Sean T Massa1, Nosayaba Osazuwa-Peters2, Kara M Christopher3, Lauren D Arnold4, Mario Schootman4, Ronald J Walker2, Mark A Varvares5. 1. Department of Otolaryngology - Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, MO, United States. Electronic address: seanmassa@slu.edu. 2. Department of Otolaryngology - Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, MO, United States. 3. Cancer Center, Saint Louis University School of Medicine, St. Louis, MO, United States. 4. College for Public Health and Social Justice, Department of Epidemiology, Saint Louis University, St. Louis, MO, United States. 5. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States.
Abstract
PURPOSE/ OBJECTIVES: The increasing survivorship of head and neck squamous cell carcinoma (HNSCC) comes with a risk of death from other causes, known as competing causes. The demographics of HNSCC are also evolving with increasing incidence of Human Papillomavirus (HPV) associated tumors. This study describes competing causes of death for the HNSCC population compared to the general population and identifies associated risk factors. METHODS: Adult patients with first mucosal HNSCC (2004-2011) were identified from the Surveillance, Epidemiology and End Result database. Competing causes of death were compared to reference populations using proportion of deaths and Standardized Mortality Ratios (SMR). A multivariable competing risk survival analysis yielded subdistribution hazard ratios (HR) for competing mortality. RESULTS: Of 64,598 HNSCC patients, 24,602 (38.1%) were deceased including 7142 deaths (29.0%) from competing causes. The most common were cardiovascular disease, lung cancer, and other cancers. All relative mortality rates were elevated, especially liver disease (SMR 38.7; 95% CI: 29.4-49.3), suicide (SMR 37.1; 95% CI: 26.1-48.6), and subsequent primary cancers (SMR 7.5; 95% CI: 6.78-8.32). Demographic and tumor factors independently increased risk of competing mortality, including age (HR per 5years 1.24; 95% CI: 1.22-1.25), sex (male HR 1.23; 95% CI: 1.16-1.32), race (Black HR 1.17; 95% CI: 1.09-1.26), insurance (uninsured HR 1.28; 95% CI: 1.09-1.50), and marital status (single HR 1.29; 95% CI: 1.21-1.37). CONCLUSION: Nearly one in three HNSCC patients died from competing causes. When developing long term survivorship regimens for HNSCC patients, clinicians should be familiar with this population's specific risks.
PURPOSE/ OBJECTIVES: The increasing survivorship of head and neck squamous cell carcinoma (HNSCC) comes with a risk of death from other causes, known as competing causes. The demographics of HNSCC are also evolving with increasing incidence of Human Papillomavirus (HPV) associated tumors. This study describes competing causes of death for the HNSCC population compared to the general population and identifies associated risk factors. METHODS: Adult patients with first mucosal HNSCC (2004-2011) were identified from the Surveillance, Epidemiology and End Result database. Competing causes of death were compared to reference populations using proportion of deaths and Standardized Mortality Ratios (SMR). A multivariable competing risk survival analysis yielded subdistribution hazard ratios (HR) for competing mortality. RESULTS: Of 64,598 HNSCC patients, 24,602 (38.1%) were deceased including 7142 deaths (29.0%) from competing causes. The most common were cardiovascular disease, lung cancer, and other cancers. All relative mortality rates were elevated, especially liver disease (SMR 38.7; 95% CI: 29.4-49.3), suicide (SMR 37.1; 95% CI: 26.1-48.6), and subsequent primary cancers (SMR 7.5; 95% CI: 6.78-8.32). Demographic and tumor factors independently increased risk of competing mortality, including age (HR per 5years 1.24; 95% CI: 1.22-1.25), sex (male HR 1.23; 95% CI: 1.16-1.32), race (Black HR 1.17; 95% CI: 1.09-1.26), insurance (uninsured HR 1.28; 95% CI: 1.09-1.50), and marital status (single HR 1.29; 95% CI: 1.21-1.37). CONCLUSION: Nearly one in three HNSCC patients died from competing causes. When developing long term survivorship regimens for HNSCC patients, clinicians should be familiar with this population's specific risks.
Authors: Matthew C Simpson; Sean T Massa; Eric Adjei Boakye; Jastin L Antisdel; Katherine A Stamatakis; Mark A Varvares; Nosayaba Osazuwa-Peters Journal: JAMA Oncol Date: 2018-02-01 Impact factor: 31.777
Authors: Daisuke Kawakita; Sarah Abdelaziz; Yuji Chen; Kerry Rowe; John Snyder; Alison Fraser; Ken Smith; Kimberly Herget; Vikrant Deshmukh; Michael Newman; Marcus Monroe; Mia Hashibe Journal: Cancer Date: 2019-11-13 Impact factor: 6.860
Authors: Lauren A Zimmaro; Sandra E Sephton; Chelsea J Siwik; Kala M Phillips; Whitney N Rebholz; Helena C Kraemer; Janine Giese-Davis; Liz Wilson; Jeffrey M Bumpous; Elizabeth D Cash Journal: Cancer Date: 2018-01-22 Impact factor: 6.860
Authors: Yao Xu; Basel Abdelazeem; Kirellos Said Abbas; Yile Lin; Haixiao Wu; Fei Zhou; Karl Peltzer; Vladimir P Chekhonin; Shu Li; Huiyang Li; Wenjuan Ma; Chao Zhang Journal: Front Med (Lausanne) Date: 2022-06-02
Authors: Thomas F Barrett; Angela L Mazul; Katelyn O Stepan; C Burton Wood; Randall C Paniello; Jose P Zevallos; Sean Massa; Ryan S Jackson; Nicole C Schmitt; Joseph Zenga; Stephen Y Kang; Patrik Pipkorn; Jason T Rich; Sidharth V Puram Journal: Oral Oncol Date: 2021-05-12 Impact factor: 5.972
Authors: Andres Stucky; Parish P Sedghizadeh; Susan Mahabady; Xuelian Chen; Cheng Zhang; Gang Zhang; Xi Zhang; Jiang F Zhong Journal: Oncotarget Date: 2017-05-19