Department of Otolaryngology-Head and Neck Surgery, University of Ottawa/The Ottawa Hospital, Suite S-3, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
J Otolaryngol Head Neck Surg. 2014 Jan 14;43(1):2. doi: 10.1186/1916-0216-43-2.
Human papilloma virus (HPV) is emerging as the primary cause for some head and neck cancers. The objective of this study was to investigate the association between head and neck cancer (HNC) survival and socioeconomic status (SES) in Canada, and to investigate changes in the relationship between HNC survival and SES from 1992 to 2005.
Cases were drawn from the Canadian Cancer Registry (1992-2005), and were categorized into three subsites: oropharynx, oral cavity, and "other" (hypopharynx, larynx, and nasopharynx). Demographic and socioeconomic information were extracted from the Canadian Census of Population data for the study period, which included three census years: 1991, 1996 and 2001. We linked cases to income quintiles (InQs) according to patients' postal codes.
Overall survival, without controlling for smoking, for oropharyngeal cancer increased dramatically from 1992-2005 in Canada. This increase in survival for oropharynx cancer was eliminated by the introduction of controls for smoking. Survival for all head and neck cancer subsites was strongly correlated with SES, as measured by income quintile, with lower InQ's having lower survival than higher. Lastly, the magnitude of the difference in survival between the highest and lowest income quintiles increased significantly over the time period studied for oropharynx cancer, but did not statistically significantly change for oral cavity cancer or other head and neck cancers.
These data confirm a significant impact of socioeconomic deprivation on overall survival for head and neck cancers in Canada, and may provide indirect evidence that HPV-positive head and neck cancers are more common in higher socioeconomic groups.
人乳头瘤病毒（HPV）正成为某些头颈部癌症的主要病因。本研究旨在探讨加拿大头颈部癌症（HNC）生存与社会经济地位（SES）之间的关系，并调查从 1992 年到 2005 年 HNC 生存与 SES 之间关系的变化。
从加拿大癌症登记处（1992-2005 年）中抽取病例，并将其分为三个亚部位：口咽、口腔和“其他”（下咽、喉和鼻咽癌）。人口普查数据提取了研究期间的人口统计学和社会经济信息，包括三个人口普查年份：1991 年、1996 年和 2001 年。我们根据患者的邮政编码将病例与收入五分位数（InQ）相关联。
在加拿大，未控制吸烟的情况下，口咽癌的总生存率从 1992 年到 2005 年急剧上升。口咽癌生存率的这种增加在引入吸烟控制后被消除。所有头颈部癌症亚部位的生存率与 SES 密切相关，收入五分位数（InQ）越低，生存率越低。最后，口咽癌的最高和最低收入五分位数之间的生存率差异幅度在研究期间显著增加，但口腔癌或其他头颈部癌症的差异没有统计学意义。
这些数据证实了社会经济贫困对加拿大头颈部癌症总生存率的显著影响，并可能提供间接证据表明 HPV 阳性头颈部癌症在较高社会经济群体中更为常见。
