Background: Decreased access to preventive care services has been proposed as a mechanism for the association between low socioeconomic status (SES) and advanced stage at diagnosis in patients with head and neck squamous cell carcinoma (HNSCC).
Methods: Retrospective analysis of patients diagnosed with HNSCC in North Carolina between 2002 and 2006.
Results: A total of 1108 patients with HNSCC were included in the study. In the multivariable analysis, use of annual routine dental services (OR 0.7, 95% CI 0.5-0.9) and colonoscopy in the past 10 years (OR 0.7, 95% CI 0.5-0.9) were associated with lower odds of advanced T stage at diagnosis. Having no insurance (OR 1.8, 95% CI 1.1-2.9), an income <$20 000 (OR 1.6 95% CI 1.03-2.6), and >10 pack-years tobacco use (OR 1.5, 95% CI 1.04-2.2) were associated with advanced T stage at diagnosis.
Conclusion: Use of preventive care services and SES independently predict stage at diagnosis in HNSCC.
Keywords: dental health services; early detection of cancer; head and neck neoplasms; neoplasm staging; preventive medicine.
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