Treatment Outcomes Differ for Racial and Ethnic Minorities with Advanced-Stage Laryngeal Cancer: A Florida Cancer Data System Analysis.

Abstract

A disparity persists in advanced-stage laryngeal cancer outcomes, in which Black patients experience lower survival rates. We examined real-world treatment patterns and outcomes by race and ethnicity in patients with advanced-stage laryngeal cancer in Florida. Data were abstracted from the Florida Cancer Data System on non-Hispanic (NH)-White, Hispanic, and NH-Black patients with advanced-stage laryngeal cancer from 2009 to 2020. Kaplan-Meier curves estimated survival by race and ethnicity. Multivariable Cox proportional hazard models calculated HRs and 95% confidence intervals (95% CI) to examine the association of race and ethnicity with treatment receipt and mortality. Cox proportional hazard models were adjusted for sociodemographic and tumor characteristics. A total of 4,316 participants with advanced-stage laryngeal cancer (75.3% NH-White, 13.1% Hispanic, and 11.6% NH-Black) were included in the analysis. In age- and sex-adjusted models, NH-Black patients had a higher risk of death (HR = 1.21; 95% CI, 1.08-1.35) compared with NH-White patients, whereas Hispanic patients had a lower risk (HR = 0.80; 95% CI, 0.71-0.90). After controlling for sociodemographic factors, mortality differences between NH-Black and NH-White patients were not statistically significant (HR = 1.12; 95% CI, 1.00-1.26). However, in treatment-stratified analyses, specifically in patients who received chemoradiation, NH-Black patients had a higher risk of death (HR = 1.25; 95% CI, 1.02-1.52) compared with NH-White patients. In conclusion, NH-Black patients with advanced-stage laryngeal cancer who underwent chemoradiation had higher mortality compared with NH-White patients, whereas Hispanic patients had lower mortality. Investigating factors such as healthcare access, comorbidities, and treatment response may help address these disparities.

Significance: This study provides important insight into racial and ethnic disparities in treatment outcomes and mortality risk among patients with advanced-stage laryngeal cancer in a real-world setting. Our findings underscore the need for a comprehensive approach to understanding outcome differences, considering the interplay of healthcare access, clinical factors, and treatment quality that influence patient care and survival.