Access to preventive care services and stage at diagnosis in head and neck cancer

Head Neck. 2020 Oct;42(10):2841-2851. doi: 10.1002/hed.26326. Epub 2020 Jul 3.

Abstract

Background: Decreased access to preventive care services has been proposed as a mechanism for the association between low socioeconomic status (SES) and advanced stage at diagnosis in patients with head and neck squamous cell carcinoma (HNSCC).

Methods: Retrospective analysis of patients diagnosed with HNSCC in North Carolina between 2002 and 2006.

Results: A total of 1108 patients with HNSCC were included in the study. In the multivariable analysis, use of annual routine dental services (OR 0.7, 95% CI 0.5-0.9) and colonoscopy in the past 10 years (OR 0.7, 95% CI 0.5-0.9) were associated with lower odds of advanced T stage at diagnosis. Having no insurance (OR 1.8, 95% CI 1.1-2.9), an income <$20 000 (OR 1.6 95% CI 1.03-2.6), and >10 pack-years tobacco use (OR 1.5, 95% CI 1.04-2.2) were associated with advanced T stage at diagnosis.

Conclusion: Use of preventive care services and SES independently predict stage at diagnosis in HNSCC.

Keywords: dental health services; early detection of cancer; head and neck neoplasms; neoplasm staging; preventive medicine.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Carcinoma, Squamous Cell* / diagnosis
  • Carcinoma, Squamous Cell* / epidemiology
  • Carcinoma, Squamous Cell* / therapy
  • Head and Neck Neoplasms* / diagnosis
  • Head and Neck Neoplasms* / epidemiology
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Income
  • Neoplasm Staging
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck