Abstract PO-263: Racial equity and oral cancer: Exploring the relationship between dentist supply and the Black-White disparity in late stage diagnosis

Abstract

Abstract Background: Oral cancer is one of the most common cancers for Black men in America, and a leading cause of cancer mortality. Like many other cancers, survival in Black adults lags behind Non-Hispanic White adults. One explanation for the mortality and survival gap may be due to the propensity for Black adults to be diagnosed at later stages. The prognosis for early stage oral cancer can be quite positive. Despite inconsistent screening reccomendations, dental professionals have established oral cancer screening as a standard of care for all comprehensive evaluations. However, in addition to the lack of access to dental coverage, limited availability of dental professionals may be, in part, driving the disparity in late stage diagnoses for Black Americans. Objective: This study aims to estimate the relationship between the Black-White disparity in late stage oral cancer diagnoses and the supply of dentists. Methodology: Data for this study comes from the Center for Disease Control (CDC) Wonder portal and the Agency for Healthcare Research and Quality (AHRQ) provider dataset. To develop a measure of Black-White disparity in late stage oral cancer diagnoses, first, the proportion of late stage diagnoses of all oral cancer diagnoses were obtained for both Non-Hispanic Black and Non-Hispanic White adults for years 2011-2015. Data was aggregated to Health Servica Area level and restricted to states in the Southeast. The outcome of interest was derived by the difference between the Non-Hispanic Black proportion of late stage diagnoses and the Non-Hispanic White proportion. This exploratory study utilized a linear regression model to estimate the relationship between this difference and the supply of dental professionals per capita in each paired Health Service Area (HSA). Results: The mean proportion of late stage diagnoses were 70.8% and 61.9% for Non-Hispanic Black and Non-Hispanic White adults, respectively. The mean difference in late stage diagnoses, at the HSA level, was approximately 8.0%. This differnce, appeared to decline as the per capita supply of dentists increased (Est = -0.03, p < 0.05). Putting this association in context, to reduce the Black-White disparity in late stage diagnoses by 1-percentage point, 33 dentists per 100,000 population must be added to the HSA. Conclusion: Greater availability to dental professionals may play an important role in reducing racial disparities in oral cancer. Still, this exploratory work is only the begining for inferring a causal relationhip between increasing dental supply and decreasing differences in late stage oral cancer diagnoses. Even under the assumption of causality, policies aiming to increase dental supply in shortage areas must ensure equitable and just access for Black communities. Citation Format: Jason Semprini. Racial equity and oral cancer: Exploring the relationship between dentist supply and the Black-White disparity in late stage diagnosis [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-263.