Vasu Divi1, Yifei Ma2, Kim F Rhoads2. 1. Department of Otolaryngology, Division of Head and Neck Surgery, Stanford University, Palo Alto, California. 2. Department of Surgery Stanford Cancer Institute, Stanford University, Palo Alto, California.
Abstract
BACKGROUND: The purpose of this study was to determine whether outcomes in head and neck cancer would vary based on geographic location of patients. METHODS: A dataset from the California Cancer Registry was linked to publicly available discharge abstracts. Patients were separated into geographic areas based on health service areas (HSAs). Multilevel logistic regression models were constructed to include geographic, patient, and hospital-level characteristics. RESULTS: There was significant variation in 5-year survival hazard ratios (HRs) among the majority of the 14 HSAs in the unadjusted model. After adjusting for patient and hospital characteristics, the differences between regions were not significant except for Orange County (HR = 0.75). Commission on Cancer certification (HR = 0.82; p < .01) and hospital volume (HR = 0.975; p < .01) were each independently associated with differences in survival. CONCLUSION: Geographic variation in 5-year survival outcomes is seen in head and neck cancer. Patient characteristics and treating hospitals explain much of this variation.
BACKGROUND: The purpose of this study was to determine whether outcomes in head and neck cancer would vary based on geographic location of patients. METHODS: A dataset from the California Cancer Registry was linked to publicly available discharge abstracts. Patients were separated into geographic areas based on health service areas (HSAs). Multilevel logistic regression models were constructed to include geographic, patient, and hospital-level characteristics. RESULTS: There was significant variation in 5-year survival hazard ratios (HRs) among the majority of the 14 HSAs in the unadjusted model. After adjusting for patient and hospital characteristics, the differences between regions were not significant except for Orange County (HR = 0.75). Commission on Cancer certification (HR = 0.82; p < .01) and hospital volume (HR = 0.975; p < .01) were each independently associated with differences in survival. CONCLUSION: Geographic variation in 5-year survival outcomes is seen in head and neck cancer. Patient characteristics and treating hospitals explain much of this variation.
Authors: Eric Adjei Boakye; Nosayaba Osazuwa-Peters; Betty Chen; Miao Cai; Betelihem B Tobo; Sai D Challapalli; Paula Buchanan; Jay F Piccirillo Journal: JAMA Otolaryngol Head Neck Surg Date: 2020-05-01 Impact factor: 6.223
Authors: David W Schoppy; Kim F Rhoads; Yifei Ma; Michelle M Chen; Brian Nussenbaum; Ryan K Orosco; Eben L Rosenthal; Vasu Divi Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-11-01 Impact factor: 6.223
Authors: Jacob A Clarke; Alyssa M Despotis; Ricardo J Ramirez; Jose P Zevallos; Angela L Mazul Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-07-29 Impact factor: 4.090
Authors: Barry L Rosenberg; Joshua A Kellar; Anna Labno; David H M Matheson; Michael Ringel; Paige VonAchen; Richard I Lesser; Yue Li; Justin B Dimick; Atul A Gawande; Stefan H Larsson; Hamilton Moses Journal: PLoS One Date: 2016-12-14 Impact factor: 3.240