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Survival differences among American Indians/Alaska natives with head and neck squamous cell carcinoma
Author(s) -
Dwojak Sunshine M.,
Sequist Thomas D.,
Emerick Kevin,
Deschler Daniel G.
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23089
Subject(s) - medicine , hypopharyngeal cancer , head and neck squamous cell carcinoma , cancer , hazard ratio , proportional hazards model , oncology , stage (stratigraphy) , epidemiology , head and neck cancer , multivariate analysis , demography , confidence interval , biology , paleontology , sociology
Background American Indians/Alaska Natives experience poor overall survival. Data are limited on American Indians/Alaska Natives with head and neck squamous cell carcinoma (HNSCC). Methods We identified all cases of HNSCC among American Indians/Alaska Natives, and white patients from 1996 to 2007 using the Surveillance, Epidemiology, and End Results (SEER) database. Univariate, multivariate, and Cox models were fit to analyze racial differences in sex, age, stage, treatment, and survival. Results American Indians/Alaska Natives experienced decreased survival for oropharyngeal cancer (hazard ratio [HR] = 1.4; p = .008). After adjusting for demographic factors, survival was decreased for oral cavity cancer (HR = 1.3; p = .05) and hypopharyngeal/laryngeal cancer (HR = 1.6; p = .04). These disparities were eliminated after adjusting for treatment for oral cavity cancer (HR = 1.2; p = .17) and stage for hypopharyngeal/laryngeal cancer (HR = 1.4; p = .12). American Indians/Alaska Natives received less surgery for oral cavity cancer (78% vs 85%; p = .02). Conclusion Disparities in survival exist among American Indians/Alaska Natives patients with HNSCC. They are related to stage and differential treatment patterns. © 2012 Wiley Periodicals, Inc. Head Neck, 2013