Head and Neck Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.
Department of Surgery, People's Hospital of Haixi, Haixi Prefecture, Qinghai, China.
PLoS One. 2023 Mar 16;18(3):e0282603. doi: 10.1371/journal.pone.0282603. eCollection 2023.
This study was to determine the racial disparities in incidence, clinicopathological features and prognosis of hypopharyngeal squamous cell carcinoma (HPSCC) in the US.
The National Program of Cancer Registries and Surveillance, Epidemiology, and End Results (SEER) database was used to determine racial disparity in age adjusted incidence rate (AAIR) of HPSCC and its temporal trend during 2004-2019. Using the separate SEER 17 database, we further evaluated racial disparity in clinicopathological features, and in prognosis using Kaplan-Meier curves and Cox proportional hazard models.
HPSCC accounted for 95.8% of all hypopharyngeal cancers and occurred much more frequently in males. Its incidence decreased in both male and females, in male non-Hispanic white (NHW), non-Hispanic black (NHB) and Hispanic as well as female NHW and NHB during the study period. NHB had the highest, whereas non-Hispanic Asian or Pacific Islanders (API) had comparable and the lowest incidence in both males and females. Among 6,172 HPSCC patients obtained from SEER 17 database, 80.6% were males and 83.9% were at the advanced stages III/IV. Five-year cancer specific and overall survival rates were 41.2% and 28.9%, respectively. NHB patients were more likely to be younger, unmarried, from the Southern region, larger sized tumor, and at the stage IV, but less likely to receive surgery. They also had higher proportions of dying from HPSCC and all causes. Multivariate analyses revealed that NHB with HPSCC at the locally advanced stage had both significantly worse cancer specific and overall survival compared with NHW, but not at early stage (I/II) or distant metastatic stage. Hispanic patients had significantly better prognosis than NHW at locally advanced and metastatic stages. NHW and API had comparable prognoses.
HPSCC displays continuously decreased incidence and racial disparity. The majority of the disease is diagnosed at the advanced stage. NHB have the highest burden of HPSCC and a worse prognosis. More studies are needed to curtail racial disparity and improve early detection.
本研究旨在确定美国下咽鳞状细胞癌（HPSCC）的发病率、临床病理特征和预后的种族差异。
利用国家癌症登记处和监测、流行病学和最终结果（SEER）数据库，确定 HPSCC 的年龄调整发病率（AAIR）的种族差异及其在 2004 年至 2019 年期间的时间趋势。使用单独的 SEER 17 数据库，我们进一步评估了临床病理特征和预后的种族差异，使用 Kaplan-Meier 曲线和 Cox 比例风险模型进行评估。
HPSCC 占所有下咽癌的 95.8%，男性更常见。在研究期间，男性和女性、男性非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）和西班牙裔以及女性 NHW 和 NHB 的发病率均下降。NHB 的发病率最高，而非西班牙裔亚洲人或太平洋岛民（API）的发病率在男性和女性中均较高，而在男性和女性中均较低。从 SEER 17 数据库中获得的 6172 例 HPSCC 患者中，80.6%为男性，83.9%处于晚期 III/IV 期。5 年癌症特异性和总体生存率分别为 41.2%和 28.9%。NHB 患者更年轻、未婚、来自南部地区、肿瘤更大，且处于 IV 期，但接受手术的可能性较小。他们死于 HPSCC 和所有原因的比例也较高。多变量分析显示，局部晚期 HPSCC 的 NHB 患者的癌症特异性和总体生存率均明显低于 NHW，但在早期（I/II 期）或远处转移期则不然。与 NHW 相比， Hispanic 患者在局部晚期和转移性阶段的预后明显更好。NHW 和 API 的预后相似。
HPSCC 的发病率持续下降，存在种族差异。大多数疾病在晚期诊断。NHB 患 HPSCC 的负担最大，预后最差。需要进一步研究以减少种族差异并改善早期发现。
