Nasopharynx Cancer in the United States: Racial and Ethnic Disparities in Stage at Presentation.

IF 2.2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Laryngoscope Pub Date : 2024-11-16 DOI:10.1002/lary.31907

Edward Christopher Dee, Stephanie Wang, Frances Dominique V Ho, Roshal R Patel, Kaitlyn Lapen, Yingzhi Wu, Fan Yang, Tej A Patel, Erin Jay G Feliciano, Sean M McBride, Nancy Y Lee

{"title":"Nasopharynx Cancer in the United States: Racial and Ethnic Disparities in Stage at Presentation.","authors":"Edward Christopher Dee, Stephanie Wang, Frances Dominique V Ho, Roshal R Patel, Kaitlyn Lapen, Yingzhi Wu, Fan Yang, Tej A Patel, Erin Jay G Feliciano, Sean M McBride, Nancy Y Lee","doi":"10.1002/lary.31907","DOIUrl":null,"url":null,"abstract":"Introduction: Although nasopharynx cancer (NPC) is rare in the United States, global epidemiology varies greatly. Therefore, understanding NPC disparities in the diverse US setting is critical.Methods and materials: Data from the National Cancer Database (NCDB, 2004-2021) identified patients with NPC; NCDB allows disaggregation by Asian American (AA) subgroups. Multivariable ordinal logistic regression adjusting for demographic and socioeconomic factors defined adjusted odds ratios (aORs).Results: Of 15,862 patients, 11,173 (70.4%) were male (median age 59). Commonest groups included 10,034 (63.3%) White, 2,272 (14.3%) Black, 1,103 (7.0%) Chinese, 442 (2.8%) Filipino, and 338 (2.1%) Vietnamese patients. Prior to disaggregation, the proportion of stage IV disease at presentation was 43.2% among White (ref), 50.0% among Black (aOR 1.12, p = 0.012), 52.0% among Native American (aOR 1.18, p > 0.05), 41.9% among AA (aOR 0.97, p > 0.05), and 55.1% among Native Hawaiian and Other Pacific Islander patients (aOR 1.47, p = 0.021). Upon disaggregation, the proportion of stage IV disease was the greatest (>50%) among Black (50.0%, aOR 1.12, p = 0.012), Laotian (61.5%, aOR 2.21, p = 0.001), Hmong (73.2%, aOR 2.92, p < 0.001), and Other Pacific Islander patients (60.9%, aOR 1.83, p = 0.004); 44.2% of Filipino patients also presented with stage IV disease (aOR 1.21, p = 0.033). Odds of presenting with advanced stage disease were lower among Chinese patients (35.7% stage IV, aOR 0.72, p < 0.001).Conclusions: Although most NPC patients were Chinese, White, or Black, stage IV disease at presentation was most common among Hmong, Laotian, non-Hawaiian Pacific Islander, and Black patients. Efforts are needed to improve awareness of NPC among less canonically affected groups.Level of evidence: Level 4 Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.31907","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Although nasopharynx cancer (NPC) is rare in the United States, global epidemiology varies greatly. Therefore, understanding NPC disparities in the diverse US setting is critical.

Methods and materials: Data from the National Cancer Database (NCDB, 2004-2021) identified patients with NPC; NCDB allows disaggregation by Asian American (AA) subgroups. Multivariable ordinal logistic regression adjusting for demographic and socioeconomic factors defined adjusted odds ratios (aORs).

Results: Of 15,862 patients, 11,173 (70.4%) were male (median age 59). Commonest groups included 10,034 (63.3%) White, 2,272 (14.3%) Black, 1,103 (7.0%) Chinese, 442 (2.8%) Filipino, and 338 (2.1%) Vietnamese patients. Prior to disaggregation, the proportion of stage IV disease at presentation was 43.2% among White (ref), 50.0% among Black (aOR 1.12, p = 0.012), 52.0% among Native American (aOR 1.18, p > 0.05), 41.9% among AA (aOR 0.97, p > 0.05), and 55.1% among Native Hawaiian and Other Pacific Islander patients (aOR 1.47, p = 0.021). Upon disaggregation, the proportion of stage IV disease was the greatest (>50%) among Black (50.0%, aOR 1.12, p = 0.012), Laotian (61.5%, aOR 2.21, p = 0.001), Hmong (73.2%, aOR 2.92, p < 0.001), and Other Pacific Islander patients (60.9%, aOR 1.83, p = 0.004); 44.2% of Filipino patients also presented with stage IV disease (aOR 1.21, p = 0.033). Odds of presenting with advanced stage disease were lower among Chinese patients (35.7% stage IV, aOR 0.72, p < 0.001).

Conclusions: Although most NPC patients were Chinese, White, or Black, stage IV disease at presentation was most common among Hmong, Laotian, non-Hawaiian Pacific Islander, and Black patients. Efforts are needed to improve awareness of NPC among less canonically affected groups.

Level of evidence: Level 4 Laryngoscope, 2024.

查看原文本刊更多论文

美国的鼻咽癌：美国鼻咽癌：发病阶段的种族和民族差异》（Nasopharynx Cancer in the United States: Racial and Ethnic Disparities in Stage at Presentation）。

简介：虽然鼻咽癌（NPC）在美国很少见，但全球的流行病学差异很大。因此，了解鼻咽癌在美国不同环境中的差异至关重要：美国国家癌症数据库（NCDB，2004-2021 年）的数据确定了鼻咽癌患者；NCDB 允许按亚裔美国人（AA）亚群进行分类。调整人口统计学和社会经济因素的多变量序数逻辑回归确定了调整后的几率比（aORs）：在 15,862 名患者中，11,173 人（70.4%）为男性（中位年龄为 59 岁）。最常见的群体包括 10,034 名白人（63.3%）、2,272 名黑人（14.3%）、1,103 名中国人（7.0%）、442 名菲律宾人（2.8%）和 338 名越南人（2.1%）。在进行分类之前，发病时处于 IV 期的患者比例分别为：白人 43.2%（参考）、黑人 50.0%（aOR 1.12，p = 0.012）、美国原住民 52.0%（aOR 1.18，p > 0.05）、AA 41.9%（aOR 0.97，p > 0.05）和夏威夷原住民及其他太平洋岛民 55.1%（aOR 1.47，p = 0.021）。细分后，IV 期患者比例最高（>50%）的人群是黑人（50.0%，aOR 1.12，p = 0.012）、老挝人（61.5%，aOR 2.21，p = 0.001）和苗族人（73.2%，aOR 2.92，p 结论：虽然大多数鼻咽癌患者是中国人，但他们的发病率却高于其他人群：虽然大多数鼻咽癌患者是中国人、白人或黑人，但苗族、老挝人、非夏威夷太平洋岛民和黑人患者在发病时最常见的是 IV 期疾病。需要努力提高受影响较小的群体对鼻咽癌的认识：4级《喉镜》，2024年。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects