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Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States.
- Source :
-
Oral Oncology . Feb2019, Vol. 89, p95-101. 7p. - Publication Year :
- 2019
-
Abstract
- <bold>Objectives: </bold>To quantify head and neck cancer (HNC) mortality rates and identify racial and socioeconomic factors associated with 90-day mortality.<bold>Methods: </bold>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.<bold>Results: </bold>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)].<bold>Conclusions: </bold>There are significant race and socioeconomic disparities among patients with HNC, and these disparities impact mortality within 90 days of treatment. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HEAD & neck cancer
*PROPORTIONAL hazards models
*LOG-rank test
*MEDICAID
*MEDICARE
Subjects
Details
- Language :
- English
- ISSN :
- 13688375
- Volume :
- 89
- Database :
- Academic Search Index
- Journal :
- Oral Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 134465477
- Full Text :
- https://doi.org/10.1016/j.oraloncology.2018.12.023