Socioeconomic Disparities in Head Neck Cancer Incidence and Mortality: Regional Wealth-Dependent Analysis in Seniors Cohorts.

Abstract

Background: Head and neck cancer (HNC) shows a "diverging scissors" pattern, with incidence and mortality linked to regional economic status.

Objective: We aim to investigate whether socioeconomic disparities between regions correlate with widening gaps in HNC incidence and mortality rates, with particular emphasis on age-related patterns among elderly populations.

Design: Cross-sectional study.

Setting: Data from the National Cancer Registry for females from 2003 to 2019.

Patients: 76 649 patients, 49 858 males, 26 791 females from 2003 to 2019 in age cohorts: 60-69, 70-79, and 80+, covering all voivodeships in Poland.

Measurements: Five Groups were established based on the Wealth Indicator (WI) value, from 54,72 to 243,66 EUR in G1-G5, respectively. Trend lines for incidence and mortality rates were calculated, and slope tests were used to determine statistical significance: positive incidence rate (IR)(+), mortality rate (MR)(+), neutral (IR(0), MR(0)), or negative (IR(-), MR(-)). Comparative analyses included slope differences between incidence and mortality trends (IR>MR, IR=MR, IR

Results: HNC incidence and mortality rates have risen consistently over two decades, regardless of regional economic status. More affluent regions show a better incidence-to-mortality ratio, but no improvement is seen in the 80+ age group. Female patients achieve consistently better outcomes than males across all regions and age groups.

Limitations: Despite the optimal selection of the WI (Wealth Indicator) indicator, it does not fully reflect the income stratification issue, particularly in the G5, the wealthiest group. The analysis does not capture the problem of increased incidence rates in the most industrialized region.

Conclusion: The findings highlight the need for enhanced screening protocols for males to address gender disparities in HNC outcomes and tailored therapeutic strategies for the 80+ age group.