BACKGROUND: The relationship between clinical outcomes and geographic determinants is not well known for head and neck cancer. Socioeconomic status (SES) factors and the distribution of health care resources might impact outcomes. METHODS: Head and neck cancer cases in the Surveillance, Epidemiology, and End Results (SEER) database were studied. Patient-level prognostic factors were identified from the SEER, and county-level factors were identified from the Area Health Resource File. Stage at presentation and observed survival were the outcomes of interest, with predictive factors identified by multivariate logistic and Cox proportional hazards regression. RESULTS: On multivariate analysis, tumor site, sex, race, marital status, rural residence, and county poverty level predicted stage at presentation. Sex, race, marital status, county-level poverty, and number of otolaryngologists predicted observed survival. CONCLUSION: Adverse county-level SES predicted advanced cancer stage at presentation and diminished observed survival. SES was a stronger predictor of patient outcomes than rurality or number of otolaryngologists.
BACKGROUND: The relationship between clinical outcomes and geographic determinants is not well known for head and neck cancer. Socioeconomic status (SES) factors and the distribution of health care resources might impact outcomes. METHODS:Head and neck cancer cases in the Surveillance, Epidemiology, and End Results (SEER) database were studied. Patient-level prognostic factors were identified from the SEER, and county-level factors were identified from the Area Health Resource File. Stage at presentation and observed survival were the outcomes of interest, with predictive factors identified by multivariate logistic and Cox proportional hazards regression. RESULTS: On multivariate analysis, tumor site, sex, race, marital status, rural residence, and county poverty level predicted stage at presentation. Sex, race, marital status, county-level poverty, and number of otolaryngologists predicted observed survival. CONCLUSION: Adverse county-level SES predicted advanced cancer stage at presentation and diminished observed survival. SES was a stronger predictor of patient outcomes than rurality or number of otolaryngologists.
Authors: Abraham Markin; Elizabeth B Habermann; Christopher J Chow; Yanrong Zhu; Selwyn M Vickers; Waddah B Al-Refaie Journal: Am J Surg Date: 2012-08-17 Impact factor: 2.565
Authors: Joseph L Russell; Nai-Wei Chen; Shani J Ortiz; Travis P Schrank; Yong-Fang Kuo; Vicente A Resto Journal: JAMA Otolaryngol Head Neck Surg Date: 2014-06 Impact factor: 6.223
Authors: Manuel A Molina; Michael C Cheung; Eduardo A Perez; Margaret M Byrne; Dido Franceschi; Frederick L Moffat; Alan S Livingstone; W Jarrard Goodwin; Juan C Gutierrez; Leonidas G Koniaris Journal: Cancer Date: 2008-11-15 Impact factor: 6.860
Authors: Khodayar Goshtasbi; Tyler M Yasaka; Mehdi Zandi-Toghani; Hamid R Djalilian; William B Armstrong; Tjoson Tjoa; Yarah M Haidar; Mehdi Abouzari Journal: Head Neck Date: 2020-11-03 Impact factor: 3.147