason
Blumberg, Jeffrey
Lumley, Catherine
Patel, Samip N.
Hackman, Trevor
Weissler, Mark Christian
Yarbrough, Wendell G.
Zanation, Adam M.
Olshan, Andrew F.


United States of America


North Carolina