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Cutaneous Head and Neck Squamous Cell Carcinoma: Impact of Socioeconomic Factors on Outcomes

By: Joshua D. Madera, MD
Posted: Thursday, February 1, 2024

The extent of disease burden and disease recurrence may be influenced by patients’ socioeconomic factors that limit their access to health care, according to a study published in the journal Otolaryngology–Head and Neck Surgery. Worsening disease-related outcomes and treatment-associated morbidity may occur as a result of delayed diagnostic and treatment-related intervention, suggested Theresa W. Guo, MD, of the University of California, San Diego Health, La Jolla, and colleagues. Thus, efforts to assure equitable access to health care and health resources for all patients should be prioritized to mitigate patients’ extent of disease burden.

From 2008 to 2022, 346 patients with cutaneous head and neck squamous cell carcinoma were recruited for the study. Demographic and socioeconomic data, as well as disease characteristics, were collected from patients’ medical records for further analysis. The American Joint Committee on Cancer 8th edition criteria were employed to stage all tumors at the initial diagnostic workup. Patients’ clinical outcomes were monitored regularly at follow-up visits.

The study authors revealed that patients who were underinsured (21.7%) were more likely to have advanced disease compared with patients with medical insurance (9.6%). Similarly, advanced disease was more commonly identified in patients who had a history of homelessness (8.5%) compared with those who were never homeless (2.1%). Moreover, rates of immunosuppression tended to be higher in underinsured patients. Furthermore, worsening rates of recurrence-free survival were independently associated with immune status (hazard ratio [HR] = 2.35) and insurance status (HR = 1.97).

Disclosure: The study authors reported no conflicts of interest.

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