An assessment of racial differences in epidemiological, clinical and psychosocial factors among head and neck cancer patients at the time of surgery

摘要

Objective:Racial disparities have been well characterized and African American(AA)patients have 30%lower 5-year survival rates than European Americans(EAs)for head and neck squamous carcinoma(HNSCC).This poorer survival can be attributed to a myriad of different factors.The purpose of this study was to characterize AA-EA similarities and differences in sociodemographic,lifestyle,clinical,and psychosocial characteristics in HNSCC patients near the time of surgery.Methods:Setting:Single tertiary care center.Participants:Thirty-nine newly diagnosed,untreated HNSCC patients(n=24 EAs,n=15 AAs)who were to undergo surgery were recruited.Study Design:Cross-sectional study Sociodemographic,lifestyle factors,and disease factors(cancer site,AJCC clinical and pathologic stage,and HPV status)were assessed.Risk factors,leisure time,quality of life and social support were also assessed using validated questionnaires.Exposures:EA and AA patients were similar in the majority of sociodemographic factors assessed.AAs had a higher trend toward pathologically later stage disease compared to EAs and significantly increased time to treatment.Results:EA and AA patients were similar in the majority of sociodemographic factors assessed.AAs had a higher trend toward pathologically later stage disease compared to EAs.AAs also had significantly increased time to treatment(P=0.05).The majority of AA patients(62%)had later stage pathologic disease.AA were less likely to complete high school or college(P=0.01)than their EA counterparts.Additionally,AAs were more likely to report having a gap in health insurance during the past decade(37%vs.15%).Conclusions:This preliminary study demonstrates a similar profile of demographics,clinical and psychosocial characteristics preoperatively for AAs and EAs.Key differences were AAs tending to have later pathologic stage disease,educational status,delays in treatment initiation,and gaps in health insurance.