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Head and neck cancer-specific survival based on socioeconomic status in Asians and Pacific Islanders†
Article first published online: 10 NOV 2010
Copyright © 2010 American Cancer Society
Volume 117, Issue 9, pages 1935–1945, 1 May 2011
How to Cite
Chu, K. P., Shema, S., Wu, S., Gomez, S. L., Chang, E. T. and Le, Q.-T. (2011), Head and neck cancer-specific survival based on socioeconomic status in Asians and Pacific Islanders. Cancer, 117: 1935–1945. doi: 10.1002/cncr.25723
The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Health Services, the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred.
- Issue published online: 19 APR 2011
- Article first published online: 10 NOV 2010
- Manuscript Revised: 13 SEP 2010
- Manuscript Accepted: 13 SEP 2010
- Manuscript Received: 30 JUL 2010
- socioeconomic status;
- head and neck cancer;
- Pacific Islanders
Lower socioeconomic status (SES) has been linked to higher incidence of head and neck cancer (HNC) and lower survival. However, little is known about the effect of SES on HNC survival in Asians and Pacific Islanders (APIs). This study's purpose was to examine the effect of SES on disease-specific survival (DSS) and overall survival (OS) in APIs with HNC using population-based data.
A total of 53,544 HNC patients (4,711 = APIs) were identified from the California Cancer Registry from 1988 to 2007. Neighborhood (block-group-level) SES, based on composite Census 1990 and 2000 data, was calculated for each patient based on address at diagnosis, categorized into statewide quintiles, and collapsed into 2 groups for comparison (low SES = quintiles 1-3; high SES = quintiles 4-5). DSS and OS were computed by the Kaplan-Meier method. Adjusted hazards ratios (HR) were estimated using Cox proportional hazards regression models.
Among APIs, lower neighborhood SES was significantly associated with poorer DSS (HR range for oral cavity, oropharynx, or larynx/hypopharynx cancer, 1.07-1.34) and OS (HR, 1.13-1.37) after adjusting for patient and tumor characteristics. Lower SES was significantly associated with poorer survival in API with all HNC sites combined: DSS HR: 1.26 (95% confidence interval [CI], 1.08-1.48) and OS HR, 1.30 (95% CI, 1.16-1.45).
Neighborhood SES was associated with longer DSS and OS in API with HNC. The effect of SES on HNC survival should be considered in future studies, and particular attention should be paid to clinical care of lower-SES HNC patients. Cancer 2011. © 2010 American Cancer Society.