Abstract
Head and neck cancer is the ninth most common cancer in the USA, accounting for 3.3 % of all cancers. The incidence of head and neck cancer has plateaued recently; however, morbidity and mortality continue to remain high. Moreover, racial disparity between African-American and White patients has been studied in the head and neck community, and a vast difference still remains in mortality rate and late stage at presentation. A review of the English literature was performed using PubMed/MEDLINE for demographics, epidemiology, and studies that focused on the disparity in head and neck cancer between African-American and White patients. Age-adjusted incidence of head and neck cancer is increased in African-Americans, while the 5-year survival is decreased compared to Whites. African-American patients present with more advanced disease. When receiving similar multidisciplinary care, the overall survival was not significantly different, but racial disparity often persists in treatment regimens. Socioeconomic determinants such as insurance status play a critical role in racial disparity, along with low levels of public awareness, a lack of knowledge of specific risk factors, and a sense of mistrust that is seen in the African-American population. Disparity in the head and neck cancer community is worrisome, and although efforts have been taken to decrease the disparity, a significant difference exists. Fortunately, the disparity is reversible and can be eliminated. To do so, it is critical to extend to underserved community programs that provide appropriate screening and diagnosis, with subsequent follow-up and treatment following the standards of care.
Similar content being viewed by others
References
Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer Stat 64(1):9–29. doi:10.3322/caac.21208
Shiboski CH, Schmidt BL, Jordan RC (2007) Racial disparity in stage at diagnosis and survival among adults with oral cancer in the US. Community Dent Oral Epidemiol 35:233–240
Mehta V, Yu GP, Schantz SP (2010) Population-based analysis of oral and oropharyngeal carcinoma: changing trends of histopathologic differentiation, survival and patient demographics. Laryngoscope 120:2203–2212
Guo Y, McGorray SP, Riggs CE Jr, Logan HL (2013) Racial disparity in oral and pharyngeal cancer in Florida in 1991–2008: mixed trends in stage of diagnosis. Community Dent Oral Epidemiol 41(2):110–119. doi:10.1111/j.1600-0528.2012.00738.x
Centers for Disease control and Prevention (CDC) (2012) Current cigarette smoking among adults—United States, 2011. MMWR Morb Mortal Wkly Rep 61:889–894
Al-Othman MO, Morris CG, Logan HL, Hinerman RW, Amdur RJ, Mendenhall WM (2003) Impact of race on outcome after definitive radiotherapy for squamous cell carcinoma of the head and neck. Cancer 98(11):2467–2472
Goodwin WJ, Thomas GR, Parker DF, Joseph D, Levis S, Franzmann E, Anello C, Hu JJ (2008) Unequal burden of head and neck cancer in the United States. Head Neck 30(3):358–371
Gourin CG, Podolsky RH (2006) Racial disparities in patients with head and neck squamous cell carcinoma. Laryngoscope. 2006 Jul;116 (7):1093–106. Erratum in. Laryngoscope 116(11):2098
Molina MA, Cheung MC, Perez EA, Byrne MM, Franceschi D, Moffat FL, Livingstone AS, Goodwin WJ, Gutierrez JC, Koniaris LG (2008) African American and poor patients have a dramatically worse prognosis for head and neck cancer: an examination of 20,915 patients. Cancer 113(10):2797–2806. doi:10.1002/cncr.23889
Bach PB, Schrag D, Brawley OW, Galaznik A, Yakren S, Begg CB (2002) Survival of blacks and whites after a cancer diagnosis. JAMA 287(16):2106–2113
Tehranifar P, Neugut AI, Phelan JC, Link BG, Liao Y, Desai M, Terry MB (2009) Medical advances and racial/ethnic disparities in cancer survival. Cancer Epidemiol Biomarkers Prev 18(10):2701–2708. doi:10.1158/1055-9965.EPI-09-0305
Chen LM, Li G, Reitzel LR, Pytynia KB, Zafereo ME, Wei Q, Sturgis EM (2009) Matched-pair analysis of race or ethnicity in outcomes of head and neck cancer patients receiving similar multidisciplinary care. Cancer Prev Res (Phila) 2(9):782–791. doi:10.1158/1940-6207.CAPR-09-0154
Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975–2010, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2010/, based on November 2012 SEER data submission, posted to the SEER web site, April 2013
Ragin CC, Langevin SM, Marzouk M, Grandis J, Taioli E (2011) Determinants of head and neck cancer survival by race. Head Neck 33(8):1092–1098. doi:10.1002/hed.21584
Schrank TP, Han Y, Weiss H, Resto VA (2011) Case-matching analysis of head and neck squamous cell carcinoma in racial and ethnic minorities in the United States–possible role for human papillomavirus in survival disparities. Head Neck 33(1):45–53. doi:10.1002/hed.21398
Jiron J, Sethi S, Ali-Fehmi R, Franceschi S, Struijk L, Van Doorn LJ, Quint W, Kato I (2014) Racial disparities in human papillomavirus (HPV) associated head and neck cancer. Am J Otolaryngol 35(2):147–153. doi:10.1016/j.amjoto.2013.09.004
Chaturvedi AK, Engels EA, Anderson WF et al (2008) Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 26:612–619
Sethi S, Ali-Fehmi R, Franceschi S et al (2012) Characteristics and survival of head and neck cancer by HPV status: a cancer registry-based study. Int J Cancer 131:1179–1186
Isayeva T, Xu J, Dai Q, Whitley AC, Bonner J, Nabell L, Spencer S, Carroll W, Jones G, Ragin C, Brandwein-Gensler M (2014) African Americans with oropharyngeal carcinoma have significantly poorer outcomes despite similar rates of human papillomavirus-mediated carcinogenesis. Hum Pathol 45(2):310–319. doi:10.1016/j.humpath.2013.09.006
Moore CE, Warren R, Maclin SD Jr (2012) Head and neck cancer disparity in underserved communities: probable causes and the ethics involved. J Health Care Poor Underserved 23(4 Suppl):88–103. doi:10.1353/hpu.2012.0165
Tomar SL, Loree M, Logan H (2004) Racial differences in oral and pharyngeal cancer treatment and survival in Florida. Cancer Causes Control 15:601–609
American Cancer Society (2000) American Cancer Society guidelines for early detection of cancer. CA Cancer J Clin 50:34–49
Dodd VJ, Watson JM, Choi Y, Tomar SL, Logan HL (2008) Oral cancer in African Americans: addressing health disparities. Am J Health Behav 32(6):684–692. doi:10.5555/ajhb.2008.32.6.684
Funding
None.
Financial Disclosures
None of the authors have financial disclosures.
Conflict of Interest
None of the authors have conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Daraei, P., Moore, C.E. Racial Disparity Among the Head and Neck Cancer Population. J Canc Educ 30, 546–551 (2015). https://doi.org/10.1007/s13187-014-0753-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13187-014-0753-4