The Scottish Audit of Head and Neck Cancer (SAHNC): Influence of socioeconomic deprivation status on 5- and 12- year survival.

Objectives: Socioeconomic factors have been implicated in affecting the survival of head and neck cancer patients, but the association with long-term survival is poorly understood. The aim of this project is to assess how socioeconomic deprivation status impacts on the long-term survival of head and neck cancer patients, and to investigate the impact on long-term survival associated with patient, tumour and treatment factors.
Methods: SAHNC is a large clinical head and neck cancer cohort recruited between 1999 and 2001 (n = 1910). Several factors are considered associated with inequalities in survival between varying deprivation categories including patient (age, sex, lifestyle, WHO status), tumour (site, stage), and treatment (modality, geographic region). Deprivation category is determined using the Carstairs and Morris index of deprivation. 5- and 12-year Kaplan-Meier Survival Analysis has been completed and differences in survival determined by the log-rank statistic.
Results: The overall 5- and 12- year survival by socioeconomic deprivation status are displayed below:
5-year Survival
Overall 44.7% (95% CI 42.4% 46.9%)
Affluent 47.4% (95% CI 41.1% 53.4%)
Deprived 38.5% (95% CI 32.1% 44.9%)

12-year Survival
Overall 25.1% (95% CI 23.2% 27.1%)
Affluent 25.7% (95% CI 20.5% 31.3%)
Deprived 22.0% (95% CI 16.8% 27.7%)

The difference in survival between the most affluent group and the most deprived group reduced from 8.9% at 5 years to 3.7% at 12 years.
Conclusions: This is a thorough analysis of the long-term survival of a national clinical cohort of head and neck cancer patients over an extended follow-up period. We have seen a reduction in the influence of deprivation on long-term survival in comparison to 5-year survival. The potential influences of patient, tumour and treatment factors on long-term survival are explored in further models.