头颈癌退伍军人的地理和社会经济状况

Geographic and Socioeconomic Landscape of Veterans With Head and Neck Cancer.

作者信息

Zayan Kristen L, McCoy Jennifer L, Boudreaux-Kelly Monique Y, Brenner Chad, Hahn Zachary, Zevallos Jose P, Spector Matthew E, Hotchkiss John, Maxwell Jessica H

机构信息

Department of Otolaryngology-Head & Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Office of Research and Development, Veteran's Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.

出版信息

Head Neck. 2025 Oct;47(10):2845-2855. doi: 10.1002/hed.28209. Epub 2025 Jun 5.

DOI:10.1002/hed.28209

PMID:40470665

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12434562/

Abstract

BACKGROUND

US Veterans experience higher rates and worse outcomes for head and neck squamous cell carcinoma (HNSCC) compared to civilians. Geographic and socioeconomic barriers remain unclear.

METHODS

This retrospective descriptive study analyzed VA data nationwide (2012-2022), identifying Veterans with HNSCC using ICD codes. Subsites included oral cavity, oropharynx (OPC), hypopharynx, larynx, and nasopharynx. Rurality, deprivation, and travel distances were assessed.

RESULTS

Among 75,453 Veterans with HNSCC, 36% lived in rural areas, with travel times of 94 min to tertiary VA facilities. Approximately 32% had high deprivation (area deprivation indices [ADI] ≥ 75). OPC cases increased from 26.3% in 2012 to 46% in 2022, while laryngeal cancers declined. OPC patients were less deprived (p < 0.001) but had similar travel distances and rurality compared to non-OPC patients.

CONCLUSION

Overall, Veterans experience high deprivation, long travel times, and over one-third live in rural communities, highlighting potential barriers to access and equity among Veterans with HNSCC.

摘要

背景

与普通民众相比，美国退伍军人头颈鳞状细胞癌（HNSCC）的发病率更高，预后更差。地理和社会经济障碍尚不清楚。

方法

这项回顾性描述性研究分析了全国范围内的退伍军人事务部（VA）数据（2012 - 2022年），使用国际疾病分类代码识别患有HNSCC的退伍军人。亚部位包括口腔、口咽（OPC）、下咽、喉和鼻咽。评估了农村地区、贫困程度和出行距离。

结果

在75453名患有HNSCC的退伍军人中，36%生活在农村地区，前往三级VA医疗机构的出行时间为94分钟。约32%的人贫困程度高（地区贫困指数[ADI]≥75）。OPC病例从2012年的26.3%增加到2022年的46%，而喉癌病例有所下降。与非OPC患者相比，OPC患者的贫困程度较低（p < 0.001），但出行距离和农村居住情况相似。