Disparities in risk of and survival from oropharyngeal squamous cell carcinoma

Background Oropharyngeal cancer has a low 5-year survival rate in the United States, indicating that much remains to be learned about risk and survival factors. The purpose of this research was to identify factors that contribute to risk of and survival from this disease in a region associated with high tobacco use. Methods. A retrospective chart review of 221 subjects with diagnosis of head and neck cancer at a regional University Medical Center during a 10-year period (1986 to 1995) was performed to identify relationships between risk and survival factors of oropharyngeal squamous cell carcinoma (OSCC). Data from 92 records met the inclusion criteria and were analyzed with the x(2) test of association, the Fisher exact test, and the log-rank test for comparison of survival distributions. The software used was SAS for Windows, release 8.2. Results. Most study subjects were white men between the ages of 50 and 75 years who chronically used tobacco and alcohol. The overall median survival period of the group was 18.1 months. The percentage of subjects surviving to 3 years was 35.6%. Disparities were identified in risk and survival by sex, race, age, dwelling, anatomic site, and exposure to carcinogenic substances. In particular, the disease more adversely affected minorities and those who chronically used tobacco or alcohol. Conclusion. Our results show that, in the examined regional population, a high prevalence of tobacco use correlated with alcohol use and a lower rate of survival from OSCC than the national rate. Also, risk of and survival from OSCC are affected by demographic, geographic, and behavioral factors. This information is useful for the design and implementation of more effective preventive and intervention strategies.