Head and Neck Cancer Stage at Diagnosis and Survival Outcomes Among South Asian Patients.

Abstract

To compare head and neck cancer (HNC) stage at diagnosis and survival outcomes between South Asian, Other Asian, and non-Hispanic white individuals in the United States. Retrospective population-based cohort study. Data from Surveillance, Epidemiology, and End Results Research Plus 17 database. Patients diagnosed with squamous HNC from 2006 to 2020 were categorized as South Asian, Other Asian, and non-Hispanic white. Logistic regression assessed the association between race/ethnicity and advanced-stage disease (stage III/IV vs I/II). Overall survival (OS) and disease-specific survival (DSS) outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression models, respectively. Among 92,664 patients (1066 South Asian, 3260 Other Asian, and 88,338 non-Hispanic white individuals), adjusted logistic regression showed South Asian individuals had a higher risk of advanced stage at diagnosis (odds ratio [OR] 1.48, 95% CI 1.29-1.70) than Other Asian (OR 1.13, 95% CI 1.05-1.22) and non-Hispanic white individuals. Adjusted Cox regression showed Other Asian (hazard ratio [HR] 0.89, 95% CI 0.84-0.94) individuals had improved OS, while South Asian individuals had similar OS (HR 1.09, 95% CI 0.99-1.21) as non-Hispanic white individuals. South Asian individuals had worse DSS (HR 1.30, 95% CI 1.16-1.46) than Other Asian (HR 1.05, 95% CI 0.98-1.12), and non-Hispanic white individuals. South Asian individuals with HNC are more likely to present with advanced disease stage and have worse survival compared with Other Asian and non-Hispanic white individuals, highlighting the importance of disaggregating Asian ethnic groups when assessing HNC outcome disparities.