@article{6e3da67e38604e68baac9a5d37332480,
title = "Socioeconomic status, access to care, risk factor patterns, and stage at diagnosis for head and neck cancer among black and white patients",
abstract = "Background: Little is known about how factors combine to influence progression of squamous cell carcinoma of the head and neck (HNSCC). We aimed to evaluate multidimensional influences of factors associated with HNSCC stage by race. Methods: Using retrospective data, patients with similar socioeconomic status (SES), access to care (travel time/distance), and behavioral risk factors (tobacco/alcohol use and dental care) were grouped by latent class analysis. Relative frequency differences (RFD) were calculated to evaluate latent classes by stage, race, and p16 status. Results: We identified three latent classes. Advanced T-stage was higher for black (RFD = +20.2%; 95% CI: −4.6 to 44.9) than white patients (RFD = +10.7%; 95% CI: 2.1–19.3) in the low-SES/high-access/high-behavioral risk class and higher for both black (RFD = +29.6%; 95% CI: 4.7–54.5) and white patients (RFD = +23.9%; 95% CI: 15.2–32.6) in the low-SES/low-access/high-behavioral risk class. Conclusion: Results suggest that SES, access to care, and behavioral risk factors combine to underly the association with advanced T-stage. Additionally, differences by race warrant further investigation.",
keywords = "HPV-related cancer, distance to care, head and neck cancer, late stage, latent class analysis, neoplasm stage, racial disparities, socioeconomic status",
author = "Emerson, {Marc A.} and Farquhar, {Douglas R.} and Lenze, {Nicholas R.} and Siddharth Sheth and Mazul, {Angela L.} and Zanation, {Adam M.} and Hackman, {Trevor G.} and Weissler, {Mark C.} and Zevallos, {Jose P.} and Yarbrough, {Wendell G.} and Paul Brennan and Behnoush Abedi-Ardekani and Olshan, {Andrew F.}",
note = "Funding Information: This work was supported by the National Cancer Institute at the National Institutes of Health (R01-CA90731 to Andrew F. Olshan). Marc A. Emerson was supported by the University of North Carolina Lineberger Comprehensive Cancer Center Cancer Control and Education Program (T32-CA057726). Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer/World Health Organization. Funding Information: This work was supported by the National Cancer Institute at the National Institutes of Health (R01‐CA90731 to Andrew F. Olshan). Marc A. Emerson was supported by the University of North Carolina Lineberger Comprehensive Cancer Center Cancer Control and Education Program (T32‐CA057726). Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer/World Health Organization. Publisher Copyright: {\textcopyright} 2022 Wiley Periodicals LLC.",
year = "2022",
month = apr,
doi = "10.1002/hed.26977",
language = "English",
volume = "44",
pages = "823--834",
journal = "Head & Neck",
issn = "1043-3074",
number = "4",
}