Decreased overall survival in black patients with HPV-associated oropharyngeal cancer

Siddharth Sheth, Douglas R. Farquhar, Nicholas R. Lenze, Angela Mazul, Paul Brennan, Devasena Anantharaman, Behnoush Abedi-Ardekani, Jose P. Zevallos, D. Neil Hayes, F. Olshan

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: Racial disparities for overall survival (OS) in head and neck cancer have been well described. However, the extent to which these disparities exist for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC), and the contribution of demographic, clinical, and socioeconomic status (SES) variables, is unknown. Materials and methods: Patients were identified from the Carolina Head and Neck Cancer Epidemiology Study (CHANCE), a population-based study in North Carolina. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for OS in black versus white patients with sequential adjustment sets. Results: A total of 157 HPV-associated OPSCC patients were identified. Of these, 93% were white and 7% were black. Black patients with HPV-associated OPSCC were more likely to be younger, have an income <$20,000, live farther away from clinic where biopsy was performed, and have advanced T stage at diagnosis. Black patients had worse OS in the unadjusted analysis (HR 4.9, 95% CI 2.2–11.1, p < 0.0001). The racial disparity in OS slightly decreased when sequentially adjusting for demographic, clinical, and SES variables. However, HR for black race remained statistically elevated in the final adjustment set which controlled for age, sex, stage, smoking, alcohol use, and individual-level household income, insurance, and education level (HR 3.4, 95% CI 1.1–10.1, p = 0.028). Conclusion: This is the first population-based study that confirms persistence of racial disparities in HPV-associated OPSCC after controlling for demographic, clinical, and individual-level socioeconomic factors.

Original languageEnglish
Article number102780
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2021

Keywords

  • Disparities
  • Head and neck neoplasms
  • Human papillomavirus
  • Race
  • Survival

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