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Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States.

Publication ,  Journal Article
Gaubatz, ME; Bukatko, AR; Simpson, MC; Polednik, KM; Adjei Boakye, E; Varvares, MA; Osazuwa-Peters, N
Published in: Oral Oncol
February 2019

OBJECTIVES: To quantify head and neck cancer (HNC) mortality rates and identify racial and socioeconomic factors associated with 90-day mortality. METHODS: The National Cancer Database (2004-2014) was queried for eligible HNC cases (n = 260,011) among adults treated with curative intent. Outcome of interest was any-cause 90-day mortality. Kaplan-Meier curves (Log-rank tests) estimated crude survival differences. A Cox proportional hazards model with further adjustments using the Šidák multiple comparison method adjusted for racial, socioeconomic and clinical factors. RESULTS: There were 9771 deaths (90-day mortality rate = 3.8%). There were crude differences in sex, race/ethnicity, comorbidity, distance, income, and insurance (Log-rank p-value < 0.0001). In the final model, blacks (aHR = 1.10, 95% CI 1.00, 1.21) and males (aHR = 1.07; 95% CI 1.00, 1.15) had greater 90-day mortality hazard, as did those uninsured (aHR = 1.72; 95% CI 1.48, 1.99), covered by Medicaid (aHR = 1.72; 95% CI 1.53, 1.93) or Medicare (aHR = 1.40; 95% CI 1.27, 1.53). Residence in lower median income zip code was associated with greater 90-day mortality [(aHR <$30,000 = 1.30; 95% CI 1.18, 1.44); (aHR $30,000-$34,999 = 1.24; 95% CI 1.13, 1.36); (aHR $35,000-$45,999 = 1.18; 95% CI 1.08, 1.27)]; and farther travel distance for treatment was associated with decreased 90-day mortality [(aHR 50-249.9 miles = 0.86; 95% CI 0.77, 0.97); (aHR > 250 miles = 0.70; 95% CI 50, 0.99)]. CONCLUSIONS: There are significant race and socioeconomic disparities among patients with HNC, and these disparities impact mortality within 90 days of treatment.

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Published In

Oral Oncol

DOI

EISSN

1879-0593

Publication Date

February 2019

Volume

89

Start / End Page

95 / 101

Location

England

Related Subject Headings

  • United States
  • Time Factors
  • Socioeconomic Factors
  • Racial Groups
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Humans
  • Healthcare Disparities
  • Head and Neck Neoplasms
 

Citation

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ICMJE
MLA
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Gaubatz, M. E., Bukatko, A. R., Simpson, M. C., Polednik, K. M., Adjei Boakye, E., Varvares, M. A., & Osazuwa-Peters, N. (2019). Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States. Oral Oncol, 89, 95–101. https://doi.org/10.1016/j.oraloncology.2018.12.023
Gaubatz, Matthew E., Aleksandr R. Bukatko, Matthew C. Simpson, Katherine M. Polednik, Eric Adjei Boakye, Mark A. Varvares, and Nosayaba Osazuwa-Peters. “Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States.Oral Oncol 89 (February 2019): 95–101. https://doi.org/10.1016/j.oraloncology.2018.12.023.
Gaubatz ME, Bukatko AR, Simpson MC, Polednik KM, Adjei Boakye E, Varvares MA, et al. Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States. Oral Oncol. 2019 Feb;89:95–101.
Gaubatz, Matthew E., et al. “Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States.Oral Oncol, vol. 89, Feb. 2019, pp. 95–101. Pubmed, doi:10.1016/j.oraloncology.2018.12.023.
Gaubatz ME, Bukatko AR, Simpson MC, Polednik KM, Adjei Boakye E, Varvares MA, Osazuwa-Peters N. Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States. Oral Oncol. 2019 Feb;89:95–101.
Journal cover image

Published In

Oral Oncol

DOI

EISSN

1879-0593

Publication Date

February 2019

Volume

89

Start / End Page

95 / 101

Location

England

Related Subject Headings

  • United States
  • Time Factors
  • Socioeconomic Factors
  • Racial Groups
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Humans
  • Healthcare Disparities
  • Head and Neck Neoplasms