Socioeconomic Status, Access to Care, Risk Factor Patterns, and Stage at Diagnosis for Head and Neck Cancer among Black and White Patients

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Citation

Emerson, Marc A.; Farquhar, Douglas R.; Lenze, Nicholas R.; Sheth, Siddharth; Mazul, Angela L.; Zanation, Adam M.; Hackman, Trevor G.; Weissler, Mark Christian; Zevallos, Jose P.; & Yarbrough, Wendell G., et al. (2022). Socioeconomic Status, Access to Care, Risk Factor Patterns, and Stage at Diagnosis for Head and Neck Cancer among Black and White Patients. Head & Neck, 44(4), 823-834. PMCID: PMC8904304

Abstract

BACKGROUND: Little is known about how factors combine to influence progression of squamous cell carcinoma of the head and neck (HNSCC). We aimed to evaluate multidimensional influences of factors associated with HNSCC stage by race.
METHODS: Using retrospective data, patients with similar socioeconomic status (SES), access to care (travel time/distance), and behavioral risk factors (tobacco/alcohol use and dental care) were grouped by latent class analysis. Relative frequency differences (RFD) were calculated to evaluate latent classes by stage, race, and p16 status.
RESULTS: We identified three latent classes. Advanced T-stage was higher for black (RFD = +20.2%; 95% CI: -4.6 to 44.9) than white patients (RFD = +10.7%; 95% CI: 2.1-19.3) in the low-SES/high-access/high-behavioral risk class and higher for both black (RFD = +29.6%; 95% CI: 4.7-54.5) and white patients (RFD = +23.9%; 95% CI: 15.2-32.6) in the low-SES/low-access/high-behavioral risk class.
CONCLUSION: Results suggest that SES, access to care, and behavioral risk factors combine to underly the association with advanced T-stage. Additionally, differences by race warrant further investigation.

URL

http://dx.doi.org/10.1002/hed.26977

Reference Type

Journal Article

Year Published

2022

Journal Title

Head & Neck

Author(s)

Emerson, Marc A.
Farquhar, Douglas R.
Lenze, Nicholas R.
Sheth, Siddharth
Mazul, Angela L.
Zanation, Adam M.
Hackman, Trevor G.
Weissler, Mark Christian
Zevallos, Jose P.
Yarbrough, Wendell G.
Brennan, Paul
Abedi-Ardekani, Behnoush
Olshan, Andrew F.

Article Type

Regular

PMCID

PMC8904304

Data Set/Study

Carolina Head and Neck Cancer Epidemiology (CHANCE) study

Continent/Country

United States of America

State

North Carolina

Race/Ethnicity

Black
White

ORCiD

Olshan - 0000-0001-9115-5128