UNLABELLED

A disparity persists in advanced-stage laryngeal cancer outcomes, in which Black patients experience lower survival rates. We examined real-world treatment patterns and outcomes by race and ethnicity in patients with advanced-stage laryngeal cancer in Florida. Data were abstracted from the Florida Cancer Data System on non-Hispanic (NH)-White, Hispanic, and NH-Black patients with advanced-stage laryngeal cancer from 2009 to 2020. Kaplan-Meier curves estimated survival by race and ethnicity. Multivariable Cox proportional hazard models calculated HRs and 95% confidence intervals (95% CI) to examine the association of race and ethnicity with treatment receipt and mortality. Cox proportional hazard models were adjusted for sociodemographic and tumor characteristics. A total of 4,316 participants with advanced-stage laryngeal cancer (75.3% NH-White, 13.1% Hispanic, and 11.6% NH-Black) were included in the analysis. In age- and sex-adjusted models, NH-Black patients had a higher risk of death (HR = 1.21; 95% CI, 1.08-1.35) compared with NH-White patients, whereas Hispanic patients had a lower risk (HR = 0.80; 95% CI, 0.71-0.90). After controlling for sociodemographic factors, mortality differences between NH-Black and NH-White patients were not statistically significant (HR = 1.12; 95% CI, 1.00-1.26). However, in treatment-stratified analyses, specifically in patients who received chemoradiation, NH-Black patients had a higher risk of death (HR = 1.25; 95% CI, 1.02-1.52) compared with NH-White patients. In conclusion, NH-Black patients with advanced-stage laryngeal cancer who underwent chemoradiation had higher mortality compared with NH-White patients, whereas Hispanic patients had lower mortality. Investigating factors such as healthcare access, comorbidities, and treatment response may help address these disparities.

SIGNIFICANCE

This study provides important insight into racial and ethnic disparities in treatment outcomes and mortality risk among patients with advanced-stage laryngeal cancer in a real-world setting. Our findings underscore the need for a comprehensive approach to understanding outcome differences, considering the interplay of healthcare access, clinical factors, and treatment quality that influence patient care and survival.