Racial/Ethnic disparities in socioeconomic status, diagnosis, treatment and survival among medicare-insured men and women with head and neck cancer.

To determine whether racial disparities persist in Medicare-insured elderly patients with head and neck cancer, we studied 7,480 patients diagnosed with head and neck cancer at age 65 or older in 1991-2002, identified from tumor registries maintained by the 16 areas participating in the Surveillance, Epidemiology and End Results program. Patients receiving cancer-directed surgery had significantly lower risks of both all-cause and disease-specific mortality than others; those with lower socioeconomic status were more likely to die of all causes than patients with higher socioeconomic status. African Americans had a marginally higher risk of all-cause mortality (hazard ratio = 1.19, 95% CI: 1.07-1.33), but had no significantly different risk of disease-specific mortality compared with Whites (1.09, 0.91-1.30). In conclusion, the risk of mortality was not significantly different among African Americans and Hispanics compared with Whites in specific tumor sites of head and neck cancer except a marginally elevated risk of all-cause mortality in African Americans with oral cavity tumor.