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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentations 2 - Care Equity, Quality, and Safety

Individual and Community-Level Social Determinant Predictors of Age-Based Treatment Disparities With HPV-Positive Oropharyngeal Cancer Patients

Monday, September 30, 2024
8:06 AM – 8:12 AM EDT
Location: MBCC, 235-237
Disclosure(s):
Cyrus W. Abrahamson, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David Jun Fei-Zhang:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Daniel C. Chelius, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Anthony M. Sheyn, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jeffrey C. Rastatter, MD, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: As HPV+ oropharyngeal squamous cell carcinomas (OPSCC) comprise 70% of OPSCC, studies have shown social determinants of health (SDoH) significantly impacting HPV+ OPSCC mortality while observing its patient population skewing towards younger demographics with rising trends of HPV-attenuated effects into older age. This study expands on this by assessing age-based treatment differences through comprehensive interactive analyses of individual and census-level clinicodemographic factors.

Methods: Retrospective cohort study of Specialized Head-Neck SEER 2011-2018 dataset was queried for 14,076 patients. Age-adjusted multivariate regressions with individual (sex, race-ethnicity) and census-level factors (Yost-Index-Socioeconomic Status (SES) [composite of 7-SES measures across income, education, housing, employment]; rurality-urbanicity) were used to assess treatment receipt (surgical, radiation, chemotherapy) and delay in treatment (3 months+) and stratified into early ( <50y) and old age (50+).

Results: For surgery, early ages displayed Black race as a markedly negative predictor/decreased receipt (OR 0.44,95% CI 0.28-0.66, p < 0.001); older ages featured negative predictors of male sex (0.76,0.68-0.85,p < 0.001) & poor census-level SES (0.85, 0.78-0.91, p < 0.001) but lesser effects with Black race (0.83, 0.69-0.99, p = 0.039). For radiation, older age showed increased receipt with male sex (1.25, 1.07-1.45, p = 0.005) and rurality (1.28, 1.01-1.63, p = 0.042) but decreased with Black race (0.78, 0.63-0.99, p = 0.04) and poor census-level SES (0.80, 0.72-0.90, p < 0.001). For chemotherapy, both groups showed markedly increased receipt with male sex (early 1.48, 1.09-2.01, p = 0.014; older 1.38,1.23-1.54, p < 0.001). For delays in treatment, early ages showed increased delays with Hispanic ethnicity (2.27, 1.09-4.38, p = 0.03); older showed with Black race (1.95, 1.47-2.56, p < 0.001) and lower Yost-Index-SES (1.27,1.17-1.62, p < 0.001)

Conclusions: Individual and census-level SDoH interactively affect care disparities across a national cohort of early/older-aged HPV+ OPSCC patients.

    Presenting Author(s)

  • Cyrus W. Abrahamson, BA

    Medical Student
    Northwestern University - Feinberg School of Medicine
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Cyrus W. Abrahamson, BA

    Medical Student
    Northwestern University - Feinberg School of Medicine
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • David J. Fei-Zhang, BA

    MD-MBA Student
    Northwestern University - Feinberg School of Medicine
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Daniel C. Chelius, MD

    Associate Professor
    Baylor College of Medicine / Texas Children's Hospital
    Houston, TX, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • JD

    Jill N. D'Souza, MD

    Associate Professor of Pediatric Otolaryngology - Head and Neck Surgery
    LSU Health Sciences Center Dept of Otolaryngology
    NEW ORLEANS, LA, United States

    Disclosure information not submitted.

  • Anthony M. Sheyn, MD

    Division Chief, Pediatric Otolaryngology
    LeBonheur Children's Hospital
    Memphis, Tennessee, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Jeffrey C. Rastatter, MD, MS

    Associate Professor
    Lurie Children's Hospital / Northwestern University
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Jeffrey C. Rastatter, MD, MS

    Associate Professor
    Lurie Children's Hospital / Northwestern University
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.