Objectives: Head and neck cancer is a deadly disease; each year 49,260 Americans develop and 11,480 die from the disease. Early diagnosis is essential for better treatment outcomes and enhanced survival. “Head and neck cancer” describes a range of malignant tumors that can appear in or around the throat, larynx (voice box), nose, sinuses, and mouth. We examined stage at diagnosis by race and time period to identify potential racial disparities and evaluate progress (or lack thereof) in early diagnosis.
Methods: Incidence data from the Florida Cancer Data System (FCDS) were used to test for differences in SEER stage classification (local, regional, distant/systemic) by racial group (white, black) and over time (1981-96, 1997-2008). The 10 FCDS site codes were each examined using Chi-square tests of association with a p-value less than 0.005 considered statistically significant.
Results: Differences in stage at diagnosis were detected between blacks and whites for 9 of the 10 sites (exception lip, p=0.06). In all cases except salivary gland, blacks were diagnosed at a more advanced stage.
Examples (column %) | Tongue | Floor of mouth | Tonsil | |||
B | W | B | W | B | W | |
Local | 22 % | 41 % | 27 % | 51 % | 15 % | 21 % |
Regional | 55 % | 49 % | 62 % | 45 % | 65 % | 69 % |
Distant/systemic | 24 % | 10 % | 11 % | 4 % | 20 % | 10 % |
Overall, more advanced stage at diagnosis during the more recent time period was detected for cancers of the tongue, salivary gland, tonsil, and other buccal and pharynx cancers.
Conclusion: Racial disparities exist with regard to stage at diagnosis for most HNC. Overall, it does not appear that early diagnosis is improving, and, for several cancer sites, the opposite trend was detected. (NICDR U54DE019261)