Sociodemographic disparities in choice of therapy and survival in advanced laryngeal cancer

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Purpose: To determine if sociodemographic factors are associated with treatment choice and survival in patients with advanced stage laryngeal cancer in the U.S. Design/setting/subjects/methods Population-based, non-concurrent cohort study of 5381 patients diagnosed with stage III or IV laryngeal squamous cell carcinoma from 1992-2009. Data was extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Main outcome(s) and measures Choice of therapy (surgical vs. non-surgical) and disease-specific survival (DSS). Results: Age ≥ 60 years (odds ratio [OR] = 0.78; 95% CI, 0.70-0.88) and more recent year of diagnosis (OR = 0.89; 95% CI, 0.87-0.90) decreased the odds of receiving surgical therapy, while residing in a county with low median household income (OR = 1.36; 95% CI, 1.17-1.57) increased the odds of receiving surgical therapy. Age ≥ 60 years (hazard ratio [HR] = 1.45; 95% CI, 1.33-1.59) and Black race (HR = 1.14; 95% CI, 1.02-1.27) were negatively associated with DSS, while female sex (HR = 0.81; 95% CI, 0.72-0.90) and married status (HR = 0.69; 95% CI, 0.63-0.75) were positively associated with DSS. Conclusions and relevance: For patients with advanced laryngeal cancer, younger age and residing in a low-income county increase the likelihood of receiving surgical therapy. Female sex and married status provide a survival benefit, while Black race appears to be a negative prognostic factor. This highlights the impact of sociodemographic factors on treatment strategies and outcomes and highlights areas for further research on health disparities.

Original languageEnglish
Pages (from-to)65-69
Number of pages5
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number2
StatePublished - 1 Mar 2016


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