Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.
Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Cancer Epidemiol Biomarkers Prev. 2023 May 1;32(5):642-652. doi: 10.1158/1055-9965.EPI-22-0963.
Oral cavity cancer (OCC) and laryngeal cancer are among the most common cancers worldwide. This study investigated survival in non-Hispanic (NH) Black, NH White, Asian, and Hispanic patients with OCC and laryngeal cancer of low, intermediate, and high neighborhood socioeconomic status (nSES).
We used data from the SEER 18 Census Tract-level SES and Rurality Database of the National Cancer Institute to create cohorts of OCC and laryngeal cancer patients from 2013 to 2018. Univariate survival analysis was performed with Kaplan-Meier curves and log-rank P values by nSES and then the cross-classification of race, ethnicity, and nSES. We used Cox proportional hazards regression model for multivariable analysis.
Higher nSES was associated with better OCC survival for NH White, NH Black, and Asian patients, and better laryngeal cancer survival for NH White, NH Black, Hispanic, and Asian patients. In the multivariable analyses of both OCC and laryngeal cancer survival, NH Black patients had worse survival than NH White patients in the high nSES tertile. NH Black patients with OCC were at higher risk of death than NH White patients at all nSES levels. Conversely, Asian patients with laryngeal cancer demonstrated better survival than other races within the high nSES.
Overall survival differs between racial and ethnic groups of similar nSESs. These health disparities in patients with OCC and laryngeal cancer reflect broader inequities in the cancer control continuum.
The cross-classification of race, ethnicity, and nSES revealed disparities in the 5-year overall survival of patients with OCC and laryngeal cancer and highlights the importance of intersectionality in the discussion of health equity.
口腔癌（OCC）和喉癌是全球最常见的癌症之一。本研究调查了低、中、高邻里社会经济地位（nSES）的非西班牙裔黑人（NH 黑人）、非西班牙裔白人（NH 白人）、亚洲人和西班牙裔患者的 OCC 和喉癌的生存情况。
我们使用美国国家癌症研究所 SEER 18 普查区社会经济地位和农村数据库的数据，创建了 2013 年至 2018 年的 OCC 和喉癌患者队列。通过 nSES 对单变量生存分析进行 Kaplan-Meier 曲线和对数秩 P 值分析，然后对种族、族裔和 nSES 进行交叉分类。我们使用 Cox 比例风险回归模型进行多变量分析。
较高的 nSES 与 NH 白人、NH 黑人、亚洲患者的 OCC 生存较好，以及 NH 白人、NH 黑人、西班牙裔和亚洲患者的喉癌生存较好相关。在 OCC 和喉癌生存的多变量分析中，NH 黑人患者在 nSES 三分位较高的情况下，生存状况比 NH 白人患者差。NH 黑人 OCC 患者的死亡风险高于所有 nSES 水平的 NH 白人患者。相反，亚洲喉癌患者的生存状况优于其他种族患者在 nSES 较高的情况下。
在具有相似 nSES 的种族和族裔群体之间，总生存情况存在差异。这些 OCC 和喉癌患者的健康差异反映了癌症控制连续体中更广泛的不平等现象。
种族、族裔和 nSES 的交叉分类揭示了 OCC 和喉癌患者 5 年总生存率的差异，并强调了在讨论健康公平问题时交叉性的重要性。
