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.
BACKGROUND
Several studies have documented disparities in head and neck cancer outcomes for black patients in the United States. Recent studies have found that differences in oropharyngeal tumor human papillomavirus (HPV) status may be a cause of this disparity.


METHODS
In all, 76,817 cases of head and neck squamous cell carcinoma (HNSCC) recorded in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program were analyzed. Racial/ethnic groups were studied, for disease-specific survival in both case-matched and nonmatched cohorts. Calculation of expected disparity magnitudes based on HPV status was performed using data reported in the literature.


RESULTS
A disease-specific survival disparity was demonstrated for Hispanic patients. However, case matching eliminated this disparity. Conversely, the disparity for black patients persisted in matched cohorts. The oropharyngeal subsite was found to be the dominant contributor to this disparity.


CONCLUSIONS
The survival disparity for Hispanic patients in SEER with HNSCC is explained by differences in presentation and treatment. Also, HPV tumor status is likely a key determinant of the disparity for black patients.
Schrank
Travis P
TP
Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, USA.
Han
Yimei
Y
Weiss
Heidi
H
Resto
Vicente A
VA
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002277:Carcinoma / Q000208:ethnology / Q000401:mortality / Q000628:therapy; D002294:Carcinoma, Squamous Cell; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006258:Head and Neck Neoplasms / Q000208:ethnology / Q000401:mortality / Q000628:therapy; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D018307:Neoplasms, Squamous Cell / Q000208:ethnology / Q000401:mortality / Q000628:therapy; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D016016:Proportional Hazards Models; D018570:Risk Assessment; D018426:SEER Program; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data