title: Racial differences in head and neck squamous cell carcinomas among non-Hispanic black and white males identified through the National Cancer Database (1998-2012).
abstract: OBJECTIVE
  Head and neck squamous cell carcinoma (HNSCC) incidence is increasing, and evidence suggests survival disparities between non-Hispanic (nH) black and white males. However, temporal changes in HNSCCs and factors contributing to survival differences have not been examined at the national level.
  
  
  METHODS
  National Cancer Database (NCDB) cases were used to evaluate temporal trends in HNSCC anatomical sites and site groupings (i.e., oral cavity, oropharyngeal, non-oropharyngeal), and to estimate incidence ratios (IRs) comparing nH black and white males in demographic and clinical characteristics.
  
  
  RESULTS
  Between 1998 and 2012, 18,443 (11 %) nH black males and 145,611 (89 %) nH white males were diagnosed with HNSCCs. Cases rose from 9094 diagnosed in 1998 to 13,838 in 2012, driven by increases in oropharyngeal tumors, particularly tumors of the tonsil and tongue. Annual percent changes in nH black males and nH white males were 1.93 and 3.17, respectively. Additionally, nH black males had higher incidence of the more aggressive non-oropharyngeal tumors (p < .0001) and distant-stage tumors (76 vs. 64 %, p < .0001). However, nH white males had higher incidence of high-risk HPV types (IRs range from 1.68, 95 % CI 1.50-1.88 in oropharyngeal tumors to 3.03, 95 % CI 1.11-8.25 in non-oropharyngeal tumors).
  
  
  CONCLUSIONS
  Incidence of oropharyngeal tumors has risen in both nH black and white males. However, nH white males have higher incidence of HPV, and nH black males have higher incidence of more aggressive and advanced HNSCCs. Racial differences in clinical characteristics associated with poorer survival exist, and future studies should determine factors associated with these differences.
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Room 888, Chicago, IL, 60612, USA. cpeter1@uic.edu.|Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago, IL, USA. cpeter1@uic.edu.|Institute for Health Research and Policy, Chicago, IL, USA. cpeter1@uic.edu.
authors.forename: Caryn E
authors.initials: CE
authors.lastname: Peterson
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Room 888, Chicago, IL, 60612, USA.
authors.forename: Shaveta
authors.initials: S
authors.lastname: Khosla
authors.affiliation: Department of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Lucy F
authors.initials: LF
authors.lastname: Chen
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Room 888, Chicago, IL, 60612, USA.|Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago, IL, USA.|Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Charlotte E
authors.initials: CE
authors.lastname: Joslin
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Room 888, Chicago, IL, 60612, USA.|School of Public Health, University of Alberta, Edmonton, AB, Canada.
authors.forename: Faith G
authors.initials: FG
authors.lastname: Davis
authors.affiliation: Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago, IL, USA.|Institute for Health Research and Policy, Chicago, IL, USA.|Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Marian L
authors.initials: ML
authors.lastname: Fitzgibbon
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Room 888, Chicago, IL, 60612, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Freels
authors.affiliation: Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago, IL, USA.|Institute for Health Research and Policy, Chicago, IL, USA.|Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Kent
authors.initials: K
authors.lastname: Hoskins
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D000077195:Squamous Cell Carcinoma of Head and Neck; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult; D001741:Black or African American
keywords: Clinical characteristics; Head and neck cancer; Human papillomavirus; Racial disparities; Temporal trends