title: Survival differences among American Indians/Alaska Natives with head and neck squamous cell carcinoma.
abstract: BACKGROUND
  American Indians/Alaska Natives experience poor overall survival. Data are limited on American Indians/Alaska Natives with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  We identified all cases of HNSCC among American Indians/Alaska Natives, and white patients from 1996 to 2007 using the Surveillance, Epidemiology, and End Results (SEER) database. Univariate, multivariate, and Cox models were fit to analyze racial differences in sex, age, stage, treatment, and survival.
  
  
  RESULTS
  American Indians/Alaska Natives experienced decreased survival for oropharyngeal cancer (hazard ratio [HR] = 1.4; p = .008). After adjusting for demographic factors, survival was decreased for oral cavity cancer (HR = 1.3; p = .05) and hypopharyngeal/laryngeal cancer (HR = 1.6; p = .04). These disparities were eliminated after adjusting for treatment for oral cavity cancer (HR = 1.2; p = .17) and stage for hypopharyngeal/laryngeal cancer (HR = 1.4; p = .12). American Indians/Alaska Natives received less surgery for oral cavity cancer (78% vs 85%; p = .02).
  
  
  CONCLUSIONS
  Disparities in survival exist among American Indians/Alaska Natives patients with HNSCC. They are related to stage and differential treatment patterns.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA. sunshine_dwojak@meei.harvard.edu
authors.forename: Sunshine M
authors.initials: SM
authors.lastname: Dwojak
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Sequist
authors.forename: Kevin
authors.initials: K
authors.lastname: Emerick
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Deschler
mesh_terms: D000368:Aged; D000413:Alaska; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018426:SEER Program; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D044465:White People / Q000706:statistics & numerical data*