TY - JOUR
T1 - Impact of County-Level Socioeconomic Status on Oropharyngeal Cancer Survival in the United States
AU - Megwalu, Uchechukwu C.
N1 - Publisher Copyright:
© 2017, © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2017.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective: To evaluate the impact of county-level socioeconomic status on survival in patients with oropharyngeal cancer in the United States. Study Design: Retrospective cohort study via a large population-based cancer database. Methods: Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 18,791 patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012. Results: Patients residing in counties with a low socioeconomic status index had worse overall survival (56.5% vs 63.0%, P <.001) and disease-specific survival (62.7% vs 70.3%, P <.001) than patients residing in counties with a high socioeconomic status index. On multivariable analysis, residing in a county with a low socioeconomic status index was associated with worse overall survival (hazard ratio, 1.21; 95% CI, 1.14-1.29; P <.001) and disease-specific survival (hazard ratio, 1.21; 95% CI, 1.12-1.30; P <.001), after adjusting for race, age, sex, marital status, year of diagnosis, site, American Joint Committee on Cancer stage group, presence of distant metastasis, presence of unresectable tumor, histologic grade, surgical resection of primary site, treatment with neck dissection, and radiation therapy. Conclusion: Residing in a county with a low socioeconomic status index is associated with worse survival. Further research is needed to elucidate the mechanism by which socioeconomic status affects survival in oropharyngeal cancer.
AB - Objective: To evaluate the impact of county-level socioeconomic status on survival in patients with oropharyngeal cancer in the United States. Study Design: Retrospective cohort study via a large population-based cancer database. Methods: Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 18,791 patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012. Results: Patients residing in counties with a low socioeconomic status index had worse overall survival (56.5% vs 63.0%, P <.001) and disease-specific survival (62.7% vs 70.3%, P <.001) than patients residing in counties with a high socioeconomic status index. On multivariable analysis, residing in a county with a low socioeconomic status index was associated with worse overall survival (hazard ratio, 1.21; 95% CI, 1.14-1.29; P <.001) and disease-specific survival (hazard ratio, 1.21; 95% CI, 1.12-1.30; P <.001), after adjusting for race, age, sex, marital status, year of diagnosis, site, American Joint Committee on Cancer stage group, presence of distant metastasis, presence of unresectable tumor, histologic grade, surgical resection of primary site, treatment with neck dissection, and radiation therapy. Conclusion: Residing in a county with a low socioeconomic status index is associated with worse survival. Further research is needed to elucidate the mechanism by which socioeconomic status affects survival in oropharyngeal cancer.
KW - SEER program
KW - head and neck cancer
KW - health status disparities
KW - oropharynx cancer
KW - social determinants of health
UR - https://www.scopus.com/pages/publications/85018939862
U2 - 10.1177/0194599817691462
DO - 10.1177/0194599817691462
M3 - Article
C2 - 28195022
AN - SCOPUS:85018939862
SN - 0194-5998
VL - 156
SP - 665
EP - 670
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
IS - 4
ER -