The role of insurance status as a mediator of racial disparities in oropharyngeal cancer outcomes

Navika Shukla, Yifei Ma, Uchechukwu C. Megwalu

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: To assess the role of insurance status as a mediator of racial disparities in oropharyngeal cancer outcomes. Methods: This was a population-based retrospective cohort study. Data were extracted from the Surveillance, Epidemiology, and End Results 18 database. The study cohort included 11 627 patients diagnosed with oropharyngeal squamous cell carcinoma between 2010 and 2015. Results: The association between black race and increased risk of unresectable disease was slightly attenuated, but persistent, after including insurance status as a covariate (odds ratio [OR] 1.34, 95%CI 1.10–1.63). Likewise, black race was no longer associated with worse disease-specific survival (hazard ratio [HR] 1.11, 95%CI 0.99–1.26), but remained associated with worse overall survival with a slightly decreased effect size (HR 1.13, 95%CI 1.01–1.25). Conclusions: Insurance status plays a significant role in, but does not completely account for, the persistent racial disparities in oropharyngeal cancer outcomes.

Original languageEnglish
Pages (from-to)3116-3124
Number of pages9
JournalHead and Neck
Volume43
Issue number10
DOIs
StatePublished - Oct 2021
Externally publishedYes

Keywords

  • disease-specific survival
  • insurance status
  • oropharyngeal cancer
  • overall survival
  • race-based disparities

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