title: Racial/Ethnic disparities in socioeconomic status, diagnosis, treatment and survival among medicare-insured men and women with head and neck cancer.
abstract: To determine whether racial disparities persist in Medicare-insured elderly patients with head and neck cancer, we studied 7,480 patients diagnosed with head and neck cancer at age 65 or older in 1991-2002, identified from tumor registries maintained by the 16 areas participating in the Surveillance, Epidemiology and End Results program. Patients receiving cancer-directed surgery had significantly lower risks of both all-cause and disease-specific mortality than others; those with lower socioeconomic status were more likely to die of all causes than patients with higher socioeconomic status. African Americans had a marginally higher risk of all-cause mortality (hazard ratio = 1.19, 95% CI: 1.07-1.33), but had no significantly different risk of disease-specific mortality compared with Whites (1.09, 0.91-1.30). In conclusion, the risk of mortality was not significantly different among African Americans and Hispanics compared with Whites in specific tumor sites of head and neck cancer except a marginally elevated risk of all-cause mortality in African Americans with oral cavity tumor.
authors.affiliation: Division of Epidemiology, School of Public Health, University of Texas Health Science Center, Houston, TX 77030, USA. Xianglin.L.Du@uth.tmc.edu
authors.forename: Xianglin L
authors.initials: XL
authors.lastname: Du
authors.forename: Chih-Chin
authors.initials: CC
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000208:ethnology / Q000706:statistics & numerical data*; D012307:Risk Factors; D018426:SEER Program; D012923:Social Class; D013534:Survival; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology