Jaibir S Pannu1, Matthew C Simpson2,3, Connor L Donovan4, Eric Adjei Boakye5, Katherine Mass1, Sai D Challapalli6, Mark A Varvares7, Nosayaba Osazuwa-Peters2,3. 1. Saint Louis University School of Medicine, St. Louis, Missouri, USA. 2. Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA. 3. Saint Louis University Cancer Center, St. Louis, Missouri, USA. 4. Fulbright College of Arts and Sciences, University of Arkansas, Fayetteville, Arkansas, USA. 5. Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois, USA. 6. Department of Otorhinolaryngology-Head and Neck Surgery, University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA. 7. Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Abstract
BACKGROUND: To describe sociodemographic factors associated with head and neck cancer (HNC) survival among patients with distant metastatic disease. METHODS: We retrospectively analyzed national data for 2889 adult patients with metastatic HNC (2007-2015). We used Fine and Gray competing risks proportional hazard models, stratified by oropharyngeal cancer status, controlled for sociodemographic factors (age, sex, race/ethnicity, marital status, and insurance status), and accounted for multiple testing. RESULTS: Median survival time was 11 months (15 months for patients married/partnered; 13 months for patients with non-Medicaid insurance; P < .01). Among patients with oropharyngeal cancer, being married/partnered was associated with lower mortality hazard (sdHRdivorced/separated = 1.37, 97.5% confidence interval [CI] = 1.07, 1.75; and sdHRnever married = 1.43, 97.5% CI = 1.14, 1.80), as was having non-Medicaid insurance (sdHRuninsured = 1.44, 97.5% CI = 1.02, 2.04). CONCLUSIONS: Health insurance and marital status are sociodemographic factors associated with survival among HNC patients with distant metastatic disease, especially in oropharyngeal cases.
BACKGROUND: To describe sociodemographic factors associated with head and neck cancer (HNC) survival among patients with distant metastatic disease. METHODS: We retrospectively analyzed national data for 2889 adult patients with metastatic HNC (2007-2015). We used Fine and Gray competing risks proportional hazard models, stratified by oropharyngeal cancer status, controlled for sociodemographic factors (age, sex, race/ethnicity, marital status, and insurance status), and accounted for multiple testing. RESULTS: Median survival time was 11 months (15 months for patients married/partnered; 13 months for patients with non-Medicaid insurance; P < .01). Among patients with oropharyngeal cancer, being married/partnered was associated with lower mortality hazard (sdHRdivorced/separated = 1.37, 97.5% confidence interval [CI] = 1.07, 1.75; and sdHRnever married = 1.43, 97.5% CI = 1.14, 1.80), as was having non-Medicaid insurance (sdHRuninsured = 1.44, 97.5% CI = 1.02, 2.04). CONCLUSIONS: Health insurance and marital status are sociodemographic factors associated with survival among HNC patients with distant metastatic disease, especially in oropharyngeal cases.
Keywords:
cancer survival; distant metastatic disease; head and neck cancer; social determinants of health; surveillance, epidemiology, and end results