Neighborhood socioeconomic status and race are associated with incidence disparities in oral cavity cancers

Salma Ramadan; Jake J Lee; Ray Wang; Ryan S Jackson; Patrik Pipkorn; Jason Rich; R Alex Harbison; Paul Zolkind; Stephen Y Kang; Sidharth V Puram; Angela L Mazul

doi:10.1016/j.oraloncology.2023.106607

Neighborhood socioeconomic status and race are associated with incidence disparities in oral cavity cancers

Oral Oncol. 2023 Dec:147:106607. doi: 10.1016/j.oraloncology.2023.106607. Epub 2023 Oct 27.

Authors

Affiliations

¹ Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
² Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH 43210, USA.
³ Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, USA; Department of Genetics, Washington University School of Medicine, Saint Louis, MO, USA. Electronic address: sidpuram@wustl.edu.
⁴ Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, USA; Department of Otolaryngology, University of Pittsburgh, and UPMC Hillman Cancer Center, Pittsburgh, PA, 15260, USA.

PMID: 37897859
DOI: 10.1016/j.oraloncology.2023.106607

Abstract

Objectives: To determine the association between neighborhood socioeconomic status (nSES), race and incidence rate trends of oral cavity cancer (OCC).

Materials and methods: We used data from the SEER (Surveillance, Epidemiology, and End Results) 18 Census Tract-level SES and Rurality Database (2006-2018) database of the National Cancer Institute to create cohorts of OCC patients between 2006 and 2018. Annual incidence rates were calculated and trends in rates were estimated using joinpoints regression.

Results: The incidence of OCC is the highest among low nSES White Americans (2.86 per 100 000 persons) and the lowest among high nSES Black Americans (1.17 per 100 000 persons). Incidence has significantly increased among Asian Americans (annual percent change [APC]: low nSES-2.4, high nSES-2.6) and White Americans (APC: low nSES-1.4, high nSES-1.6). Significant increases in the incidence of oral tongue cancer in these groups primarily drive this increase. Other increases were noted in alveolar ridge cancer among White Americans and hard palate cancer among Asian Americans. OCC incidence decreased significantly in Hispanic Americans of high nSES (APC: -2.5) and Black Americans of low nSES (APC: -2.7). Floor of mouth cancer incidence decreased among most groups.

Conclusion: Despite the overall decreasing incidence of OCC, these trends are inconsistent among all OCC subsites. Differences are seen by race, nSES, and subsite, indicating intersectional barriers that extend beyond nSES and race and ethnicity alone. Further research on risk factors and developing interventions targeting vulnerable groups is needed.

Keywords: Disparities; Head and neck cancer; Incidence; Oral cavity cancer; Race; Socioeconomic status.

MeSH terms

Ethnicity
Humans
Incidence
Mouth Neoplasms* / epidemiology
Social Class*
White