Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Jan;33(1):45-53.
doi: 10.1002/hed.21398.

Case-matching analysis of head and neck squamous cell carcinoma in racial and ethnic minorities in the United States--possible role for human papillomavirus in survival disparities

Travis P Schrank  1 , Yimei Han, Heidi Weiss, Vicente A Resto
Affiliations
Comparative Study

Case-matching analysis of head and neck squamous cell carcinoma in racial and ethnic minorities in the United States--possible role for human papillomavirus in survival disparities

Travis P Schrank et al. Head Neck. 2011 Jan.

Abstract

Background: Several studies have documented disparities in head and neck cancer outcomes for black patients in the United States. Recent studies have found that differences in oropharyngeal tumor human papillomavirus (HPV) status may be a cause of this disparity.

Methods: In all, 76,817 cases of head and neck squamous cell carcinoma (HNSCC) recorded in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program were analyzed. Racial/ethnic groups were studied, for disease-specific survival in both case-matched and nonmatched cohorts. Calculation of expected disparity magnitudes based on HPV status was performed using data reported in the literature.

Results: A disease-specific survival disparity was demonstrated for Hispanic patients. However, case matching eliminated this disparity. Conversely, the disparity for black patients persisted in matched cohorts. The oropharyngeal subsite was found to be the dominant contributor to this disparity.

Conclusions: The survival disparity for Hispanic patients in SEER with HNSCC is explained by differences in presentation and treatment. Also, HPV tumor status is likely a key determinant of the disparity for black patients.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier estimate of disease-specific survival for all available white, Hispanic, and black patients. Unmatched analysis. Solid lines: probability of survival; dashed lines: 95% confidence interval, estimated by the log-transform method; vertical hashes: right censoring. [Color figure can be viewed in the online issue, which is available at www.interscience.wiley.com.]
FIGURE 2
FIGURE 2
Kaplan–Meier estimate of disease-specific survival for case-matched cohorts. (A) Hispanic/White case matched pairs (n = 2609). (B) Black/White case matched pairs (n = 4671). Solid lines: probability of survival; dashed lines: 95% confidence interval, estimated by the log-transform method; vertical hashes: right censoring. [Color figure can be viewed in the online issue, which is available at www.interscience.wiley.com.]
FIGURE 3
FIGURE 3
Kaplan–Meier estimate of disease-specific survival of head and neck squamous cell carcinoma (HNSCC) for case-matched cohorts, by race and subsite. (A) Hypopharynx. (B) Oral cavity. (C) Larynx. (D) Oropharynx. Solid lines: probability of survival; dashed lines: 95% confidence interval, estimated by the log-transform method; vertical hashes: right censoring. [Color figure can be viewed in the online issue, which is available at www.interscience.wiley.com.]
See this image and copyright information in PMC

References

    1. Molina MA, Cheung MC, Perez EA, et al. African American and poor patients have a dramatically worse prognosis for head and neck cancer: an examination of 20,915 patients. Cancer. 2008;113:2797–2806. - PubMed
    1. Nichols AC, Bhattacharyya N. Racial differences in stage and survival in head and neck squamous cell carcinoma. Laryngoscope. 2007;117:770–775. - PubMed
    1. Hobbs F, Stoops N, Long JF. Census 2000 Special Reports: United States Census Bureau. 2002. Demographic trends in the 20th century.
    1. DeNavas-Walt C, Proctor BD, Smith JC. Current population reports: consumer income: United States Census Bureau. 2008. Income, poverty, and health insurance coverage in the United States: 2007.
    1. Rutledge MS, McLaughlin CG. Hispanics and health insurance coverage: the rising disparity. Med Care. 2008;46:1086–1092. - PubMed

Publication types

MeSH terms