Abstract A58: Racial disparities in head and neck cancers in an urban hospital

• Published in: Cancer epidemiology, biomarkers & prevention Vol. 27; no. 7_Supplement; p. A58
• Main Authors: Zeigler-Johnson, Charnita, Keith, Scott, Guiles, Frances, Cognetti, David, Bar-Ad, Voichita, Axelrod, Rita
• Format: Journal Article
• Language: English
• Published: 01.07.2018
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1538-7755.DISP17-A58

Abstract Introduction: Although head and neck cancer incidence rates are higher for white residents in Philadelphia, PA, related mortality rates are highest for black residents. It is not clear how clinical factors and risk factors like HPV and smoking contribute to these disparities. The goal of this study is to determine which factors are associated with advanced head and neck cancers in a diverse sample of patients from a Philadelphia hospital. Methods: Cancer registry data from Thomas Jefferson University (957 beds, Philadelphia, PA) were used to obtain clinical records from 922 head and neck cancer patients diagnosed from 2011-2015. One patient of other race was removed from these analyses. We examined advanced cancer among the primary racial groups represented in our hospital population. Chi-square tests were used to examine differences in categorical variables. The Kruskal-Wallis test was used to compare continuous variables. Logistic and Cox regression models were designed to examine independent associations with advanced disease and time to mortality. Covariates included age, race, tumor stage, HPV status, smoking status, gender, and treatment type. Results: Our sample included 921 patients (788 white, 96 black, 37 Asian). Our descriptive analysis showed that among the three groups, blacks were more likely to be female (p=0.033). Positive HPV status was most prevalent for white patients (p=0.004). Oral and nasopharyngeal cancers were most common among Asians, and oropharyngeal cancers were most common among whites. In univariate analysis, black patients were most likely to die from their cancer. Multivariable analyses showed that current smoking (compared to never smoking) was associated with T3/T4 stage at diagnosis (OR=6.85, 95% CI=1.11-42.2). Time to death was significantly shorter for older individuals (HR=1.02 95% CI=1.01-1.05), current smokers (HR=2.24, 95% CI=1.25-4.00) and patients receiving radiation only (HR=7.70, 95% CI=1.38-42.95). Positive HPV status was protective (HR=0.29, 95% CI=0.19-0.44). No significant race effects were observed in these models. Conclusions: The results of this study suggest that race is not independently associated with head and neck cancer or associated mortality. These results also suggest that some risk factors for head and neck cancer and related outcomes may be modified by educational and behavioral interventions. Citation Format: Charnita Zeigler-Johnson, Scott Keith, Frances Guiles, David Cognetti, Voichita Bar-Ad, Rita Axelrod. Racial disparities in head and neck cancers in an urban hospital [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A58.