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

Abstract

AbstractBackgroundSalivary 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.MethodsRetrospective 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.ResultsIncreasing 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.ConclusionsThrough quantifying SDoH‐derived SGC‐disparities, the SVI can guide targeted initiatives against SDoH that elicit the most detrimental associations for specific sociodemographics.