Community socioeconomic status and rural/racial disparities in HPV-/+ head and neck cancer.
Community socioeconomic status and rural/racial disparities in HPV-/+ head and neck cancer.
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DOI：
10.1016/j.tipsro.2023.100205
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发表时间：
2023-06
影响因子：
--
通讯作者：
Williams, Jessica C.
中科院分区：
文献类型：
--
作者：
Semprini, Jason;Williams, Jessica C.
较低的社区社会经济地位与头颈癌患者的诊断和治疗延迟以及生存率降低有关。在社区社会经济地位的条件下，头颈癌结果的城乡差异很小。在低社会经济水平的社区，我们仍然观察到非西班牙裔黑人成年人在延迟诊断和治疗方面存在显着差异。社区水平的因素在多大程度上可以解释个体水平的差异因头颈癌患者的HPV病因而异。头颈癌（HNC）是美国癌症发病率和死亡率的主要原因，但负担并不均匀。在整个国家人权委员会中，农村和种族差异很明显。大多数HNC差异研究强调了使农村和种族差异永久化的个人因素，忽视了社区因素的作用。我们分析了来自监测流行病学和最终结果（SEER）计划的“专业HNC-人乳头瘤病毒（HPV）普查-道SES”样本（2010-2016）的数据。除了癌症患者的特征外，该数据还包括基于患者的人口普查的社会经济地位（SES）五分位数。我们的结果变量包括HNC患者是否1）在远处诊断，2）在诊断后两个月或两个月以上接受初始治疗，3）接受放射治疗，4）在诊断后存活两年。我们测试了SES五分位数之间的差异，在整个样本中，然后在农村/种族类别中。然后，我们测试了每个农村/种族类别的条件SES五分位数之间的差异。对于HPV（−）和HPV + HNC，SES较高的普查区域中的患者远期诊断和延迟治疗的发生率较低SES普查区域中的患者低8-10%，生存率高12.0-14.5%。放射治疗仅在HPV + HNC患者的SES五分位数之间存在差异。我们发现，几乎没有证据表明，在每一个社会经济的五分之一的城乡差异。然而，在较低的SES五分位数中，我们发现延迟检测和治疗存在显着的种族差异。这些差异在SES最低的五分位数中最大，因为非西班牙裔黑人患者报告的延迟检测和治疗开始率比非西班牙裔白色患者高10-11%。我们的研究说明了在健康差异研究中利用社区层面因素的价值和制约因素，这些因素最终可以帮助设计有效的政策，解决和实现农村和种族癌症平等。
Lower community socioeconomic status is associated with delayed diagnosis and treatment, and lower survival for Head and Neck Cancer patients. Rural-Urban disparities in Head and Neck Cancer outcomes are minimal after conditioning on community socioeconomic status. In low socioeconomic communities, we still observe significant disparities in delayed diagnosis and treatment for non-Hispanic Black adults. The extent to which community-level factors may explain individual-level differences varies by HPV etiology of Head and Neck Cancer patients. Head and Neck Cancer (HNC) is a major cause of cancer morbidity and mortality in the United States, but the burden is not evenly distributed. Rural and racial disparities are obvious across the HNC continuum. Most HNC disparities research have emphasized individual factors perpetuating rural and racial disparities, ignoring the role of community-level factors. We analyzed data from the Surveillance Epidemiology and End Results (SEER) program’s “Specialized HNC-Human Papillomavirus (HPV) Census-Tract SES” datafile (2010–2016). In addition to cancer patient characteristics, this data includes a socioeconomic status (SES) quintile based on the patient’s census-tract. Our outcome variables included whether the HNC patient 1) was diagnosed at a distant stage, 2) received initial treatment two or more months after diagnosis, 3) received radiation therapy, 4) survived two years after diagnosis. We tested for differences across SES quintiles, in the full sample and then within rural/racial categories. We then tested for differences between each rural/racial category conditional on SES quintile. For both HPV(−) and HPV + HNCs, patients in higher SES census-tracts have 8–10% lower rates of distant stage diagnoses and delayed treatment initiation, and 12.0–14.5% higher survival rates than patients in lower SES census-tracts. Radiation treatment only varied across SES quintiles in HPV + HNC patients. We find little evidence of rural–urban differences within each socioeconomic quintile. However, within lower SES quintiles, we found significant racial disparities in delayed detection and treatment. These differences were largest in the lowest SES quintile, as non-Hispanic Black patients reported 10–11% higher rates of delayed detection and treatment initiation than non-Hispanic White patients. Our research illustrates the value and constraints in leveraging community-level factors in health disparities research that can ultimately assist in designing effective policies that address and achieve rural and racial cancer equity.
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影响因子：
4.8
作者：
Mazul, Angela L.;Naik, Akash N.;Puram, Sidharth, V
通讯作者：
Puram, Sidharth, V
影响因子：
2.1
作者：
Le Campion ACOV;Ribeiro CMB;Luiz RR;da Silva Júnior FF;Barros HCS;Dos Santos KCB;Ferreira SJ;Gonçalves LS;Ferreira SMS
通讯作者：
Ferreira SMS
影响因子：
4.8
作者：
Mahal, Brandon A.;Inverso, Gino;Chuang, Sung-Kiang
通讯作者：
Chuang, Sung-Kiang
DOI：
10.1016/j.adaj.2022.04.002
发表时间：
2022-07
期刊：
Journal of the American Dental Association (1939)
影响因子：
--
作者：
Fellows JL;Atchison KA;Chaffin J;Chávez EM;Tinanoff N
通讯作者：
Tinanoff N
影响因子：
45.3
作者：
Chaturvedi, Anil K.;Engels, Eric A.;Gillison, Maura L.
通讯作者：
Gillison, Maura L.