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
. 2011 May 1;117(9):1935-45.
doi: 10.1002/cncr.25723. Epub 2010 Nov 10.

Head and neck cancer-specific survival based on socioeconomic status in Asians and Pacific Islanders

Karen P Chu  1 , Sarah Shema, Simon Wu, Scarlett L Gomez, Ellen T Chang, Quynh-Thu Le
Affiliations

Head and neck cancer-specific survival based on socioeconomic status in Asians and Pacific Islanders

Karen P Chu et al. Cancer. .

Abstract

Background: Lower socioeconomic status (SES) has been linked to higher incidence of head and neck cancer (HNC) and lower survival. However, little is known about the effect of SES on HNC survival in Asians and Pacific Islanders (APIs). This study's purpose was to examine the effect of SES on disease-specific survival (DSS) and overall survival (OS) in APIs with HNC using population-based data.

Methods: A total of 53,544 HNC patients (4,711 = APIs) were identified from the California Cancer Registry from 1988 to 2007. Neighborhood (block-group-level) SES, based on composite Census 1990 and 2000 data, was calculated for each patient based on address at diagnosis, categorized into statewide quintiles, and collapsed into 2 groups for comparison (low SES = quintiles 1-3; high SES = quintiles 4-5). DSS and OS were computed by the Kaplan-Meier method. Adjusted hazards ratios (HR) were estimated using Cox proportional hazards regression models.

Results: Among APIs, lower neighborhood SES was significantly associated with poorer DSS (HR range for oral cavity, oropharynx, or larynx/hypopharynx cancer, 1.07-1.34) and OS (HR, 1.13-1.37) after adjusting for patient and tumor characteristics. Lower SES was significantly associated with poorer survival in API with all HNC sites combined: DSS HR: 1.26 (95% confidence interval [CI], 1.08-1.48) and OS HR, 1.30 (95% CI, 1.16-1.45).

Conclusions: Neighborhood SES was associated with longer DSS and OS in API with HNC. The effect of SES on HNC survival should be considered in future studies, and particular attention should be paid to clinical care of lower-SES HNC patients.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: none

Figures

Figure 1
Figure 1
Disease-Specific Survival of All Patients Diagnosed with Head and Neck Cancer By High (Quintiles 4 – 5) and Low (Quintiles 1 – 3) Neighborhood Socioeconomic Status in California between 1988–2007. (a) Nasopharynx; (b) Oropharynx; (c) Oral cavity; (d) Larynx/Hypopharynx
Figure 2
Figure 2
(a) Disease Specific Survival (DSS) in Asian-Pacific Islanders (API) Diagnosed with OC, OPC, and LX/HPC By High (Quintiles 4 – 5) and Low (Quintiles 1 – 3) Neighborhood Socioeconomic Status in California between 1988 – 2007. (b) Combined Overall Survival (OS) in API Diagnosed with OC, OPC, and LX/HPC based on Socioeconomic Quintiles in California between 1988 – 2007. (c) Disease Specific Survival in Asian Pacific Islanders Diagnosed with OC, OPC, or LX/HPC based on each Socioeconomic Status Quintile in California, 1988 – 2007.
See this image and copyright information in PMC

References

    1. American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society; 2009.
    1. Givens DJ, Karnell LH, Gupta AK, et al. Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2009;135:1209–17. - PubMed
    1. Terrell JE, Fisher SG, Wolf GT. Long-term quality of life after treatment of laryngeal cancer. The Veterans Affairs Laryngeal Cancer Study Group. Arch Otolaryngol Head Neck Surg. 1998;124:964–71. - PubMed
    1. Mowry SE, Tang C, Sadeghi A, Wang MB. Standard chemoradiation versus intensity-modulated chemoradiation: a quality of life assessment in oropharyngeal cancer patients. Eur Arch Otorhinolaryngol. 2010;267(7):1111–6. - PMC - PubMed
    1. Buckwalter AE, Karnell LH, Smith RB, Christensen AJ, Funk GF. Patient-reported factors associated with discontinuing employment following head and neck cancer treatment. Arch Otolaryngol Head Neck Surg. 2007;133:464–70. - PubMed

Publication types