Survival inequalities in head and neck cancers: A hospital‐based cohort study

• Published in: Head & neck Vol. 45; no. 9; pp. 2377 - 2393
• Main Authors: Menezes, Fabrício dos Santos, Verzinhasse Peres, Stela, Castro Junior, Gilberto, Antunes, José Leopoldo Ferreira, Latorre, Maria do Rosário Dias de Oliveira, Toporcov, Tatiana Natasha
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.09.2023; Wiley Subscription Services, Inc
• Subjects: Cohort analysis; Cohort Studies; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - therapy; healthcare disparities; Humans; Laryngeal Neoplasms - therapy; Larynx; mortality; Mouth Neoplasms; Oral cavity; oropharnyx cancer; Oropharyngeal Neoplasms; Oropharynx; Patients; Social Class; social inequalities; Survival; mortality; healthcare disparities; head and neck cancer; social inequalities; oropharnyx cancer; survival
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.27433

Background We investigated whether the socioeconomic status (SES) influenced survival rates in oropharynx cancers (OPC), oral cavity cancers (OCC), and larynx cancers (LC) in Brazilian patients. Methods This hospital‐based cohort study assessed the age‐standardized 5‐year relative survival (RS) using the Pohar Perme estimator. Results Overall, we identified 37 191 cases, and 5‐year RS were 24.4%, 34.1%, and 44.9% in OPC, OCC, and LC, respectively. In multiple Cox regression, the highest risk of death occurred in the most vulnerable social strata for all subsites—that is, illiterates or patients relying on publicly funded healthcare services. Disparities increased over time by 34.9% in OPC due to the rising of survival rates in the highest SES, whereas they reduced by 10.2% and 29.6% in OCC and LC. Conclusions The potential inequities were more significant for OPC than for OCC and LC. It is urgent to tackle social disparities to improve prognoses in highly unequal countries.