Abstract A93: Treatment and survival after head and neck cancer diagnosis by race in Louisiana's public hospital system

Abstract

Abstract Incidence and survival rates of head and neck cancer (HNC) vary by demographic characteristics, with significant disparities for men and African Americans. Depending on tumor site and stage, treatments options vary, albeit most often are a combination of surgery, radiotherapy and chemotherapy. The objectives of this study are to examine the effect of race on HNC treatment and survival in Louisiana public hospitals from 2000 to 2010. Cases of HNC were identified using Louisiana Health Care Services Division ICON database, which is composed of diagnostic and billing data for all patients undergoing primary treatment in the facilities. This data was subsequently linked to the Louisiana Tumor Registry (LTR) database. Survival rates by, race, sub-site and stage were calculated. Data were analyzed using SAS Version 9.3. Chi-square statistics were used to calculate difference in proportions while log adjusted mixed models were implemented to evaluate the impact of time to first course treatment between groups. Finally, Cox regression models were performed to estimate hazard ratios. A total of 1,168 HNC cases were diagnosed with from 2000 to 2010. Blacks initiated first course treatment after diagnosis 5.7 days (p=0.002) later than whites, adjusted for site, age and stage. While there was no age difference at the time of diagnosis, blacks were significantly more likely to be diagnosed with a late stage HNC compared to whites (p=0.003). In addition it does not appear that treatment type varied by race. Survival functions by stage and tumor site consistently demonstrated poorer survival among blacks compared to whites. The current study suggests that survival differences between blacks and whites in Louisiana are more likely to be influenced by time to treatment and stage rather than any specific treatment differences. Citation Format: Edward S. Peters, Meghan M. Brashear, Tekeda F. Ferguson. Treatment and survival after head and neck cancer diagnosis by race in Louisiana's public hospital system. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A93.