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: PMC8904304Abstract
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.26977Reference Type
Journal ArticleYear Published
2022Journal Title
Head & NeckAuthor(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
RegularPMCID
PMC8904304Data Set/Study
Carolina Head and Neck Cancer Epidemiology (CHANCE) studyContinent/Country
United States of AmericaState
North CarolinaRace/Ethnicity
BlackWhite