The relationship between survival and socio-economic status for head and neck cancer in Canada

Journal of Otolaryngology-Head & Neck Surgery

Martin Corsten¹  Chris Connell²  Euna Hwang¹  Stephanie Johnson-Obaseki¹  James Ted McDonald² 

[1] Department of Otolaryngology-Head and Neck Surgery, University of Ottawa/The Ottawa Hospital, Suite S-3, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada;Department of Economics, University of New Brunswick, Fredericton, Canada

关键词: Human papillomavirus;    Age at diagnosis;    Income;    Socioeconomic status;    Survival;    Head and neck cancer;   

Others  :  1144007
DOI  :  10.1186/1916-0216-43-2

 received in 2013-08-29, accepted in 2013-12-16,  发布年份 2014

【 摘 要 】

Background

Human papilloma virus (HPV) is emerging as the primary cause for some head and neck cancers. The objective of this study was to investigate the association between head and neck cancer (HNC) survival and socioeconomic status (SES) in Canada, and to investigate changes in the relationship between HNC survival and SES from 1992 to 2005.

Methods

Cases were drawn from the Canadian Cancer Registry (1992–2005), and were categorized into three subsites: oropharynx, oral cavity, and “other” (hypopharynx, larynx, and nasopharynx). Demographic and socioeconomic information were extracted from the Canadian Census of Population data for the study period, which included three census years: 1991, 1996 and 2001. We linked cases to income quintiles (InQs) according to patients’ postal codes.

Results

Overall survival, without controlling for smoking, for oropharyngeal cancer increased dramatically from 1992–2005 in Canada. This increase in survival for oropharynx cancer was eliminated by the introduction of controls for smoking. Survival for all head and neck cancer subsites was strongly correlated with SES, as measured by income quintile, with lower InQ’s having lower survival than higher. Lastly, the magnitude of the difference in survival between the highest and lowest income quintiles increased significantly over the time period studied for oropharynx cancer, but did not statistically significantly change for oral cavity cancer or other head and neck cancers.

Conclusions

These data confirm a significant impact of socioeconomic deprivation on overall survival for head and neck cancers in Canada, and may provide indirect evidence that HPV-positive head and neck cancers are more common in higher socioeconomic groups.

【 授权许可】

   
2014 McDonald et al.; licensee BioMed Central Ltd.

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