title: Head and neck cancer-specific survival based on socioeconomic status in Asians and Pacific Islanders.
abstract: BACKGROUND
  Lower socioeconomic status (SES) has been linked to higher incidence of head and neck cancer (HNC) and lower survival. However, little is known about the effect of SES on HNC survival in Asians and Pacific Islanders (APIs). This study's purpose was to examine the effect of SES on disease-specific survival (DSS) and overall survival (OS) in APIs with HNC using population-based data.
  
  
  METHODS
  A total of 53,544 HNC patients (4,711 = APIs) were identified from the California Cancer Registry from 1988 to 2007. Neighborhood (block-group-level) SES, based on composite Census 1990 and 2000 data, was calculated for each patient based on address at diagnosis, categorized into statewide quintiles, and collapsed into 2 groups for comparison (low SES = quintiles 1-3; high SES = quintiles 4-5). DSS and OS were computed by the Kaplan-Meier method. Adjusted hazards ratios (HR) were estimated using Cox proportional hazards regression models.
  
  
  RESULTS
  Among APIs, lower neighborhood SES was significantly associated with poorer DSS (HR range for oral cavity, oropharynx, or larynx/hypopharynx cancer, 1.07-1.34) and OS (HR, 1.13-1.37) after adjusting for patient and tumor characteristics. Lower SES was significantly associated with poorer survival in API with all HNC sites combined: DSS HR: 1.26 (95% confidence interval [CI], 1.08-1.48) and OS HR, 1.30 (95% CI, 1.16-1.45).
  
  
  CONCLUSIONS
  Neighborhood SES was associated with longer DSS and OS in API with HNC. The effect of SES on HNC survival should be considered in future studies, and particular attention should be paid to clinical care of lower-SES HNC patients.
authors.affiliation: Stanford University Medical Center, Stanford, California 94305-5847, USA.
authors.forename: Karen P
authors.initials: KP
authors.lastname: Chu
authors.forename: Sarah
authors.initials: S
authors.lastname: Shema
authors.forename: Simon
authors.initials: S
authors.lastname: Wu
authors.forename: Scarlett L
authors.initials: SL
authors.lastname: Gomez
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.forename: Quynh-Thu
authors.initials: QT
authors.lastname: Le
mesh_terms: D000368:Aged; D044466:Asian People; D005006:Ethnicity; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D012923:Social Class