Geographic Disparities in Sinonasal Masses: A Single Institution Experience.

Abstract

To identify, describe, and understand geographic disparities in the presentation, treatment, and outcomes of patients with sinonasal masses in southern Arizona. Retrospective cohort study of 86 patients with sinonasal masses treated at the University of Arizona between January 2010 and December 2024. Single tertiary academic medical center. Patients were stratified into urban (n = 41), suburban (n = 12), or rural (n = 33) locations based on home location population size. We analyzed patient demographics and clinical data to determine the influence of geographic location on diagnostic delays, treatment, and survival. Statistical significance was defined as P < .05. The mean age at presentation was 62.3 years across all locations. Diabetes was more common in rural locations (36.4%) (P = .006). Patients from rural locations exhibited the highest tobacco exposure (21.2% current smokers, 33.3% former smokers) (P = .044). Squamous cell carcinoma was the most common subtype (33.7%). The longest interval from symptom onset to diagnosis was in rural locations (342.7 days) (P = .29). Geographic location was the strongest predictor of diagnostic delays, with urban locations independently associated with a 205-day shorter time to diagnosis than rural locations (P = .021). Patients from urban locations received the most radiation therapy (82.9%) (P = .047). Race and geographic location significantly influenced the risk of death (Likelihood ratio χ²(6) = 24.21, P < .001). This study identifies significant geographic disparities in diabetes, smoking, diagnostic delays, treatment, and racial and ethnic risk of death. Prospective studies are required to investigate these factors further and improve equitable access to comprehensive care for patients with sinonasal masses.