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NB-IRDT

Influence of socioeconomic status on stage at presentation of laryngeal cancer in the United States

Author: Nicole L. Lebo, Diana Khalil, Adele Balram, Margaret Holland, Martin Corsten, James Ted McDonald, Stephanie Johnson-Obaseki
Year: 2019
Category: Health Publications

Read the journal article from Otolaryngology–Head and Neck Surgery

Objective

Identify socioeconomic predictors of stage at diagnosis of laryngeal cancer in the United States.

Study design

Retrospective analysis of the North American Association of Central Cancer Registries’ Incidence Data–Cancers in North America Deluxe Analytic File for expanded races.

Setting

All centers reporting to the US Centers for Disease Control and Prevention’s National Program of Cancer Registries.

Results

A total of 72,472 patients were identified and included. Analysis revealed significant correlation between advanced stage at diagnosis and: Medicaid insurance, lack of insurance, female sex, older age, black race, and certain states of residence. The strongest predictor of advanced stage was lack of insurance (OR, 2.212; P < .001; 95% CI, 2.035-2.406). The strongest protective factor was residing in the state of Utah (OR, 0.571; P < .001; 95% CI, 0.536-0.609). Once adjusted for regional price and wage disparities, relative income was not a significant predictor of stage at presentation across multiple analyses.

Conclusion

Multiple socioeconomic factors were predictive of severity of disease at presentation of laryngeal cancer in the United States. This study demonstrated that insurance type was strongly predictive, whereas relative income had surprisingly little influence.