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头颈癌的健康社会决定因素与治疗决策

Social determinants of health and treatment decisions in head and neck cancer.

作者信息

Shehan Jennifer N, Alwani Tooba, LeClair Jessica, Mahoney Taylor F, Agarwal Pratima, Chaudhry Salil T, Wang Judy J, Noordzij Jacob Pieter, Tracy Lauren F, Edwards Heather A, Grillone Gregory, Salama Andrew R, Jalisi Scharukh M, Devaiah Anand K

机构信息

Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA.

Boston University School of Medicine, Boston, Massachusetts, USA.

出版信息

Head Neck. 2022 Feb;44(2):372-381. doi: 10.1002/hed.26931. Epub 2021 Dec 10.

DOI:10.1002/hed.26931
PMID:34889486
Abstract

BACKGROUND

This study compares select social determinants of health (SDOH) with treatment modality selection and treatment completion in head and neck cancer (HNC) patients, to better understand disparities in health outcomes.

METHODS

A retrospective cohort study of HNC (n = 1428) patients was conducted. Demographic and disease-specific variables were recorded, including treatment modality selection and completion. Data were analyzed using two-sample t tests, chi-square, and Fisher's exact tests.

RESULTS

Primary language was significantly associated with treatment choice, where non-English speakers were less likely to choose treatment as recommended by the Tumor Board. Lower mean distance from the hospital (37.38 [48.31] vs. 16.92 [19.10], p < 0.0001) and a county-based higher mean percentage of bachelor degree or higher education (42.16 [8.82] vs. 44.95 [6.19], p < 0.0003) were associated with treatment selection.

CONCLUSION

Language, distance from the hospital, and education affected treatment selection in this study and may be useful in understanding how to counsel patients on treatment selection for HNC.

摘要

背景

本研究比较了头颈癌(HNC)患者健康的特定社会决定因素(SDOH)与治疗方式选择及治疗完成情况,以更好地理解健康结果的差异。

方法

对头颈癌患者(n = 1428)进行了一项回顾性队列研究。记录了人口统计学和疾病特异性变量,包括治疗方式选择和完成情况。使用两样本t检验、卡方检验和费舍尔精确检验对数据进行分析。

结果

主要语言与治疗选择显著相关,非英语使用者不太可能选择肿瘤委员会推荐的治疗方法。与医院的平均距离较短(37.38 [48.31] 对 16.92 [19.10],p < 0.0001)以及基于县的本科及以上学历平均百分比更高(42.16 [8.82] 对 44.95 [6.19],p < 0.0003)与治疗选择相关。

结论

在本研究中,语言、与医院的距离和教育程度影响了治疗选择,可能有助于理解如何就头颈癌的治疗选择向患者提供咨询。

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