DETERMINANTS OF HEAD AND NECK CANCER SURVIVAL BY RACE

Background. Several factors contribute to the documented racial disparity in head and neck cancer, among which are socioeconomic status, access to care, and biologic factors. Methods. Clinical characteristics of 87 African-American patients with head and neck cancer and a random sample of 261 white patients matched on age and smoking dose were associated with outcome. Results. Black patients with cancers of the oral cavity and larynx were more likely diagnosed with advanced stages than whites, after adjusting for socioeconomic and insurance status and other confounding factors. There was a significant difference in relapse-free survival between blacks and whites with tumors of the larynx (hazard ratio [HR] = 3.36, 95% confidence interval [CI]: 1.62-7.00), but not with tumors of the oral cavity or pharynx. Conclusions. Differences in disease outcome may be attributed to a combination of tumor stage, socioeconomic status, and access to health care. The inclusion of biologic markers such as human papillomavirus (HPV) status is needed in future studies to further evaluate racial disparities in head and neck cancer outcomes. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 1092-1098, 2011