Racial disparities in surgical treatment of oropharyngeal cancer: A Surveillance, Epidemiology, and End Results review

Head Neck. 2023 Sep;45(9):2313-2322. doi: 10.1002/hed.27467. Epub 2023 Jul 17.

Abstract

Objectives: Oropharyngeal squamous cell carcinoma (OPSCC) has been rising. This manuscript looks to explore racial disparities in the surgical management of OPSCC.

Methods: A cancer database was queried for patients with OPSCC diagnosed from 2004 to 2017. Univariate and multivariable logistic regressions were used to evaluate associations between patient race/ethnicity, surgical treatment, and reasons for lack of surgery.

Results: 37 306 (74.3%) patients did not undergo surgery, while 12 901 (25.7%) patients did. Non-Hispanic black (NHB) patients were less likely to undergo surgery than other races (17.9% vs. 26.5%; p < 0.0001). In clinical discussions, the Asian, Native American, Hawaiian, Pacific Islander (ANAHPI), and unknown race group was more likely to directly refuse surgery when recommended (2.5% vs. 1.5%; p = 0.015).

Conclusion: Racial differences exist in treatment for OPSCC. NHB patients are less likely to actually undergo surgical management for OPSCC, while other patients are more likely to directly "refuse" surgery outright when offered.

Keywords: TORS; epidemiology; head and neck surgery; health disparities; oropharyngeal carcinoma; racial disparities; squamous cell carcinoma; surgical disparities.

MeSH terms

  • Black or African American
  • Ethnicity
  • Head and Neck Neoplasms* / surgery
  • Healthcare Disparities*
  • Humans
  • Oropharyngeal Neoplasms* / surgery
  • Squamous Cell Carcinoma of Head and Neck* / surgery