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dc.contributor.authorVyfhuis, Melissa A L
dc.contributor.authorSuzuki, Ikumi
dc.contributor.authorBentzen, Soren M
dc.contributor.authorCullen, Kevin J
dc.contributor.authorGoloubeva, Olga G
dc.date.accessioned2021-05-03T16:47:37Z
dc.date.available2021-05-03T16:47:37Z
dc.date.issued2021-03-30
dc.identifier.urihttp://hdl.handle.net/10713/15553
dc.description.abstractBackground: In head and neck squamous cell carcinoma (HNSCC), Black patients continue to have worse survival when compared with White patients. The cause of this disparity is multifaceted and cannot be explained by one etiology alone. To investigate this disparity, we used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to examine adherence to guideline-concordant care (GCC) as defined by the National Comprehensive Cancer Network. Patients and Methods: In this retrospective study, Medicare beneficiaries diagnosed with nonmetastatic HNSCC as their first cancer between 1992 and 2011 and a random sample of Medicare controls matched to cases (2:1) diagnosed between 2004 and 2011 (n = 16,378), were included in this analysis. Results: Black patients were less likely to receive GCC in advanced-stage oropharyngeal (66% vs. 74%; p =.007) and oral cavity (56% vs. 71%; p =.002) squamous cell carcinoma (SCC). On multivariate analysis, Black patients demonstrated an increased risk of death in advanced oropharyngeal (p <.001), oral cavity (p =.01), and hypopharyngeal (p =.01) SCC. Conclusion: Black patients did not consistently receive GCC across HNSCC subsites, contributing to the poorer outcomes seen when compared with White patients. Future research should focus on elucidating the mechanisms behind the non-GCC given to Black patients with HNSCC and other factors that may contribute to this disparity such as tumor biology. Implications for Practice: Black patients with head and neck cancer (HNC) continue to have worse survival than White patients. This study examined if the racial disparity in survival from curable HNC is affected by adherence to guideline-concordant care (GCC). It was discovered that Black patients were less likely to receive appropriate treatment in certain HNCs. Although adherence to proper therapy was associated with improved survival in patients with HNC, the difference in survival, where Black patients had inferior outcomes, remained. This analysis uncovered a major contributor to the disparity seen in patients with HNC. As such, cancer centers serving a predominantly Black population with HNC can design specific clinical interventions to ensure GCC for all patients, potentially improving outcomes for everyone.en_US
dc.description.urihttps://doi.org/10.1002/onco.13763en_US
dc.language.isoenen_US
dc.publisherWiley-Blackwellen_US
dc.relation.ispartofThe Oncologisten_US
dc.rights© 2021 AlphaMed Press.en_US
dc.subjectBlack patientsen_US
dc.subjectDisparityen_US
dc.subjectGuideline-concordant careen_US
dc.subjectHead and neck cancersen_US
dc.subjectSEERen_US
dc.titleAdherence to Guideline-Concordant Care and Its Effect on Survival in Black Patients with Head and Neck Cancers: A SEER-Medicare Analysisen_US
dc.typeArticleen_US
dc.identifier.doi10.1002/onco.13763
dc.identifier.pmid33783061
dc.source.countryUnited States


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