Effect of socioeconomic status on survival in patients with head and neck cancer

Abstract

Background: The aim of this study was to assess the survival outcomes of head and neck cancer (HNC) by socioeconomic status.

Methods: A national retrospective population-based cohort of HNC patients diagnosed in Israel between 2000 and 2017 was conducted. Site of residence and socioeconomic status were correlated with overall survival (OS), controlling for prognostic factors that included tumor site, stage, age, sex, and ethnic group.

Results: Overall, 11 826 patients were identified. Patients from high socioeconomic areas had better overall 5-year survival than patients from low socioeconomic areas (p < 0.005). Patients in stage 3 from a high socioeconomic status had a longer median survival rate of 1.5 years than patients in the low-status group. In a cox proportional hazards analysis, we found age >65 (HR 2.91, 95% confidence interval [CI]: 2.75-3.09, p < 0.001) and low socioeconomic group (HR 1.25, 95% CI: 1.18-1.33, p < 0.001) to be correlated with inferior OS.

Conclusion: Our findings show that patients with HNC living in low socioeconomic areas had worse OS.

Keywords: head and neck cancer; rural; socioeconomic; survival.