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• W2022168570 abstract "Recent prospective studies have identified the association of HPV-negative oropharyngeal carcinoma with poor locoregional control and overall survival. African American (AA) patients have been found to have a substantially higher rate of HPV-negative tumors when compared to whites (CA), and worse overall disease outcomes. In order to identify disparities that may be altered through quality improvement endeavors, we sought to determine whether African American patients face treatment delays after diagnosis when compared to white patients, when controlling for disease and socioeconomic variables. The National Cancer Database was queried for all Class 1 cases of oropharyngeal cancer treated at U.S. reporting facilities between 2000 and 2009. AA and CA patients were evaluated for differences in time to first treatment based on disease stage, comorbidities, type of first treatment, insurance status, and household income. A total of 7,544 cases of oropharyngeal cancer were identified between AA (n=1350) and CA (n=6194) patients. A delay from diagnosis to first course of treatment greater than 66 days (the time after which the last 10% of patients initiated therapy) was more commonly seen in AA patients (14.7%) when compared to CA patients (8.9%, p < 0.0001). This difference between AA and CA patients was most pronounced in patients with Stage IV disease (18.9% v. 11.3%, p <0.0001). There was no significant difference in time to treatment between AA and CA patients with low comorbidity scores, high household incomes, or uninsured status. However, AA patients in the lowest income bracket had significant delays compared to CA patients with similar household incomes (20.4% v. 10.4%, p=0.0005). Additionally, AA patients who received combined radiation and chemotherapy as their first course of treatment had longer delays than their CA counterparts (19.6%, v. 11.7%, p <0.000.1). Based on this nationally representative cohort, African Americans face significant delays in treatment after being diagnosed with oropharyngeal cancer when compared to whites, with differences most pronounced for poor patients with advanced disease. Improving time to initiation of treatment, especially combined chemoradiation, after diagnosis may complement current efforts to improve outcomes in African Americans with HPV-negative oropharyngeal carcinoma." @default.
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• W2022168570 date "2012-11-01" @default.
• W2022168570 modified "2023-09-24" @default.
• W2022168570 title "African Americans Face Significant Delays to Treatment After Diagnosis of Oropharyngeal Carcinoma" @default.
• W2022168570 doi "https://doi.org/10.1016/j.ijrobp.2012.07.1242" @default.
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