Online Program

Racial differences in head and neck squamous cell carcinomas among cases identified through the National Cancer Database (1998-2012)

Monday, November 2, 2015

Caryn Peterson, PhD, MS, Division of Epidemiology & Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL
Shaveta Khosla, MPH, School of Public Health, UIC, Chicago, IL
Lucy Chen, MD, Univeristy of Illinois, Chicago, IL
Charlotte E. Joslin, OD, PhD, Dept. of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL
Faith Davis, PhD, Public Health Sciences, School of Public Health University of Alberta, Edmonton, AB, Canada
OBJECTIVE:Data from SEER and small, localized studies indicate higher mortality rates in non-Hispanic Black (NHB) males than in non-Hispanic White (NHW) males diagnosed with head and neck squamous cell carcinomas (HNSCC). Human Papillomavirus (HPV) related tumors of the tongue and oropharynx have better outcomes than HPV-negative HNSCCs.  This analysis describes trends in HNSCC tumors and assesses NHB-NHW differences in clinical factors.  

METHODS:NHB and NHW cases from the National Cancer Database (NCDB) were used to evaluate trends in HNSCC tumor sites (tongue, oropharynx, and non-oropharynx) and racial differences in clinical factors (diagnosis stage and grade) and HPV status. Chi-square statistics tested racial differences in these factors.

RESULTS: Between 1998-2012, 19,757 (11%) NHB and 163,216 (89%) NHW were diagnosed with HNSCCs.  Within NCDB, overall incidence increased from 9870 cases in 1998 to 14,293 in 2012. Incidence of tongue and oropharynx tumors rose steadily from 50% of HNSCCs in 1998 to 70% in 2012. This increase was significantly greater in NHW (from 51% to 71%) than in NHB (from 49% to 59%), p<.0001. Between 1998 and 2012, 70% of NHB were diagnosed with high-grade tumors versus 67% of NHW, p<.0001; 61% of NHB were diagnosed at stage IV versus 48% of NHW, p<.0001.  Among NHB diagnosed between 2008 and 2012, when HPV status was available for analysis, 6% were HPV-positive compared to 13% of NHW, p<.0001.

CONCLUSION:Within NCDB, representing approximately 70% of HNSCC cases in the U.S., NHB have more advanced and aggressive HNSCCs than NHW and fewer HPV-related tumors.

Learning Areas:


Learning Objectives:
Describe trends in head and neck squamous cell carcinomas(HNSCCs) in the U.S. Assess NHB-NHW differences in clinical prognostic factors for HNSCCs

Keyword(s): Cancer, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Research Assistant Professor in the Division of Epidemiology and Biostatistics at the School of Public Health of the University of Illinois at Chicago (UIC), and Education Coordinator of the UIC Cancer Education and Career Development Program, funded by the National Cancer Institute. I am also a co-investigator in an ACS-funded grant focusing racial disparities in ovarian cancer. My epidemiologic research is related to racial, ethnic, and socioeconomic disparities in cancer outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.