Author:
Karanth Shama,Mistry Shilpi,Wheeler Meghann,Akinyemiju Tomi,Divaker Joel,Yang Jae Jeong,Yoon Hyung-Suk,Braithwaite Dejana
Abstract
Abstract
Purpose
Disparities in oral cavity and pharyngeal cancer based on race/ethnicity and socioeconomic status have been reported, but the impact of living within areas that are persistently poor at the time of diagnosis and outcome is unknown. This study aimed to investigate whether the incidence, 5-year relative survival, stage at diagnosis, and mortality among patients with oral cavity and pharyngeal cancers varied by persistent poverty.
Methods
Data were drawn from the SEER database (2006–2017) and included individuals diagnosed with oral cavity and pharyngeal cancers. Persistent poverty (at census tract) is defined as areas where ≥ 20% of the population has lived below the poverty level for ~ 30 years. Age-adjusted incidence and 5-year survival rates were calculated. Multivariable logistic regression was used to estimate the association between persistent poverty and advanced stage cancer. Cumulative incidence and multivariable subdistribution hazard models were used to evaluate mortality risk. In addition, results were stratified by cancer primary site, sex, race/ethnicity, and rurality.
Results
Of the 90,631 patients included in the analysis (61.7% < 65 years old, 71.6% males), 8.8% lived in persistent poverty. Compared to non-persistent poverty, patients in persistent poverty had higher incidence and lower 5-year survival rates. Throughout 10 years, the cumulative incidence of cancer death was greater in patients from persistent poverty and were more likely to present with advanced-stage cancer and higher mortality risk. In the stratified analysis by primary site, patients in persistent poverty with oropharyngeal, oral cavity, and nasopharyngeal cancers had an increased risk of mortality compared to the patients in non-persistent poverty.
Conclusion
This study found an association between oral cavity and pharyngeal cancer outcomes among patients in persistent poverty indicating a multidimensional strategy to improve survival.
Funder
Cancer Center, University of Florida Health
Publisher
Springer Science and Business Media LLC
Reference39 articles.
1. Siegel RL, Miller KD, Wagle NS, Jemal A (2023) Cancer statistics, 2023. CA: Cancer J Clinicians 73(1):17–48
2. Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A et al (2004) Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clinicians. 54(2):78–93
3. Auluck A, Walker BB, Hislop G, Lear SA, Schuurman N, Rosin M (2014) Population-based incidence trends of oropharyngeal and oral cavity cancers by sex among the poorest and underprivileged populations. BMC Cancer 14(1):316
4. Karanth SD, Akinyemiju T, Walker CJ, Yang D, Migliorati CA, Yoon H-S et al (2023) The Intersectionality between race, ethnicity, and residential-level socioeconomic status in disparities of head and neck cancer outcomes: a SEER study. Cancer Epidemiol Biomark Prev 32(4):516–523
5. Miller KK, Crandall MS, Weber BA (2002) Persistent poverty and place: how do persistent poverty and poverty demographics vary across the rural-urban continuum. Measuring Rural Diversity 2002 [Google Scholar]