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Mäkitie AA, Alabi RO, Pulkki-Råback L, Almangush A, Beitler JJ, Saba NF, Strojan P, Takes R, Guntinas-Lichius O, Ferlito A. Psychological Factors Related to Treatment Outcomes in Head and Neck Cancer. Adv Ther 2024; 41:3489-3519. [PMID: 39110309 DOI: 10.1007/s12325-024-02945-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/04/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Patients with head and neck cancer (HNC) often demonstrate stress, distress, anxiety, depression, and are at risk for suicide. These affect their quality of life (QoL) but less attention has been given to psychological variables that may impact response to treatment. OBJECTIVES This study aims to systematically review publications during 2013-2023 to collate evidence on the effects of psychological variables on HNC treatment outcomes. METHODS We searched Ovid Medline, PubMed, Scopus, and Web of Science for articles that examined psychological factors related to treatment outcomes in patients with HNC. RESULTS There were 29 studies (5 before treatment, 2 during, 17 after, and 5 covering the whole management trajectory) including 362,766 patients. The psychological factors were either behavioral (adjustment and coping strategy, unrealistic ideas, self-blame), cognitive (elevated risk of psychiatric co-comorbidity), or emotional (distress, depression, anxiety, nervousness, and fear of disfigurement and complications). It was found that there was a relationship between depression and decreased survival in patients with HNC. Pretreatment pain was an independent predictor of decreased survival in a large sample of patients. The distress level was approximately 54%, emotional problems ranged between 10 and 44%, while financial difficulties were identified in 54% of the patients. Sixty-nine percent of patients were reported to have used at least one cost-coping strategy within 6 months after treatment initiation. During post-treatment period, depression increased from 15% at the baseline to 29%, while the fear of recurrence was found among at least 35% of patients. DISCUSSION AND CONCLUSION Several psychological factors predict QoL and survival among HNC survivors. Distress encompasses depression and anxiety, and physical burden from HNC diagnosis and treatment. Routine screening and early interventions that target distress could improve HNC survivors' QoL. A systematic and standardized measurement approach for QoL is warranted to homogenize these findings and to understand the underlying relationships.
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Affiliation(s)
- Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O.Box 263, 00029 HUS, Helsinki, Finland.
- Faculty of Medicine, Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland.
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
| | - Rasheed Omobolaji Alabi
- Faculty of Medicine, Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | | | - Alhadi Almangush
- Faculty of Medicine, Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
- Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
| | - Jonathan J Beitler
- Harold Alfond Center for Cancer Care, Maine General Hospital, Augusta, ME, USA
- Dept of Radiation Oncology, John J. Cochran Veterans Hospital, St. Louis, MO, USA
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, 30322, USA
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Robert Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Wu C, McLeod MC, Song Z, Chen H, Rose JB, Bhatia S, Gillis A. Exploring Disparities in Pancreatic Ductal Adenocarcinoma Outcomes among Asian and Pacific Islander Subgroups. CANCER RESEARCH COMMUNICATIONS 2024; 4:2153-2162. [PMID: 39023120 PMCID: PMC11331565 DOI: 10.1158/2767-9764.crc-24-0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/04/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a challenging malignancy with known disparities in outcomes across ethnicities. Studies specifically investigating PDAC in Asian populations are sparse, overlooking the rich diversity within this group. This research seeks to fill that gap by examining survival differences across the broad spectrum of Asian ethnicities, acknowledging the complexity and varied experiences within these communities. Utilizing the National Cancer Database from 2004 to 2019, we categorized patients into East Asian, Southeast Asian, South Asian, and Pacific Islander groups. Non-Asians or Pacific Islanders were excluded. Overall survival was analyzed using a Cox hazards model. The study consisted of 13,254 patients. Most patients were East Asian (59.4%, n = 7,866). Southeast Asians exhibited the poorest survival in unadjusted analysis (HR, 1.32; 95% confidence interval, 1.23-1.42; P < 0.001) compared with South Asians who exhibited the best survival. Multivariable analysis revealed significantly worse survival for East Asians and Pacific Islanders relative to South Asians, whereas Southeast Asians' results were not significantly different. Asian subgroup differences notably affect PDAC outcomes. Research on genetic and cultural aspects, especially in Southeast Asians, and tackling health disparities are crucial for enhancing survival in this diverse disease. SIGNIFICANCE This study highlights the significant survival disparities among Asian subgroups with pancreatic cancer, utilizing a large national database. By differentiating among East Asian, Southeast Asian, South Asian, and Pacific Islander groups, it underscores the need for tailored research and healthcare approaches. Addressing these differences is essential for developing culturally sensitive interventions and potentially improving outcomes in a disease that uniquely affects these diverse populations.
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Affiliation(s)
- Christopher Wu
- General Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
| | - M. Chandler McLeod
- General Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Zhixing Song
- General Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Herbert Chen
- General Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
| | - John Bart Rose
- General Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Smita Bhatia
- Pediatric Hematology/Oncology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Andrea Gillis
- General Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
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Whitehead RA, Patel EA, Liu JC, Bhayani MK. Racial Disparities in Head and Neck Cancer: It's Not Just About Access. Otolaryngol Head Neck Surg 2024; 170:1032-1044. [PMID: 38258967 DOI: 10.1002/ohn.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/07/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVE Medical literature identifies stark racial disparities in head and neck cancer (HNC) in the United States, primarily between non-Hispanic white (NHW) and non-Hispanic black (NHB) populations. The etiology of this disparity is often attributed to inequitable access to health care and socioeconomic status (SES). However, other contributors have been reported. We performed a systematic review to better understand the multifactorial landscape driving racial disparities in HNC. DATA SOURCES A systematic review was conducted in Covidence following Preferred Reporting Items for Systematic Reviews and Meta-analyses Guidelines. A search of PubMed, SCOPUS, and CINAHL for literature published through November 2022 evaluating racial disparities in HNC identified 2309 publications. REVIEW METHODS Full texts were screened by 2 authors independently, and inconsistencies were resolved by consensus. Three hundred forty publications were ultimately selected and categorized into themes including disparities in access/SES, treatment, lifestyle, and biology. Racial groups examined included NHB and NHW patients but also included Hispanic, Native American, and Asian/Pacific Islander patients to a lesser extent. RESULTS Of the 340 articles, 192 focused on themes of access/SES, including access to high-quality hospitals, insurance coverage, and transportation contributing to disparate HNC outcomes. Additional themes discussed in 148 articles included incongruities in surgical recommendations, tobacco/alcohol use, human papillomavirus-associated malignancies, and race-informed silencing of tumor suppressor genes. CONCLUSION Differential access to care plays a significant role in racial disparities in HNC, disproportionately affecting NHB populations. However, there are other significant themes driving racial disparities. Future studies should focus on providing equitable access to care while also addressing these additional sources of disparities in HNC.
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Affiliation(s)
- Russell A Whitehead
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Evan A Patel
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Jeffrey C Liu
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Mihir K Bhayani
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Arboleda LPA, de Carvalho GB, Santos-Silva AR, Fernandes GA, Vartanian JG, Conway DI, Virani S, Brennan P, Kowalski LP, Curado MP. Squamous Cell Carcinoma of the Oral Cavity, Oropharynx, and Larynx: A Scoping Review of Treatment Guidelines Worldwide. Cancers (Basel) 2023; 15:4405. [PMID: 37686681 PMCID: PMC10486835 DOI: 10.3390/cancers15174405] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Head and neck cancer (HNC) treatments have been based on single or multimodal therapies with surgery, radiotherapy (RT), chemotherapy, and immunotherapy. However, treatment recommendations among countries may differ due to technological/human resources and usual local practices. This scoping review aims to identify, compare, and map the clinical practice guidelines (CPGs) for treating squamous cell carcinoma (SCC) of the oral cavity, oropharynx, and larynx worldwide. A search strategy on global CPGs for HNC was performed by using five electronic databases and grey literature. CPGs were selected for inclusion using EndNote-20 and Rayyan online software. No language or publication date restrictions were applied. The results were analyzed descriptively considering the most updated CPG version. In total, 25 CPGs covering the head and neck region (10), the larynx (7), the oral cavity (5), and the oropharynx (3), were found in 13 geographical regions, and 19 were developed by medical societies from 1996 to 2023. Surgery and RT remain the main modalities for early-stage HNC, with surgery preferred in low-resource countries, and RT in selected cases, especially in the larynx/oropharynx aiming to achieve a cure with organ preservation. Human papillomavirus infection for oropharyngeal SCC is not tested in some Asian countries and there is still no consensus to treat p16-positive cases differently from p16-negative. Recommendations for larynx preservation vary according to facilities in each country, however, individualized choice is emphasized. Inequality across countries/continents is evident, with a similar pattern of recommendations among developed as well as developing ones. No CPGs were found in Latin America as well as Oceania countries, where the incidence of HNC is high and limitations of access to treatment may be encountered.
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Affiliation(s)
| | - Genival Barbosa de Carvalho
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C.Camargo Cancer Center, Sao Paulo 01508-020, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
| | - Gisele Aparecida Fernandes
- Group of Epidemiology and Statistics on Cancer, A.C.Camargo Cancer Center, Rua Tagua, 440, Liberdade, Sao Paulo CEP 01508-020, Brazil
| | - Jose Guilherme Vartanian
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C.Camargo Cancer Center, Sao Paulo 01508-020, Brazil
| | - David I. Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow G2 3JZ, UK
| | - Shama Virani
- Genomic Epidemiology Group, International Agency for Research on Cancer (IARC/WHO), G2 3JZ Lyon, France
| | - Paul Brennan
- Genomic Epidemiology Group, International Agency for Research on Cancer (IARC/WHO), G2 3JZ Lyon, France
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C.Camargo Cancer Center, Sao Paulo 01508-020, Brazil
- Department of Head and Neck Surgery, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil
| | - Maria Paula Curado
- Group of Epidemiology and Statistics on Cancer, A.C.Camargo Cancer Center, Rua Tagua, 440, Liberdade, Sao Paulo CEP 01508-020, Brazil
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Nguyen J, Takesh T, Parsangi N, Song B, Liang R, Wilder-Smith P. Compliance with Specialist Referral for Increased Cancer Risk in Low-Resource Settings: In-Person vs. Telehealth Options. Cancers (Basel) 2023; 15:2775. [PMID: 37345112 DOI: 10.3390/cancers15102775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/13/2023] [Accepted: 05/13/2023] [Indexed: 06/23/2023] Open
Abstract
Efforts are underway to improve the accuracy of non-specialist screening for oral cancer (OC) risk, yet better screening will only translate into improved outcomes if at-risk individuals comply with specialist referral. Most individuals from low-resource, minority, and underserved (LRMU) populations fail to complete a specialist referral for OC risk. The goal was to evaluate the impact of a novel approach on specialist referral compliance in individuals with a positive OC risk screening outcome. A total of 60 LRMU subjects who had screened positive for increased OC risk were recruited and given the choice of referral for an in-person (20 subjects) or a telehealth (40 subjects) specialist visit. Referral compliance was tracked weekly over 6 months. Compliance was 30% in the in-person group, and 83% in the telehealth group. Approximately 83-85% of subjects from both groups who had complied with the first specialist referral complied with a second follow-up in-person specialist visit. Overall, 72.5% of subjects who had chosen a remote first specialist visit had entered into the continuum of care by the study end, vs. 25% of individuals in the in-person specialist group. A two-step approach that uses telehealth to overcome barriers may improve specialist referral compliance in LRMU individuals with increased OC risk.
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Affiliation(s)
- James Nguyen
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Thair Takesh
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Negah Parsangi
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Bofan Song
- College of Optical Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Rongguang Liang
- College of Optical Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Petra Wilder-Smith
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
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Noel CW, Hueniken K, Forner D, Liu G, Eng L, Hosni A, Hahn E, Irish JC, Gilbert R, Yao CMKL, Monteiro E, O’Sullivan B, Waldron J, Huang SH, Goldstein DP, de Almeida JR. Association of Household Income at Diagnosis With Financial Toxicity, Health Utility, and Survival in Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2023; 149:63-70. [PMID: 36416855 PMCID: PMC9685545 DOI: 10.1001/jamaoto.2022.3755] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/02/2022] [Indexed: 11/24/2022]
Abstract
Importance While several studies have documented a link between socioeconomic status and survival in head and neck cancer, nearly all have used ecologic, community-based measures. Studies using more granular patient-level data are lacking. Objective To determine the association of baseline annual household income with financial toxicity, health utility, and survival. Design, Setting, and Participants This was a prospective cohort of adult patients with head and neck cancer treated at a tertiary cancer center in Toronto, Ontario, between September 17, 2015, and December 19, 2019. Data analysis was performed from April to December 2021. Exposures Annual household income at time of diagnosis. Main Outcome and Measures The primary outcome of interest was disease-free survival. Secondary outcomes included subjective financial toxicity, measured using the Financial Index of Toxicity (FIT) tool, and health utility, measured using the Health Utilities Index Mark 3. Cox proportional hazards models were used to estimate the association between household income and survival. Income was regressed onto log-transformed FIT scores using linear models. The association between income and health utility was explored using generalized linear models. Generalized estimating equations were used to account for patient-level clustering. Results There were 555 patients (mean [SD] age, 62.7 [10.7] years; 109 [20%] women and 446 [80%] men) included in this cohort. Two-year disease-free survival was worse for patients in the bottom income quartile (<$30 000: 67%; 95% CI, 58%-78%) compared with the top quartile (≥$90 000: 88%; 95% CI, 83%-93%). In risk-adjusted models, patients in the bottom income quartile had inferior disease-free survival (adjusted hazard ratio, 2.13; 95% CI, 1.22-3.71) and overall survival (adjusted hazard ratio, 2.01; 95% CI, 0.94-4.29), when compared with patients in the highest quartile. The average FIT score was 22.6 in the lowest income quartile vs 11.7 in the highest quartile. In adjusted analysis, low-income patients had 12-month FIT scores that were, on average, 134% higher (worse) (95% CI, 16%-253%) than high-income patients. Similarly, health utility scores were, on average, 0.104 points lower (95% CI, 0.026-0.182) for low-income patients in adjusted analysis. Conclusions and Relevance In this cohort study, patients with head and neck cancer with a household income less than CAD$30 000 experienced worse financial toxicity, health status, and disease-free survival. Significant disparities exist for Ontario's patients with head and neck cancer.
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Affiliation(s)
- Christopher W. Noel
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Katrina Hueniken
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - David Forner
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology–Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Geoffrey Liu
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Lawson Eng
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ezra Hahn
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan C. Irish
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ralph Gilbert
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Christopher M. K. L. Yao
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Eric Monteiro
- Department of Otolaryngology–Head and Neck Surgery, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
| | - Brian O’Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - John Waldron
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Shao Hui Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David P. Goldstein
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - John R. de Almeida
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Lin JT, Chuang YC, Chen MK, Lo YS, Lin CC, Ho HY, Liu YT, Hsieh MJ. Shuterin Enhances the Cytotoxicity of the Natural Killer Leukemia Cell Line KHYG-1 by Increasing the Expression Levels of Granzyme B and IFN-γ through the MAPK and Ras/Raf Signaling Pathways. Int J Mol Sci 2022; 23:12816. [PMID: 36361609 PMCID: PMC9654641 DOI: 10.3390/ijms232112816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 08/26/2023] Open
Abstract
Natural killer (NK) cell therapy is an emerging tool for cancer immunotherapy. NK cells are isolated from peripheral blood, and their number and activity are limited. Therefore, primary NK cells should be expanded substantially, and their proliferation and cytotoxicity must be enhanced. Shuterin is a phytochemical isolated from Ficus thonningii. In this study, we explored the possible capacity of shuterin to enhance the proliferation and activity of KHYG-1 cells (an NK leukemia cell line). Shuterin enhanced the proliferation of KHYG-1 cells and their cytotoxicity to K562 cells. Moreover, this phytochemical induced the expression of granzyme B by promoting the phosphorylated cyclic adenosine monophosphate response element-binding protein (CREB) and mitogen-activated protein kinase (MAPK) signaling pathways. Furthermore, the secretion of interferon (IFN)-γ increased with increasing levels of shuterin in KHYG-1 cells and NK cells obtained from adults with head and neck squamous cell carcinoma. Shuterin appeared to induce IFN-γ secretion by increasing the expression of lectin-like transcript 1 and the phosphorylation of proteins involved in the Ras/Raf pathway. Thus, shuterin represents a promising agent for promoting the proliferation and cytotoxicity of NK cells.
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Affiliation(s)
- Jen-Tsun Lin
- Department of Medicine, Division of Hematology and Oncology, Changhua Christian Hospital, Changhua 500, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Yi-Ching Chuang
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Mu-Kuan Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Yu-Sheng Lo
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Chia-Chieh Lin
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Hsin-Yu Ho
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Yen-Tze Liu
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
- Department of Family Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Ming-Ju Hsieh
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
- College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
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Muallah D, Matschke J, Muallah S, Klimova A, Kroschwald LM, Schröder TA, Lauer G, Haim D. Socioeconomic disparities between oral cavity cancer patients in Germany. Front Public Health 2022; 10:831479. [PMID: 35937274 PMCID: PMC9353687 DOI: 10.3389/fpubh.2022.831479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/29/2022] [Indexed: 12/24/2022] Open
Abstract
ObjectiveIn many countries the access to high quality medical service depends on socioeconomic factors. Therefore, these factors are associated with the treatment and prognosis of many diseases. In Germany health care is claimed to be independent from such factors due to obligatory health insurance and a well-developed medical infrastructure. Thus, socioeconomically caused health disparities should be absent. The aim of this study was to analyze the association between socioeconomic factors and the survival of oral cavity cancer in Germany.Patients and methodsIn this descriptive cohort study socioeconomic status related factors as well as demographic, tumor-specific, and comorbidity factors of 500 patients treated for oral cavity cancer were obtained in the university hospital of Dresden. Pearson correlation was used to describe associations between continuous variables. Associations between categorical variables were assessed using the chi-square test. Overall and recurrence-free survival were studied using the Kaplan-Meier method. Log-rank test was carried out to test between-group differences. Cox proportional hazard models were used to estimate the risk of death and the risk of recurrence.ResultsSignificant differences in overall survival were found between the different educational levels and sex. Seventy-nine percent of the patients did not have a university degree or master craftsman/craftswoman. Less discrepancy was observed according to the marital status (49.4% married/engaged vs. 47.8% single, divorced, or widowed). In the multivariable analysis only sex, age at diagnosis, the Charlson score, the number of positive lymph nodes, and the nodal status were identified as independent predictors for overall survival whereas sex and the age at diagnosis were identified as independent predictors for recurrence-free survival.ConclusionDespite the equitable health system in Germany, significant associations between overall survival of oral cavity cancer and different socioeconomic factors could be found. For elimination of these disparities, health education programs should be established in socially deprived areas. Furthermore, clinicians should keep these factors in mind when determining recall periods for dental check-ups.
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Affiliation(s)
- David Muallah
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
- *Correspondence: David Muallah
| | - Jan Matschke
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Sophie Muallah
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Anna Klimova
- Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany
| | - Lysann Michaela Kroschwald
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Tom Alexander Schröder
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Günter Lauer
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
| | - Dominik Haim
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Dresden, Germany
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Moon PK, Ma Y, Megwalu UC. Head and Neck Cancer Stage at Presentation and Survival Outcomes Among Native Hawaiian and Other Pacific Islander Patients Compared With Asian and White Patients. JAMA Otolaryngol Head Neck Surg 2022; 148:636-645. [PMID: 35616952 PMCID: PMC9136676 DOI: 10.1001/jamaoto.2022.1086] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Research studies often group Native Hawaiian and Other Pacific Islander individuals together with Asian individuals despite being consistently identified as having worse health outcomes and higher rates of comorbidities and mortality. Native Hawaiian and Other Pacific Islander individuals also have high incidence rates of oral cavity and pharyngeal cancer compared with the general population; however, disparities in clinical presentation and survival outcomes of head and neck cancer squamous cell carcinoma (HNSCC) among this population have not been investigated nor compared with those of other races. Objective To determine the association of race with cancer stage at diagnosis and survival outcomes among Native Hawaiian and Other Pacific Islander patients with HNSCC compared with Asian and non-Hispanic White patients. Design, Setting, and Participants This was a retrospective population-based cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) 18 database. Asian, Native Hawaiian or Other Pacific Islander, and non-Hispanic White adult patients diagnosed in 1988 through 2015 with HNSCC of the oral cavity, oropharynx, nasopharynx, larynx, and hypopharynx were included; any patient whose record was missing data on disease or demographic information was excluded. Main Outcomes and Measures Cancer stage at presentation was compared among Asian, Native Hawaiian and Other Pacific Islander, and non-Hispanic White patients using a multivariable logistic regression model. Survival outcomes were compared among these racial groups using Cox regression models. Data analyses were performed from July 1, 2021, to March 20, 2022. Results The total study population comprised 76 473 patients: 4894 Asian (mean [SD] age at presentation, 60.7 [14.6] years), 469 Native Hawaiian and Other Pacific Islander (57.8 [12.3] years), and 71 110 non-Hispanic White (62.2 [12.1] years) individuals. Native Hawaiian and Other Pacific Islander patients were more likely to present with advanced-stage HNSCC (odds ratio [OR], 1.38; 95% CI, 1.12 -1.72) compared with non-Hispanic White patients. Asian patients presented with similar stage disease (OR, 1.04; 95% CI, 0.97-1.11) compared with non-Hispanic White patients. Native Hawaiian and Other Pacific Islander patients had worse disease-specific survival (HR, 1.18; 95% CI, 1.02-1.36) compared with non-Hispanic White patients after adjusting for clinical and demographic factors. In contrast, Asian patients had improved disease-specific survival (HR, 0.93; 95% CI, 0.88-0.98) compared with non-Hispanic White patients. Conclusions and Relevance This retrospective population-based cohort study suggests that Native Hawaiian and Other Pacific Islander race was associated with more advanced HNSCC, and worse disease-specific survival compared with non-Hispanic White race, while Asian race was associated with improved survival. This study highlights the importance of disaggregating Asian from Pacific Islander data when assessing health disparities, and the need for culturally sensitive interventions to promote earlier detection of head and neck cancer and improved survival among the Native Hawaiian and Other Pacific Islander population.
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Affiliation(s)
- Peter Kim Moon
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Yifei Ma
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Uchechukwu C. Megwalu
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
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10
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Sorice KA, Fang CY, Wiese D, Ortiz A, Chen Y, Henry KA, Lynch SM. Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum. Cancer Med 2022; 11:2125-2144. [PMID: 35166051 PMCID: PMC9119356 DOI: 10.1002/cam4.4601] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/03/2021] [Accepted: 12/28/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND There is extensive interest in understanding how neighborhood socioeconomic status (nSES) may affect cancer incidence or survival. However, variability regarding items included and approaches used to form a composite nSES index presents challenges in summarizing overall associations with cancer. Given recent calls for standardized measures of neighborhood sociodemographic effects in cancer disparity research, the objective of this systematic review was to identify and compare existing nSES indices studied across the cancer continuum (incidence, screening, diagnosis, treatment, survival/mortality) and summarize associations by race/ethnicity and cancer site to inform future cancer disparity studies. METHODS Using PRISMA guidelines, peer-reviewed articles published between 2010 and 2019 containing keywords related to nSES and cancer were identified in PubMed. RESULTS Twenty-four nSES indices were identified from 75 studies. In general, findings indicated a significant association between nSES and cancer outcomes (n = 64/75 studies; 85.33%), with 42/64 (65.63%) adjusting for highly-correlated individual SES factors (e.g., education). However, the direction of association differed by cancer site, race/ethnicity, and nSES index. CONCLUSIONS This review highlights several methodologic and conceptual issues surrounding nSES measurement and potential associations with cancer disparities. Recommendations pertaining to the selection of nSES measures are provided, which may help inform disparity-related disease processes and improve the identification of vulnerable populations in need of intervention.
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Affiliation(s)
- Kristen A. Sorice
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Carolyn Y. Fang
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Daniel Wiese
- Geography and Urban StudiesTemple UniversityPhiladelphiaPAUSA
| | - Angel Ortiz
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Yuku Chen
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Kevin A. Henry
- Geography and Urban StudiesTemple UniversityPhiladelphiaPAUSA
| | - Shannon M. Lynch
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
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11
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Galante ML, Silva DPD, Gabriel M, Michel-Crosato E, Pucca Junior GA, Biazevic MGH, Carrer FCDA. Brazilian Oral health teams in primary care and oral cancer: Results of a national evaluation. Braz Oral Res 2021; 35:e116. [PMID: 34816904 DOI: 10.1590/1807-3107bor-2021.vol35.0116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 06/02/2021] [Indexed: 12/12/2022] Open
Abstract
Oral cancer is one of the most prevalent cancers in Brazil. An understanding of how public policies are implemented to address this problem can contribute to the construction of solutions. The "Programa de Melhoria do Acesso e da Qualidade" (PMAQ-AB and PMAQ-CEO) at the level of primary and secondary care are evaluations that also collect data on prevention and monitoring strategies for oral cancer. This study aimed to analyze the results of the incorporation of oral health teams to evaluate the strategies adopted by Brazil regarding the impact on the diagnosis of oral cancer. Of the 17,202 family health teams evaluated, 72.10% had oral health teams (OHT). Considering the strategies for prevention, screening, campaign, and follow-up of suspected cases, 72.27% of the campaign teams and 59.09% of the teams who accompanied suspected cases had OHT. In secondary care, more than 65% of the teams in the Southeast and South regions registered cases of oral cancer, and the referral network was more represented. The inclusion of OHT had a positive impact on campaign actions, follow-up, referral to specialists, and registration of suspected cases throughout Brazil.
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Affiliation(s)
- Mariana Lopes Galante
- Universidade de São Paulo - USP, School of Dentistry, Department of Community Dentistry, São Paulo, SP, Brazil
| | - Dorival Pedroso da Silva
- Universidade de São Paulo - USP, School of Dentistry, Department of Traumatology, Surgery and Maxillo Facial Prosthesis, São Paulo, SP, Brazil
| | - Mariana Gabriel
- University of Mogi das Cruzes, Dentistry Course, Department of Community Dentistry, Mogi das Cruzes, SP, Brazil
| | - Edgard Michel-Crosato
- Universidade de São Paulo - USP, School of Dentistry, Department of Community Dentistry, São Paulo, SP, Brazil
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12
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7-Epitaxol Induces Apoptosis and Autophagy in Head and Neck Squamous Cell Carcinoma through Inhibition of the ERK Pathway. Cells 2021; 10:cells10102633. [PMID: 34685613 PMCID: PMC8534141 DOI: 10.3390/cells10102633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 01/10/2023] Open
Abstract
As the main derivative of paclitaxel, 7-Epitaxol is known to a have higher stability and cytotoxicity. However, the anticancer effect of 7-Epitaxol is still unclear. The purpose of this study was to explore the anticancer effects of 7-Epitaxol in squamous cell carcinoma of the head and neck (HNSCC). Our study findings revealed that 7-Epitaxol potently suppressed cell viability in SCC-9 and SCC-47 cells by inducing cell cycle arrest. Flow cytometry and DAPI staining demonstrated that 7-Epitaxol treatment induced cell death, mitochondrial membrane potential and chromatin condensation in OSCC cell lines. The compound regulated the proteins of extrinsic and intrinsic pathways at the highest concentration, and also increased the activation of caspases 3, 8, 9, and PARP in OSCC cell lines. Interestingly, a 7-Epitaxol-mediated induction of LC3-I/II expression and suppression of p62 expression were observed in OSCC cells lines. Furthermore, the MAPK inhibitors indicated that 7-Epitaxol induces apoptosis and autophagy marker proteins (cleaved-PARP and LC3-I/II) by reducing the phosphorylation of ERK1/2. In conclusion, these findings indicate the involvement of 7-Epitaxol in inducing apoptosis and autophagy through ERK1/2 signaling pathway, which identify 7-Epitaxol as a potent cytotoxic agent in HNSCC.
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13
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Lawrence LA, Heuermann ML, Javadi P, Sharma A. Socioeconomic Status and Rurality Among Patients With Head and Neck Cancer. Otolaryngol Head Neck Surg 2021; 166:1028-1037. [PMID: 34126811 DOI: 10.1177/01945998211019278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Describe the relationship among rurality, socioeconomic status (SES), and patient/tumor characteristics in patients presenting with head and neck cancer. STUDY DESIGN Retrospective single-institution study. SETTING Academic tertiary-level medical center. METHODS Patients with head and neck cancer presenting between 2011 and 2015 were included. Stage at presentation, insurance status, and demographic characteristics were collected. Rurality was measured through Rural-Urban Continuum Codes. SES was measured by SES index scores of the Agency for Healthcare Research and Quality, which incorporate multiple components of SES. Associations among rurality, SES, and patient/tumor characteristics were assessed with univariate and multivariable statistics. All P values were calculated via 2-sided hypotheses. The threshold for statistical significance was set at P < .05. Statistical analyses were conducted with Stata/SE 14 (StataCorp). RESULTS The study included 266 patients diagnosed with head and neck cancer between 2011 and 2015. Rural residence was associated with lower SES (P < .001). T and N stages were associated with rurality (P = .036 and .050, respectively). Higher educational status was associated with oropharyngeal cancer (P = .005). CONCLUSIONS Rurality and SES have distinct impacts on patients with head and neck cancer. Specifically, rurality is associated with tumor stage among patients with head and neck cancer. Knowledge of disparities among patients with rural residency may help target interventions to facilitate earlier diagnosis.
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Affiliation(s)
- Lauren A Lawrence
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA
| | - Mitchell L Heuermann
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA
| | - Pardis Javadi
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA
| | - Arun Sharma
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA
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14
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Liver Cancer Incidence and Area-Level Geographic Disparities in Pennsylvania-A Geo-Additive Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207526. [PMID: 33081168 PMCID: PMC7588924 DOI: 10.3390/ijerph17207526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/04/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
Many neighborhood socioeconomic index measures (nSES) that capture neighborhood deprivation exist but the impact of measure selection on liver cancer (LC) geographic disparities remains unclear. We introduce a Bayesian geoadditive modeling approach to identify clusters in Pennsylvania (PA) with higher than expected LC incidence rates, adjusted for individual-level factors (age, sex, race, diagnosis year) and compared them to models with 7 different nSES index measures to elucidate the impact of nSES and measure selection on LC geospatial variation. LC cases diagnosed from 2007–2014 were obtained from the PA Cancer Registry and linked to nSES measures from U.S. census at the Census Tract (CT) level. Relative Risks (RR) were estimated for each CT, adjusted for individual-level factors (baseline model). Each nSES measure was added to the baseline model and changes in model fit, geographic disparity and state-wide RR ranges were compared. All 7 nSES measures were strongly associated with high risk clusters. Tract-level RR ranges and geographic disparity from the baseline model were attenuated after adjustment for nSES measures. Depending on the nSES measure selected, up to 60% of the LC burden could be explained, suggesting methodologic evaluations of multiple nSES measures may be warranted in future studies to inform LC prevention efforts.
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15
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Anwar N, Pervez S, Chundriger Q, Awan S, Moatter T, Ali TS. Oral cancer: Clinicopathological features and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan. PLoS One 2020; 15:e0236359. [PMID: 32760151 PMCID: PMC7410283 DOI: 10.1371/journal.pone.0236359] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/03/2020] [Indexed: 12/19/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) has the highest prevalence in head and neck cancers and is the first and second most common cancer in males and females of Pakistan respectively. Major risk factors include peculiar chewing habits like areca nut, betel quid, and tobacco. The majority of OSCC presents at an advanced stage with poor prognosis. On the face of such a high burden of this preventable cancer, there is a relative lack of recent robust data and its association with known risk factors from Pakistan. The aim of this study was to identify the socioeconomic factors and clinicopathological features that may contribute to the development of OSCC. A total of 186 patients diagnosed and treated at a tertiary care hospital, Karachi Pakistan were recruited. Clinicopathological and socioeconomic information was obtained on a structured questionnaire. Descriptive analysis was done for demographics and socioeconomic status (SES) while regression analysis was performed to evaluate the association between SES and chewing habits, tumor site, and tumor stage. The majority of patients were males and the mean age of OSCC patients was 47.62±12.18 years. Most of the patients belonged to low SES (68.3%) and 77.4% were habitual of chewing. Gender (male) and SES were significantly associated with chewing habits (p<0.05). Odds of developing buccal mucosa tumors in chewers (of any type of substance) and gutka users were 2 and 4 times higher than non-chewers respectively. Middle age, chewing habits, and occupation were significantly associated with late stage presentation of OSCC (p<0.05). In conclusion, male patients belonging to low SES in their forties who had chewing habits for years constituted the bulk of OSCC. Buccal mucosa was the most common site in chewers and the majority presented with late stage tumors.
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Affiliation(s)
- Namrah Anwar
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Shahid Pervez
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Qurratulain Chundriger
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sohail Awan
- Department of Otolaryngology, Head and Neck Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Tariq Moatter
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Tazeen Saeed Ali
- School of Nursing and Midwifery, Aga Khan University Hospital, Karachi, Pakistan
- * E-mail:
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16
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Malik NH, Maganti M, McQuestion M, Tjong MC, Keilty D, Monteiro E, Huang SH, Jang RWJ, Gomes A, Pun J, Ringash J. Pre-treatment psychoeducational intervention and outcomes in head and neck cancer patients undergoing radiotherapy. Support Care Cancer 2020; 29:1643-1652. [PMID: 32761517 DOI: 10.1007/s00520-020-05627-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND To investigate the relationship between attendance to a pre-treatment psychoeducational intervention (prehab) with treatment outcomes and toxicities in patients receiving radiotherapy for head and neck cancers (HNCs). METHODS Patients were included from prehab inception in 2013 to 2017, comparing overall survival (OS), locoregional recurrence-free survival (LRFS), and locoregional recurrence (LRR) between prehab attendees (PA) and non-attendees (PNA). Multivariable analysis was performed for OS and LRFS. RESULTS Among 864 PA and 1128 PNA, 2-year OS was 88% vs 80% (p < 0.001), and LRFS was 84% vs 75% (p < 0.001). On multivariable analysis (MVA), OS and LRFS were independently and unfavourably associated with PNA. The PA cohort had a lower frequency of a "rocky treatment course" compared with the PNA cohort (52/150, 35% vs 71/150, 47%; p = 0.034). CONCLUSIONS Prehab at our institution is associated with improved long-term oncologic outcomes. Prospective data is needed to better understand this association.
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Affiliation(s)
- Nauman H Malik
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Manjula Maganti
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
- University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada
| | - Maurene McQuestion
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Michael C Tjong
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Dana Keilty
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Shao Hui Huang
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Raymond Woo-Jun Jang
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Andrea Gomes
- Department of Speech Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Joanne Pun
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Clinical Nutrition, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
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17
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Li W, Liu G, Lv S, Xu S, Liang H, Liu K, Qiang M, Chen X, Guo X, Lv X, Xia W, Xiang Y. Educational disparities in nasopharyngeal carcinoma survival: Temporal trends and mediating effects of clinical factors. Clin Transl Med 2020; 10:e134. [PMID: 32696529 PMCID: PMC7418802 DOI: 10.1002/ctm2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wang‐Zhong Li
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Guo‐Ying Liu
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Shu‐Hui Lv
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Sen‐Kui Xu
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Radiation OncologySun Yat‐Sen University Cancer Center Guangzhou China
| | - Hu Liang
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Kui‐Yuan Liu
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Meng‐Yun Qiang
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Xi Chen
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Xiang Guo
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Xing Lv
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Wei‐Xiong Xia
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
| | - Yan‐Qun Xiang
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat‐Sen University Cancer Center Guangzhou China
- Department of Nasopharyngeal CarcinomaSun Yat‐Sen University Cancer Center Guangzhou China
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18
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Hung LC, Kung PT, Lung CH, Tsai MH, Liu SA, Chiu LT, Huang KH, Tsai WC. Assessment of the Risk of Oral Cancer Incidence in A High-Risk Population and Establishment of A Predictive Model for Oral Cancer Incidence Using A Population-Based Cohort in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E665. [PMID: 31968579 PMCID: PMC7014279 DOI: 10.3390/ijerph17020665] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/18/2020] [Accepted: 01/19/2020] [Indexed: 12/13/2022]
Abstract
We aimed to assess the risk of oral cancer incidence in a high-risk population, establish a predictive model for oral cancer among these high-risk individuals, and assess the predictive ability of the constructed model. Individuals aged ≥30 years who had a habit of smoking or betel nut chewing and had undergone oral cancer screening in 2010 or 2011 were selected as study subjects. The incidence of oral cancer among the subjects at the end of 2014 was determined. The annual oral cancer incidence among individuals with a positive screening result was 624 per 100,000 persons, which was 6.5 times that of the annual oral cancer incidence among all individuals screened. Male sex, aged 45-64 years, divorce, low educational level, presence of diabetes, presence of other cancers, high comorbidity severity, a habit of smoking or betel nut chewing, and low monthly salary were high-risk factors for oral cancer incidence (p < 0.05). The area under the curve of the predictive model for oral cancer incidence was 0.73, which indicated a good predictive ability. Therefore, the oral cancer screening policy for the high-risk population with a habit of smoking and/or betel nut chewing is beneficial for the early diagnosis of oral cancer.
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Affiliation(s)
- Li-Chen Hung
- Department of Public Health, China Medical University, Taichung 40402, Taiwan;
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
| | - Chi-Hsuan Lung
- Department of Social Work, National Quemoy University, Quemoy 892, Taiwan;
| | - Ming-Hsui Tsai
- Department of Otolaryngology, China Medical University Hospital, Taichung 40447, Taiwan;
| | - Shih-An Liu
- Department of ENT, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Li-Ting Chiu
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
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19
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Gondivkar SM, Bhowate RR, Gadbail AR, Gondivkar RS, Sarode SC. Impact of socioeconomic inequalities on quality of life in oral submucous fibrosis patients. Future Oncol 2019; 15:875-883. [PMID: 30669879 DOI: 10.2217/fon-2018-0645] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIM The purpose of this study was to analyze the impact of socioeconomic characteristics on oral health-related quality of life (OHRQoL) in patients with oral submucous fibrosis (OSF). METHODS A total of 300 OSF patients' quality of life (QoL) data were obtained using OHRQoL-OSF and global self ratings of oral health and overall wellbeing. The socioeconomic status (SES) of participants was analyzed by using modified Kuppuswamy scale. RESULTS OSF patients with lower SES had worse OHRQoL as compared with those with middle and upper SES (p < 0.001). The household income of the family was found to be strongly associated with poor OHRQoL. CONCLUSION Socioeconomic characteristics should be considered in the holistic management of OSF as it has been strongly associated with the OHRQoL of these patients.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Rahul R Bhowate
- Department of Oral Medicine & Radiology, Sharad Pawar Dental College & Hospital, DMIMSU, Sawangi (M), Wardha, Maharashtra, India
| | - Amol R Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, India
| | - Rima S Gondivkar
- # 301, Aarti regency, Mahalakshmi Nagar, Manewada Road, Nagpur, Maharashtra, India
| | - Sachin C Sarode
- Department of Oral Pathology & Microbiology, Dr DY Patil Dental College & Hospital, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
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20
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Pagedar NA, Davis AB, Sperry SM, Charlton ME, Lynch CF. Population analysis of socioeconomic status and otolaryngologist distribution on head and neck cancer outcomes. Head Neck 2018; 41:1046-1052. [PMID: 30549368 DOI: 10.1002/hed.25521] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/13/2018] [Accepted: 10/05/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The relationship between clinical outcomes and geographic determinants is not well known for head and neck cancer. Socioeconomic status (SES) factors and the distribution of health care resources might impact outcomes. METHODS Head and neck cancer cases in the Surveillance, Epidemiology, and End Results (SEER) database were studied. Patient-level prognostic factors were identified from the SEER, and county-level factors were identified from the Area Health Resource File. Stage at presentation and observed survival were the outcomes of interest, with predictive factors identified by multivariate logistic and Cox proportional hazards regression. RESULTS On multivariate analysis, tumor site, sex, race, marital status, rural residence, and county poverty level predicted stage at presentation. Sex, race, marital status, county-level poverty, and number of otolaryngologists predicted observed survival. CONCLUSION Adverse county-level SES predicted advanced cancer stage at presentation and diminished observed survival. SES was a stronger predictor of patient outcomes than rurality or number of otolaryngologists.
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Affiliation(s)
- Nitin A Pagedar
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa
| | - Andrew B Davis
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa
| | - Steven M Sperry
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa
| | - Mary E Charlton
- Department of Epidemiology, University of Iowa, Iowa City, Iowa
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa
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21
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Lai YC, Tang PL, Chu CH, Kuo TJ. Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan. PeerJ 2018; 6:e5591. [PMID: 30245932 PMCID: PMC6147123 DOI: 10.7717/peerj.5591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/16/2018] [Indexed: 01/29/2023] Open
Abstract
Objectives The five-year survival rate of head and neck cancer (HNC) after radiotherapy (RT) varies widely from 35% to 89%. Many studies have addressed the effect of socioeconomic status and urban dwelling on the survival of HNC, but a limited number of studies have focused on the survival rate of HNC patients after RT. Materials and methods During the period of 2000–2013, 40,985 working age individuals (20 < age < 65 years) with HNC patients treated with RT were included in this study from a registry of patients with catastrophic illnesses maintained by the Taiwan National Health Insurance Research Database (NHIRD). Results The cumulative survival rate of HNC following RT in Taiwan was 53.2% (mean follow-up period, 3.75 ± 3.31 years). The combined effects of income and geographic effect on cumulative survival rates were as follows: high income group > medium income group > low income group and northern > central > southern > eastern Taiwan. Patients with moderate income levels had a 36.9% higher risk of mortality as compared with patients with high income levels (hazard ratio (HR) = 1.369; p < 0.001). Patients with low income levels had a 51.4% greater risk of mortality than patients with high income levels (HR = 1.514, p < 0.001). Conclusion In Taiwan, income and residential area significantly affected the survival rate of HNC patients receiving RT. The highest income level group had the best survival rate, regardless of the geographic area. The difference in survival between the low and high income groups was still pronounced in more deprived areas.
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Affiliation(s)
- Yu Cheng Lai
- Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Occupational Therapy, Shu Zen junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Pei Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan.,College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi Hsiang Chu
- Department of Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tsu Jen Kuo
- Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Dental Technology, Shu-Zen junior College of Medicine and Management, Kaohsiung, Taiwan.,Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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22
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Tribius S, Meyer MS, Pflug C, Hanken H, Busch CJ, Krüll A, Petersen C, Bergelt C. Socioeconomic status and quality of life in patients with locally advanced head and neck cancer. Strahlenther Onkol 2018; 194:737-749. [PMID: 29736758 DOI: 10.1007/s00066-018-1305-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 04/10/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Socioeconomic aspects play an important role in health care. Patients with locally advanced head and neck cancer (LAHNC) experience detrimental effects on their quality of life (QoL). This prospective study examines QoL differences between patients with different socioeconomic status (SES) after intensity-modulated radiation therapy (IMRT). PATIENTS AND METHODS In all, 161 patients were questioned at the end of IMRT and at 12 and 24 months follow-up using the questionnaires of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-30 and QLQ-HN35. Patients' QoL 2 years after IMRT was compared to a population reference sample and QoL of patients from lower, middle, and higher social class 2 years after IMRT was analyzed by ANCOVA using baseline QoL (end of radiation treatment) as a covariate. RESULTS Patients with high SES report worse QoL at the end of IMRT in the domains global health status (-15.2; p = 0.005), role function (-23.8; p = 0.002), and social function (-19.4; p = 0.023) compared to patients with middle and low SES. QoL improved during the first 12 and 24 months. However, 2 years after IMRT, middle and low SES patients report lower QoL in the domains global health status, physical function, and role function, and report a higher general (fatigue, pain, dyspnea) and head and neck cancer-specific symptom burden (pain, swallowing, senses, speech, social eating, opening mouth, and felt ill) than patients with high SES. CONCLUSION After IMRT for LAHNC, patients with high SES report worse QoL compared to patients with middle or low SES. There is a marked improvement within the first 24 months in many domains. However, the magnitude of improvement in patients with middle or low SES is significantly smaller compared to patients with high SES.
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Affiliation(s)
- S Tribius
- Department of Radiation Oncology, Asklepios Hospital St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
| | - M S Meyer
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Pflug
- Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Hanken
- Department of Oral & Maxillofacial Surgery, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C-J Busch
- Department of Otolaryngology, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Krüll
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Petersen
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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23
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Kufta K, Forman M, Swisher-McClure S, Sollecito TP, Panchal N. Pre-Radiation dental considerations and management for head and neck cancer patients. Oral Oncol 2018; 76:42-51. [DOI: 10.1016/j.oraloncology.2017.11.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/22/2017] [Accepted: 11/25/2017] [Indexed: 12/20/2022]
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24
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Tangjaturonrasme N, Vatanasapt P, Bychkov A. Epidemiology of head and neck cancer in Thailand. Asia Pac J Clin Oncol 2017; 14:16-22. [PMID: 28816028 DOI: 10.1111/ajco.12757] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/05/2017] [Indexed: 12/23/2022]
Abstract
Cancer is the most common cause of death in Thailand, with the mortality almost doubled during 1998-2011 (from 48.4 to 95.2 per 100 000). The estimated number of new cancer cases in 2011 was 112 392. Our review provides baseline data on the current epidemiological situation with head and neck (HN) cancer in Thailand based on reports of the National Cancer Registry and findings from local and international publications. Collectively, HN cancer approaches age-standardized rate (ASR) incidence of 15.7 and 10.7 per 100 000 males and females, respectively, and is ranked among the top five dominant cancers in Thailand. The leading HN malignancies in men are oral (ASR incidence 4.6 per 100 000), nasopharyngeal (ASR 2.8) and laryngeal (ASR 2.7) cancers, while the most common cancers in women are thyroid (ASR 5.1) and oral (ASR 3.2) carcinomas. Some local habits (betel quid chewing, traditional cigarette smoking and alcohol intake) are associated with the high incidence of oral cancer in Northeast Thailand. Despite important prognostic significance, the role of human papillomavirus infection in various HN cancers from Thailand has been scarcely addressed. There is a growing incidence of thyroid cancer over the last two decades. The Thai population overall, compared to worldwide rates of HN malignancies, has a lower incidence of laryngeal and thyroid cancers but higher incidence of nasopharyngeal cancer.
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Affiliation(s)
| | - Patravoot Vatanasapt
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Andrey Bychkov
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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25
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Lu HJ, Mu-Hsin Chang P. How to treat recurrent/metastatic head and neck cancer: the economic issue in real-world practice. Curr Med Res Opin 2017; 33:779-780. [PMID: 28084109 DOI: 10.1080/03007995.2017.1282446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hsueh-Ju Lu
- a Division of Medical Oncology, Department of Internal Medicine , Chung Shan Medical University Hospital , Taichung , Taiwan
- b School of Medicine , Chung Shan Medical University , Taichung , Taiwan
| | - Peter Mu-Hsin Chang
- c Division of Medical Oncology, Department of Oncology , Taipei Veterans General Hospital , Taipei , Taiwan
- d Faculty of Medicine , National Yang-Ming University , Taipei , Taiwan
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26
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Wong TH, Skanthakumar T, Nadkarni N, Nguyen HV, Iyer NG. Survival of patients with head and neck squamous cell carcinoma by housing subsidy in a tiered public housing system. Cancer 2017; 123:1998-2005. [PMID: 28135397 DOI: 10.1002/cncr.30557] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/12/2016] [Accepted: 12/19/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Socioeconomic status affects survival in patients diagnosed with head and neck squamous cell carcinoma (HNSCC), even in health systems with universal health care. Singapore has a tiered subsidized housing system, in which income determines eligibility for subsidies by size of apartment. The objective of this study was to assess whether a patient's residential type (small/heavily subsidized, medium/moderate subsidy, large/minimal or no subsidy) influenced mortality. A secondary analysis examined whether patients in smaller subsidized apartments were more likely to present with advanced disease. METHODS An historical cohort study of patients in a tertiary referral center with HNSCC was identified in the multidisciplinary cancer database from 1992 to 2014. Clinicopathologic data were extracted for analysis. Patient residential postal codes were matched to type of housing. Logistic regression was performed to evaluate the relationship between all-cause mortality and the predictors of interest as well as the association between housing type and disease stage at presentation. RESULTS Of the 758 patients identified, most were men (73.4%), the median age was 64 years, 30.5% and 15.2% were smokers and former smokers, respectively. Over one-half (56.8%) of patients presented with advanced disease. Male gender, age, stage at presentation, survival time from diagnosis, and smoker status were significant predictors of mortality. Patients living in the smaller, higher subsidy apartments had poorer survival, although they were not more likely to present with advanced disease, suggesting that the survival difference was not because of delayed presentation. CONCLUSIONS Patients with HNSCC living in smaller, higher-subsidy apartments have poorer survival despite no apparent delays in presentation. Cancer 2017;123:1998-2005. © 2017 American Cancer Society.
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Affiliation(s)
- Ting Hway Wong
- Department of General Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | | | | | - Hai Van Nguyen
- School of Pharmacy, Memorial University of Newfoundland, Canada
| | - N Gopalakrishna Iyer
- Duke-National University of Singapore Medical School, Singapore.,Division of Surgical Oncology, National Cancer Center Singapore, Singapore
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27
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Yang SH, Chen SF, Nieh S, Liu CL, Lin YS, Lee CC, Lin FH. The Effect of Individual and Neighbourhood Socioeconomic Status on Diabetes Mellitus Survival in Working Age Patients in Taiwan. PLoS One 2017; 12:e0169550. [PMID: 28081258 PMCID: PMC5230791 DOI: 10.1371/journal.pone.0169550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/19/2016] [Indexed: 12/31/2022] Open
Abstract
Purpose Diabetes mellitus (DM) is a global pandemic metabolic disorder. In recent years, the amount of medical resources required for the treatment of diabetes has increased as diabetes rates have gradually risen. The combined effects of individual and neighbourhood socio-economic status (SES) on DM survival rates are still not clear, especially in patients of working age. In this paper, we aim to analyze the combined effects of neighbourhood and individual SES on DM survival rates in patients of working age in Taiwan. Methods The study of 23,781 people who were diagnosed with DM by using population—based study between 2002 and 2006. Each sample was followed up for 4 years or as a sensor case. We defined Individual SES and neighbourhood SES by each patient’s job category and household income which characterized as advantaged or disadvantaged. Then we compared the survival rates by SES group used Cox proportional hazards model for adjust risk factors. Results The 4-year overall survival rates of diabetic patients were worst for those with low individual SES who living in advantaged neighbourhoods. After adjustment for patient characteristics, DM patients with high individual SES living in disadvantaged neighbourhoods had the same risk of mortality as those patients with high individual SES living in advantaged neighbourhoods (hazard ratio: 1.11; 95% confidence interval [CI]: 0.81–1.51). The study found that DM patients with low individual SES who live in disadvantaged areas had a greater risk of mortality than those with high SES (odds ratio: 2.57; 95% CI: 2.04–3.24). There were significant differences in survival rates between patients with high individual SES and patients with low individual SES. In contrast, the results did not statistically significant differences in survival rates between advantaged and disadvantaged neighbourhood SES groups. Conclusion DM patients with low individual SES had the worst survival rate, regardless of whether they were living in a high or low SES neighbourhood area. The competitive cause of death, i.e., the fact that complications, rather than DM itself, are often the cause of death, may be the reason for the inverse relationship found between the effects of individual SES and neighbourhood SES on DM survival. We conclude that the socio-economic gradient in survival among DM patients may be the result of differences in access to medical treatment and attributes related to individual SES.
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Affiliation(s)
- Shih-Hsien Yang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Administration Office, National Defense Medical Center & Tri-Service General Hospital Beitou Branch, Taipei, Taiwan
| | - Su-Feng Chen
- Department of Dental Hygiene, China Medical University, Taichung, Taiwan
| | - Shin Nieh
- Department of Pathology, National Defense Medical Center & Tri-Service General Hospital, Taipei, Taiwan
| | - Chia-Lin Liu
- Department of Pathology, National Defense Medical Center & Tri-Service General Hospital, Taipei, Taiwan
| | - Yaoh-Shiang Lin
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- * E-mail: (FHL); (YSL)
| | - Ching-Chih Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- * E-mail: (FHL); (YSL)
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28
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The "rocky treatment course": identifying a high-risk subgroup of head and neck cancer patients for supportive interventions. Support Care Cancer 2016; 25:719-727. [PMID: 27815711 DOI: 10.1007/s00520-016-3450-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 10/10/2016] [Indexed: 01/14/2023]
Abstract
PURPOSE We aim to identify the risk factors for a "rocky" treatment course (RTC) in head and neck cancer. METHODS A retrospective case-control study was conducted utilizing data from a prospective study. We defined the RTC as a composite of adverse outcomes including G-tube dependence and increased nursing interventions. Statistically associative variables were included in a multivariable logistic regression. We also evaluated whether the RTC, or its components, associated with worse cancer outcomes. RESULTS Being single, unemployed, having N2/3 disease and receiving chemoradiotherapy were associated with a RTC. In turn, G-tube dependence was associated with worse 3-year OS (73 vs 91 %; p = 0.02) and increased nursing interventions with worse 3-year locoregional recurrence-free survival (LRFS) (85 vs 92 %; p = 0.03) and locoregional recurrence (LRR) (14 vs 7 %; p = 0.03). CONCLUSIONS We identified baseline factors associated with a RTC for head and neck cancer patients. Future supportive care interventions could be evaluated using the RTC as a marker of benefit.
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29
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Auluck A, Walker BB, Hislop G, Lear SA, Schuurman N, Rosin M. Socio-economic deprivation: a significant determinant affecting stage of oral cancer diagnosis and survival. BMC Cancer 2016; 16:569. [PMID: 27480165 PMCID: PMC4970228 DOI: 10.1186/s12885-016-2579-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/18/2016] [Indexed: 01/16/2023] Open
Abstract
Background Many factors contribute to socioeconomic status (SES), yet in most survival studies only income is used as a measure for determining SES. We used a complex, composite, census-based metric for socioeconomic deprivation to better distinguish individuals with lower SES and assess its impact on survival and staging trends of oral cancers. Methods Oropharyngeal (OPC) and oral cavity cancer (OCC) cases were identified from the British Columbia cancer registry between 1981–2009 and placed into affluent and deprived neighborhoods using postal codes linked to VANDIX (a composite SES index based on 7 census variables encompassing income, housing, family structure, education, and employment). Stage and cancer-specific survival rates were examined by sex, SES, and time period. Results Approximately 50 % of OPC and OCC cases of both sexes resided in SES deprived neighborhoods. Numbers of cases have increased in recent years for all but OCC in men. The deprivation gap in survival between affluent and deprived neighborhoods widened in recent years for OPC and OCC in men, while decreasing for OPC and increasing slightly for OCC in women. Greater proportions of OCC cases were diagnosed at later stage disease for both sexes residing in deprived neighborhoods, a trend not seen for OPC. Conclusion SES remains a significant independent determinant of survival for both OPC and OCC when using a composite metric for SES. OPC survival rates among men have improved, albeit at slower rates in deprived communities. OCC screening programs need to be targeted towards SES-deprived neighborhoods where greater proportions of cases were diagnosed at a later stage and survival rates have significantly worsened in both sexes.
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Affiliation(s)
- Ajit Auluck
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada. .,Cancer Control Research Department, BC Cancer Agency, Vancouver, Canada. .,BC Oral Cancer Prevention Program, BC Cancer Agency Research Centre, 675 W. 10th Ave, 3rd Floor, Room 119, Vancouver, B.C, V5Z1L3, Canada.
| | | | - Greg Hislop
- Cancer Control Research Department, BC Cancer Agency, Vancouver, Canada
| | - Scott A Lear
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.,Division of Cardiology, Providence Health Care, Vancouver, Canada
| | - Nadine Schuurman
- Department of Geography, Simon Fraser University, Burnaby, BC, Canada
| | - Miriam Rosin
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada.,Cancer Control Research Department, BC Cancer Agency, Vancouver, Canada
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30
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Oruç Z, Büyükbayram ME, Kaplan MA, Urakçı Z, Küçüköner M, Işıkdoğan A. Effects of educational status and the living environment on the prognosis of head and neck squamous cell carcinoma. JOURNAL OF ONCOLOGICAL SCIENCES 2016. [DOI: 10.1016/j.jons.2016.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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31
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Anyiwe K, Qiao Y, De P, Yoshida EM, Earle CC, Thein HH. Effect of socioeconomic status on hepatocellular carcinoma incidence and stage at diagnosis, a population-based cohort study. Liver Int 2016; 36:902-10. [PMID: 26455359 DOI: 10.1111/liv.12982] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/05/2015] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) incidence is increasing worldwide and cirrhosis is the most important risk factor predominantly caused by chronic viral hepatitis infection. We studied the impact of socioeconomic status (SES) on HCC incidence and stage at diagnosis among viral hepatitis cases. METHODS A population-based retrospective cohort study was conducted through the Ontario Cancer Registry linked data. Incidence rates were calculated using person-time methodology. Association between SES (income quintile) and HCC incidence was assessed using proportional-hazards regression. The impact of SES on HCC stage was investigated using logistic regression. RESULTS Among 11 350 individuals diagnosed with viral hepatitis between 1991 and 2010, a crude HCC incidence rate of 21.4 cases per 1000 person-years was observed. Adjusting for age, gender, urban/rural residence and year of viral hepatitis diagnosis, a significant association was found between SES and HCC incidence, with an increased risk among individuals in the lowest three income quintiles (incidence rate ratio, IRR = 1.235; 95% CI: 1.074-1.420; IRR = 1.183; 95% CI: 1.026-1.364; IRR = 1.158; 95% CI: 1.000-1.340 respectively). No significant association between SES and HCC incidence was found after additionally adjusting for risk factors associated with HCC. However, HCC risk factors such as cirrhosis and HIV are associated with SES. Furthermore, no association was found between SES and HCC stage. CONCLUSIONS The association between SES and HCC incidence is likely because of differences in risk factors across income quintiles. Investigating how SES affects HCC incidence facilitates an understanding of which populations are at elevated risk for HCC.
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Affiliation(s)
- Kika Anyiwe
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Yao Qiao
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Prithwish De
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Surveillance and Cancer Registry, Cancer Care Ontario, Toronto, ON, Canada
| | - Eric M Yoshida
- Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - Craig C Earle
- Ontario Institute for Cancer Research, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Hla-Hla Thein
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Ontario Institute for Cancer Research, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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32
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Influence of deprivation on health-related quality of life of patients with cancer of the head and neck in Merseyside and Cheshire. Br J Oral Maxillofac Surg 2016; 54:669-76. [PMID: 27130568 DOI: 10.1016/j.bjoms.2016.03.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 03/31/2016] [Indexed: 11/24/2022]
Abstract
The incidence of cancer of the head and neck, and the outcome of treatment in terms of survival and health-related quality of life (HRQoL), is linked to deprivation. We have explored the association of social deprivation with HRQoL and with fear of recurrence in patients treated for cancer of the head and neck in Merseyside and Cheshire. In 2013, we posted cross-sectional surveys to 805 patients treated for oral, oropharyngeal, or laryngeal tumours. We used the University of Washington quality of life score (UW-QoLv4) to measure HRQoL, a 7-item questionnaire to measure fear of recurrence, and the 2010 Index of Multiple Deprivation (IMD) to measure deprivation. There was a 60% (448) response to the survey, with response ranging from 52% (167/322) from those living in the most deprived national quartile of residential areas to 74% (110/148) living in the least deprived quartile. Relative to the national distribution, the sample was notably deprived as 37% (167/448) lived in the most deprived quartile. After adjusting for clinical and personal characteristics, the results suggest a residual association between deprivation and overall quality of life (QoL), particularly socioemotional function. The association seemed weaker in regard to fear of recurrence and physical function. Our findings emphasise the need to explore ways to encourage more patients to attend follow-up appointments as this might improve their QoL, reduce distress, and help them to improve their life-style. It could also have an impact on survival.
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33
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Chu KP, Habbous S, Kuang Q, Boyd K, Mirshams M, Liu FF, Espin-Garcia O, Xu W, Goldstein D, Waldron J, O'Sullivan B, Huang SH, Liu G. Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada. Cancer Epidemiol 2015; 40:102-12. [PMID: 26706365 DOI: 10.1016/j.canep.2015.11.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/17/2015] [Accepted: 11/21/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND Despite universal healthcare in some countries, lower socioeconomic status (SES) has been associated with worse cancer survival. The influence of SES on head and neck cancer (HNC) survival is of immense interest, since SES is associated with the risk and prognostic factors associated with this disease. PATIENTS AND METHODS Newly diagnosed HNC patients from 2003 to 2010 (n=2124) were identified at Toronto's Princess Margaret Cancer Centre. Principal component analysis was used to calculate a composite score using neighbourhood-level SES variables obtained from the 2006 Canada Census. Associations of SES with overall survival were evaluated in HNC subsets and by p16 status (surrogate for human papillomavirus). RESULTS SES score was higher for oral cavity (n=423) and p16-positive oropharyngeal cancer (OPC, n=404) patients compared with other disease sites. Lower SES was associated with worse survival [HR 1.14 (1.06-1.22), p=0.0002], larger tumor staging (p<0.001), current smoking (p<0.0001), heavier alcohol consumption (p<0.0001), and greater comorbidity (p<0.0002), but not with treatment regimen (p>0.20). After adjusting for age, sex, and stage, the lowest SES quintile was associated with the worst survival only for OPC patients [HR 1.66 (1.09-2.53), n=832], primarily in the p16-negative subset [HR 1.63 (0.96-2.79)]. The predictive ability of the prognostic models improved when smoking/alcohol was added to the model (c-index 0.71 vs. 0.69), but addition of SES did not (c-index 0.69). CONCLUSION SES was associated with survival, but this effect was lost after accounting for other factors (age, sex, TNM stage, smoking/alcohol). Lower SES was associated with greater smoking, alcohol consumption, comorbidity, and stage.
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Affiliation(s)
- K P Chu
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - S Habbous
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - Q Kuang
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - K Boyd
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - M Mirshams
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - F-F Liu
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - O Espin-Garcia
- Department of Biostatistics, Princess Margaret Hospital, Toronto, Canada
| | - W Xu
- Department of Biostatistics, Princess Margaret Hospital, Toronto, Canada
| | - D Goldstein
- Otolaryngology-Head and Neck Surgery, University of Toronto, Canada
| | - J Waldron
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - B O'Sullivan
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - S H Huang
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - G Liu
- Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada.
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Takenaka Y, Yasui T, Enomoto K, Miyabe H, Morizane N, Ashida N, Shimizu K, Hirose M, Yamamoto Y, Uno A. Health insurance status and survival among patients with head and neck cancer in Japan. Int J Clin Oncol 2015; 21:517-22. [DOI: 10.1007/s10147-015-0921-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022]
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Guo Y, Logan HL, Marks JG, Shenkman EA. The relationships among individual and regional smoking, socioeconomic status, and oral and pharyngeal cancer survival: a mediation analysis. Cancer Med 2015; 4:1612-9. [PMID: 26250857 PMCID: PMC4618632 DOI: 10.1002/cam4.509] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/14/2015] [Accepted: 07/15/2015] [Indexed: 12/13/2022] Open
Abstract
Poorer survival from oral and pharyngeal cancer (OPC) has been reported for populations of lower socioeconomic status (SES), adjusting for risk factors such as patient and clinical characteristics. Beyond these risk factors, higher rates of tobacco use may be a mediator for the observed poorer OPC survival for low SES populations. In this study, we aimed to examine the impact of the relationships among SES, individual smoking status, and living in a region with a higher smoking rate on OPC survival. We obtained Florida Cancer Data System data from 1996 to 2010 and merged the data with US Census data and Behavioral Risk Factor Surveillance System data from 1996 to 2010. We built multivariable survival models to quantify the mediational effect of individual smoking on overall and OPC-specific survival, adjusting for regional smoking, demographics, and clinical characteristics. We found that lower SES, individual smoking, and living in a region with a higher smoking rate were all strongly associated with poorer survival. We estimated that the indirect effect of individual smoking accounted for a large part (ranged from 13.3% to 30.2%) of the total effect of SES on overall and OPC-specific survival. In conclusion, individual and regional smoking are both significant and independent predictors of poor cancer survival. Higher rate of individual smoking is partially responsible for poorer cancer survival in low SES populations. Results of this study provide rationale for considering a multi-level approach that simultaneously targets both individual and contextual factors for future smoking cessation interventions.
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Affiliation(s)
- Yi Guo
- Department of Health Outcomes and Policy, University of FloridaGainesville, Florida
| | - Henrietta L Logan
- Department of Community Dentistry and Behavioral Science, University of FloridaGainesville, Florida
| | - John G Marks
- Department of Community Dentistry and Behavioral Science, University of FloridaGainesville, Florida
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Policy, University of FloridaGainesville, Florida
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Impact of parotid gland dose and patient-related factors on radiation damage to dental hard tissues. J Dent Sci 2015. [DOI: 10.1016/j.jds.2015.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wuthrick EJ, Zhang Q, Machtay M, Rosenthal DI, Nguyen-Tan PF, Fortin A, Silverman CL, Raben A, Kim HE, Horwitz EM, Read NE, Harris J, Wu Q, Le QT, Gillison ML. Institutional clinical trial accrual volume and survival of patients with head and neck cancer. J Clin Oncol 2014; 33:156-64. [PMID: 25488965 DOI: 10.1200/jco.2014.56.5218] [Citation(s) in RCA: 187] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE National Comprehensive Cancer Network guidelines recommend patients with head and neck cancer (HNC) receive treatment at centers with expertise, but whether provider experience affects survival is unknown. PATIENTS AND METHODS The effect of institutional experience on overall survival (OS) in patients with stage III or IV HNC was investigated within a randomized trial of the Radiation Therapy Oncology Group (RTOG 0129), which compared cisplatin concurrent with standard versus accelerated fractionation radiotherapy. As a surrogate for experience, institutions were classified as historically low- (HLACs) or high-accruing centers (HHACs) based on accrual to 21 RTOG HNC trials (1997 to 2002). The effect of accrual volume on OS was estimated by Cox proportional hazards models. RESULTS Median RTOG accrual (1997 to 2002) at HLACs was four versus 65 patients at HHACs. Analysis included 471 patients in RTOG 0129 (2002 to 2005) with known human papillomavirus and smoking status. Patients at HLACs versus HHACs had better performance status (0: 62% v 52%; P = .04) and lower T stage (T4: 26.5% v 35.3%; P = .002) but were otherwise similar. Radiotherapy protocol deviations were higher at HLACs versus HHACs (18% v 6%; P < .001). When compared with HHACs, patients at HLACs had worse OS (5 years: 51.0% v 69.1%; P = .002). Treatment at HLACs was associated with increased death risk of 91% (hazard ratio [HR], 1.91; 95% CI, 1.37 to 2.65) after adjustment for prognostic factors and 72% (HR, 1.72; 95% CI, 1.23 to 2.40) after radiotherapy compliance adjustment. CONCLUSION OS is worse for patients with HNC treated at HLACs versus HHACs to cooperative group trials after accounting for radiotherapy protocol deviations. Institutional experience substantially influences survival in locally advanced HNC.
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Affiliation(s)
- Evan J Wuthrick
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA.
| | - Qiang Zhang
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Mitchell Machtay
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - David I Rosenthal
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Phuc Felix Nguyen-Tan
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - André Fortin
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Craig L Silverman
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Adam Raben
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Harold E Kim
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Eric M Horwitz
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Nancy E Read
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Jonathan Harris
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Qian Wu
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Quynh-Thu Le
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
| | - Maura L Gillison
- Evan J. Wuthrick and Maura L. Gillison, Ohio State University Medical Center, Columbus; Mitchell Machtay, Case Western Reserve University, Cleveland, OH; Qiang Zhang, Jonathan Harris, and Qian Wu, Radiation Therapy Oncology Group Statistical Center; Eric M. Horwitz, Fox Chase Cancer Center, Philadelphia, PA; David I. Rosenthal, University of Texas MD Anderson Cancer Center, Houston, TX; Phuc Felix Nguyen-Tan, Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal; André Fortin, Hôtel-Dieu de Quebec, Quebec City, Quebec; Nancy E. Read, Western University, London Regional Cancer Center, London, Ontario, Canada; Craig L. Silverman, James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Adam Raben, Christiana Care Helen F. Graham Cancer Center, Newark, DE; Harold E. Kim, Wayne State University, Detroit, MI; and Quynh-Thu Le, Stanford University, Palo Alto, CA
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Takenaka Y, Takemoto N, Nakahara S, Yamamoto Y, Yasui T, Hanamoto A, Fukusumi T, Michiba T, Cho H, Yamamoto M, Inohara H. Prognostic significance of body mass index before treatment for head and neck cancer. Head Neck 2014; 37:1518-23. [DOI: 10.1002/hed.23785] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/11/2014] [Accepted: 05/28/2014] [Indexed: 12/13/2022] Open
Affiliation(s)
- Yukinori Takenaka
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Norihiko Takemoto
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Susumu Nakahara
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Toshimichi Yasui
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Atshushi Hanamoto
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Takahito Fukusumi
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Takahiro Michiba
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Hironori Cho
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Masashi Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery; Osaka University Graduate School of Medicine; Suita Osaka Japan
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Bonfante GMDS, Machado CJ, Souza PEAD, Andrade EIG, Acurcio FDA, Cherchiglia ML. [Specific 5-year oral cancer survival and associated factors in cancer outpatients in the Brazilian Unified National Health System]. CAD SAUDE PUBLICA 2014; 30:983-97. [PMID: 24936815 DOI: 10.1590/0102-311x00182712] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 11/06/2013] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the specific five-year oral cancer survival rate and associated factors in Brazil. This was a retrospective cohort study using the Oncological Database as the source, with probabilistic-deterministic linkage of all the records for authorization of radiotherapy and/or chemotherapy in the Unified National Health System from 2000 to 2006, generating a single record for each patient. The current study included patients diagnosed with oral cancer from 2002 to 2003 (except for cancer of lip), and ranging from 19 to 100 years of age (N = 6,180). Specific five-year survival was 60%. Decreased specific survival was associated with: age > 40 years; stages III or IV; location on the tongue, floor of the mouth, or base of the tongue; not performing surgical treatment, performing only chemotherapy or radiotherapy and chemotherapy; and residence in certain States of Brazil. The results emphasize the need to include assessment of regional disparities as a possibility for increasing health interventions and improving survival.
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Väisänen JA, Syrjälä AMH, Pesonen PRO, Pukkila MJ, Koivunen PT, Alho OP. Characteristics and medical-care-seeking of head and neck cancer patients: a population-based cross-sectional survey. Oral Oncol 2014; 50:740-5. [PMID: 24856187 DOI: 10.1016/j.oraloncology.2014.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 04/25/2014] [Accepted: 04/27/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Well-known risk factors, such as smoking and alcohol consumption, easily denounce head and neck cancer patients as smokers, alcohol abusers, and persons who are socially excluded and have low socioeconomic status. To diagnose these patients as early as possible, we should not have a prejudiced assumption of their characteristics. MATERIALS AND METHODS We collected detailed data on patient characteristics and health behavior and explored whether these traits had any effect on seeking medical advice in a population-based cross-sectional study involving 85 patients with head and neck cancer diagnosed between January 2003 and December 2007, residing in two health care districts (population 1,600,000) in Finland. The data were gathered from patient charts and questionnaires. The questionnaire data were compared with the general population in Finland. RESULTS We found these patients to be ordinary elderly people whose demographic and social features resembled those of the general population. They smoked more often, but otherwise had a rather healthy lifestyle. Only half were aware that smoking and alcohol consumption were risk factors of head and neck cancer. In a multivariate analysis, fear of physicians (adjusted odds ratio 11.0; 95% confidence interval 1.2-103), medical-care-seeking for symptoms other than pain (18.5; 2.2-156), and not suspecting cancer (11.2; 1.7-75.1) were independent risk factors for delayed consultation (combined appraisal and help-seeking interval over 3 months). CONCLUSION Head and neck cancer patients deviated from the same-aged general population only in excessive smoking. Fear of doctors, having no pain, and no suspicion of cancer resulted in delayed medical-care-seeking.
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Affiliation(s)
- Janne A Väisänen
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
| | | | | | - Matti J Pukkila
- Department of Otorhinolaryngology - Head and Neck Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Petri T Koivunen
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Olli-Pekka Alho
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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The relationship between survival and socio-economic status for head and neck cancer in Canada. J Otolaryngol Head Neck Surg 2014; 43:2. [PMID: 24422754 PMCID: PMC3896831 DOI: 10.1186/1916-0216-43-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 12/16/2013] [Indexed: 11/17/2022] Open
Abstract
Background Human papilloma virus (HPV) is emerging as the primary cause for some head and neck cancers. The objective of this study was to investigate the association between head and neck cancer (HNC) survival and socioeconomic status (SES) in Canada, and to investigate changes in the relationship between HNC survival and SES from 1992 to 2005. Methods Cases were drawn from the Canadian Cancer Registry (1992–2005), and were categorized into three subsites: oropharynx, oral cavity, and “other” (hypopharynx, larynx, and nasopharynx). Demographic and socioeconomic information were extracted from the Canadian Census of Population data for the study period, which included three census years: 1991, 1996 and 2001. We linked cases to income quintiles (InQs) according to patients’ postal codes. Results Overall survival, without controlling for smoking, for oropharyngeal cancer increased dramatically from 1992–2005 in Canada. This increase in survival for oropharynx cancer was eliminated by the introduction of controls for smoking. Survival for all head and neck cancer subsites was strongly correlated with SES, as measured by income quintile, with lower InQ’s having lower survival than higher. Lastly, the magnitude of the difference in survival between the highest and lowest income quintiles increased significantly over the time period studied for oropharynx cancer, but did not statistically significantly change for oral cavity cancer or other head and neck cancers. Conclusions These data confirm a significant impact of socioeconomic deprivation on overall survival for head and neck cancers in Canada, and may provide indirect evidence that HPV-positive head and neck cancers are more common in higher socioeconomic groups.
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Chang TS, Chang CM, Hsu TW, Lin YS, Lai NS, Su YC, Huang KY, Lin HL, Lee CC. The combined effect of individual and neighborhood socioeconomic status on nasopharyngeal cancer survival. PLoS One 2013; 8:e73889. [PMID: 24069242 PMCID: PMC3771923 DOI: 10.1371/journal.pone.0073889] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 07/23/2013] [Indexed: 11/26/2022] Open
Abstract
Background The relationship between individual and neighborhood socioeconomic status (SES) and mortality rates in patients with nasopharyngeal carcinoma (NPC) is unknown. This population-based study aimed to examine the association between SES and survival of patients with NPC in Taiwan. Materials and Methods A population-based follow-up study was conducted of 4691 patients diagnosed with NPC between 2002 and 2006. Each patient was traced to death or for 5 years. Individual SES was defined by enrollee job category. Neighborhood SES was based on household income dichotomized into advantaged and disadvantaged areas. Cox proportional hazards model was used to compare the death-free survival rates between the different SES groups after adjusting for possible confounding factors and risk factors. Results In NPC patients below the age of 65 years, 5-year overall survival rates were worst for those with low individual SES living in disadvantaged neighborhoods. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score), NPC patients with low individual SES residing in disadvantaged neighborhoods were found to have a 2-fold higher risk of mortality than patients with high individual SES residing in advantaged neighborhoods. We found no significant difference in mortality rates between different SES groups in NPC patients aged 65 and above. Conclusions Our findings indicate that NPC patients with low individual SES who live in disadvantaged neighborhoods have the higher risk of mortality than their more privileged counterparts. Public health strategies and welfare policies would be well advised to try to offset the inequalities in health care and pay more attention to addressing the needs of this vulnerable group.
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Affiliation(s)
- Ting-Shou Chang
- Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chang
- Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Ta-Wen Hsu
- Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Yaoh-Shiang Lin
- Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ning-Sheng Lai
- Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Yu-Chieh Su
- Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Kuang-Yung Huang
- Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- Division of Rheumatology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Hung-Lung Lin
- Department of Research, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- Center for Clinical Epidemiology and Biostatistics, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
- Community Medicine Research Center and the Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Department of Education, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- * E-mail:
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Amar A, Curioni OA, de Paiva DL, Rapoport A, Dedivitis RA, Cernea CR, Brandão LG. Epidemiological assessment and therapeutic response in hypopharyngeal cancer. Braz J Otorhinolaryngol 2013; 79:500-4. [PMID: 23929153 PMCID: PMC9442406 DOI: 10.5935/1808-8694.20130089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 04/29/2013] [Indexed: 11/20/2022] Open
Abstract
Despite the low incidence, diagnostic and therapeutic advances, hypopharyngeal cancer still has high mortality. Objective To evaluate retrospectively the epidemiological profile and response to surgery and radiation/chemotherapy of patients with hypopharyngeal cancer. Method We reviewed the medical records of 114 patients treated between 2002 and 2009 in a tertiary hospital with histopathological diagnosis of squamous cell carcinoma. Results The mean age of the patients was 57 years, 94.7% were males and 5.3% females, 98.2% were smokers and 92% consumed alcohol; 72% are illiterate or did not complete first grade schooling. The main complaints were: neck node (28%), pain and dysphagia (22%), odynophagia (12.2%), dysphonia (7.8%). The clinical staging was: I (1.7%), II (3.5%), III (18.4%), IV (76.3%). The treatment was carried out with radiotherapy and chemotherapy alone in 35%, with mean 2-year survival of 20% and 5-year survival of 18%; surgery followed by radiotherapy and chemotherapy in 22.8% with 2-year survival of 60.0% and 5 years of 55.0%; chemotherapy alone in 2.6%, and 39.4% without treatment. Conclusion Most patients already had advanced clinical stages and independent of the treatment option, had a low survival rate, confirming the poor prognosis of this neoplasm.
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Affiliation(s)
- Ali Amar
- PhD in Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP (Assistant Physician - Department Head and Neck Surgery and Otorhinolaryngology - Heliópolis Hospital)
| | - Otávio Alberto Curioni
- Senior Associate Professor - Department of Surgery - School of Medical Sciences - Lusiada Foundation, Santos/SP (Head of the Department of Head and Neck Surgery and Otorhinolaryngology - Heliópolis Hospital, São Paulo. Head and Neck Surgeon of São José Hospital - RBBP, São Paulo)
| | - Diógenes Lopes de Paiva
- Resident physician in the Department of Head and Neck Surgery and Otorhinolaryngology, Heliópolis Hospital (Resident Physician, Department of Head and Neck Surgery and Otorhinolaryngology, Heliópolis Hospital)
| | - Abrão Rapoport
- Senior Associate Professor at the Department of Surgery, Medical School of the University of São Paulo (Technical Director of the Department of Health, Heliópolis Hospital, São Paulo. Head and Neck Surgeon - RBBP of São José Hospital, São Paulo)
| | - Rogério Aparecido Dedivitis
- Senior Associate Professor - Larynx Group Supervisor - Department of Head and Neck Surgery, Medical School of the University of São Paulo (MD)
- Send correspondence to: Rogério Aparecido Dedivitis. Rua Cônego Xavier, nº 276. São Paulo - SP. Brazil. CEP: 04231-030. Tel: (13) 8193-5000.
| | - Claudio Roberto Cernea
- Associate Professor, Department of Head and Neck Surgery, Medical School of the University of São Paulo
| | - Lenine Garcia Brandão
- Full Professor - Department of Head and Neck Surgery, Medical School of the University of São Paulo. Department of Head and Neck Surgery and Otorhinolaryngology, Heliópolis Hospital, São Paulo, Brazil
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Kent EE, Sender LS, Morris RA, Grigsby TJ, Montoya MJ, Ziogas A, Anton-Culver H. Multilevel socioeconomic effects on quality of life in adolescent and young adult survivors of leukemia and lymphoma. Qual Life Res 2012; 22:1339-51. [PMID: 22922952 DOI: 10.1007/s11136-012-0254-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE Cancer registry survival analyses have shown that adolescent and young adult patients with low socioeconomic status (SES) have reduced survival compared to those with higher SES. The objective of this study was to determine whether neighborhood- (nSES) and/or individual-level SES (iSES) also predicted current quality of life in adolescent and young adult survivors. METHODS The Socioeconomics and Quality of Life study surveyed adolescent and young adult survivors of leukemia and lymphoma at least one year post-diagnosis using population-based ascertainment. Factor analysis was used to create a multidimensional age-relevant iSES score and compared with a preexisting census-block-group derived nSES score. Four quality of life domains were assessed: physical health, psychological and emotional well-being, social relationships, and life skills. Nested multivariable linear regression models were run to test the associations between both SES measures and quality of life and to compare the explanatory power of nSES and iSES. RESULTS Data from 110 individuals aged 16-40 were included in the final analysis. After adjustment for sociodemographic confounders, low nSES was associated only with poorer physical health, whereas low iSES was related to poorer quality of life in all four domains with iSES accounting for an additional 14, 12, 25, and 10 % of the variance, respectively. CONCLUSIONS Measures of SES at the individual as compared to the neighborhood level may be stronger indicators of outcomes in adolescents and young adults, which has important implications for SES measurement in the context of cancer surveillance.
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Affiliation(s)
- Erin E Kent
- Cancer Prevention Fellowship Program, National Cancer Institute, National Institutes of Health, 6116 Executive Blvd, Bethesda, MD 20892, USA.
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Reitzel LR, Nguyen N, Zafereo ME, Li G, Wei Q, Sturgis EM. Neighborhood deprivation and clinical outcomes among head and neck cancer patients. Health Place 2012; 18:861-8. [PMID: 22445028 DOI: 10.1016/j.healthplace.2012.03.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 02/03/2012] [Accepted: 03/04/2012] [Indexed: 11/17/2022]
Abstract
The unique effects of neighborhood-level economic deprivation on survival, recurrence, and second primary malignancy development were examined using adjusted Cox proportional hazards regression models among 1151 incident squamous cell carcinomas of the head and neck patients. Cancer site was examined as a potential moderator. Main analyses yielded null results; however, interaction analyses indicated poorer overall survival [HR=1.59 (1.00-2.53)] and greater second primary malignancy development [HR=2.99 (1.46-6.11)] among oropharyngeal cancer patients from highly deprived neighborhoods relative to less deprived neighborhoods. Results suggest a dual focus on individual and neighborhood risk factors could help improve clinical outcomes among oropharyngeal cancer patients.
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Affiliation(s)
- Lorraine R Reitzel
- Department of Health Disparities Research-Unit 1440, PO Box 301402, University of Texas MD Anderson Cancer Center, Houston, Texas 77230-1402, USA.
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Lee CC, Chien SH, Hung SK, Yang WZ, Su YC. Effect of individual and neighborhood socioeconomic status on oral cancer survival. Oral Oncol 2011; 48:253-61. [PMID: 22041306 DOI: 10.1016/j.oraloncology.2011.10.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 10/04/2011] [Accepted: 10/04/2011] [Indexed: 11/25/2022]
Abstract
This population-based study investigated the relationship between individual and neighborhood socioeconomic status (SES) and oral cancer mortality. A population-based follow-up study was conducted of 3607 oral cancer patients (predominantly male) who were diagnosed between 2004 and 2005. Each patient was traced to death or for 2 years. Individual SES was defined by enrollee category. Neighborhood SES was defined by income, and numbers of doctors, and neighborhoods were grouped into advantaged and disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rate between the different SES groups after adjusting for possible confounding and risk factors. In oral cancer patients aged below 65 years, death rates among those with low SES were highest in disadvantaged neighborhoods. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score, urbanization, and area of residence), tumor extent, treatment modalities (operation, adjuvant therapy), hospital characteristics (ownership, teaching level, caseload), and year of diagnosis, oral cancer patients with low individual SES in disadvantaged neighborhoods conferred a 1.46- to 1.64-fold higher risk for death, compared with patients with high individual SES in advantaged neighborhoods. No statistically significant difference was found in risk of death between different SES groups in patients aged 65 and above. Our findings indicate that oral cancer patients with low individual SES have the highest risk of mortality even under a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group.
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Affiliation(s)
- Ching-Chih Lee
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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