Assessing social vulnerabilities of salivary gland cancer care, prognosis, and treatment in the United States

• Published in: Head & neck Vol. 46; no. 9; pp. 2152 - 2166
• Main Authors: Bindra, Govind S., Fei‐Zhang, David J., Desai, Atharva, Maddalozzo, John, Smith, Stephanie S., Patel, Urjeet A., Chelius, Daniel C., D'Souza, Jill N., Rastatter, Jeffrey C., Gillespie, M. Boyd, Sheyn, Anthony M.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.09.2024; Wiley Subscription Services, Inc
• Subjects: Chemotherapy; epidemiology; Head & neck cancer; head and neck cancer; Oral cancer; Radiation therapy; Salivary gland; salivary gland cancer; social determinants of health; social vulnerability; Surgery; Survival; epidemiology; social vulnerability; social determinants of health; salivary gland cancer; head and neck cancer
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27783

Background Salivary gland cancers (SGC)‐social determinants of health (SDoH) investigations are limited by narrow scopes of SGC‐types and SDoH. This Social Vulnerability Index (SVI)‐study hypothesized that socioeconomic status (SES) most contributed to SDoH‐associated SGC‐disparities. Methods Retrospective cohort of 24 775 SGCs assessed SES, minority‐language status (ML), household composition (HH), housing‐transportation (HT), and composite‐SDoH measured by the SVI via regressions with surveillance and survival length, late‐staging presentation, and treatment (surgery, radio‐, chemotherapy) receipt. Results Increasing social vulnerability showed decreases in surveillance/survival; increased odds of advanced‐presenting‐stage (OR: 1.12, 95% CI: 1.07, 1.17), chemotherapy receipt (OR: 1.13, 95% CI: 1.03, 1.23); decreased odds of primary surgery (0.89, 0.84, 0.94), radiotherapy (0.91, 0.85, 0.97, p = 0.003) for SGCs. Trends were differentially correlated with SES, ML, HH, and HT‐vulnerabilities. Conclusions Through quantifying SDoH‐derived SGC‐disparities, the SVI can guide targeted initiatives against SDoH that elicit the most detrimental associations for specific sociodemographics.