Socioeconomic Status and Rurality Among Patients With Head and Neck Cancer

Abstract

Objective Describe the relationship among rurality, socioeconomic status (SES), and patient/tumor characteristics in patients presenting with head and neck cancer. Study Design Retrospective single-institution study. Setting Academic tertiary-level medical center. Methods Patients with head and neck cancer presenting between 2011 and 2015 were included. Stage at presentation, insurance status, and demographic characteristics were collected. Rurality was measured through Rural-Urban Continuum Codes. SES was measured by SES index scores of the Agency for Healthcare Research and Quality, which incorporate multiple components of SES. Associations among rurality, SES, and patient/tumor characteristics were assessed with univariate and multivariable statistics. All P values were calculated via 2-sided hypotheses. The threshold for statistical significance was set at P < .05. Statistical analyses were conducted with Stata/SE 14 (StataCorp). Results The study included 266 patients diagnosed with head and neck cancer between 2011 and 2015. Rural residence was associated with lower SES ( P < .001). T and N stages were associated with rurality ( P = .036 and .050, respectively). Higher educational status was associated with oropharyngeal cancer ( P = .005). Conclusions Rurality and SES have distinct impacts on patients with head and neck cancer. Specifically, rurality is associated with tumor stage among patients with head and neck cancer. Knowledge of disparities among patients with rural residency may help target interventions to facilitate earlier diagnosis.