Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentations 1 - Care Equity, Quality, and Safety

The Impact of Digital Inequities on Oropharyngeal Cancer Disparities in the US

Sunday, September 29, 2024
1:36 PM – 1:42 PM EDT
Location: MBCC, 224
Disclosure(s):
Achilles A. Kanaris:

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: In the modern era, the use of technology can substantially impact care access but has been seldom investigated in oropharyngeal cancer (OPC) patients, despite the extent of large-data approaches to assess the impact of traditional social determinants of health (SDoH). Thus, this study sought to implement the Digital Inequity Index (DII), a comprehensive tool that quantifiably measures modern-technology access in the US, to assess digital inequity impact on OPC disparities nationwide.

Methods: This retrospective cohort study on 70,604 patients from 2008-2017 in SEER assessed for regression trends in long-term follow-up period, survival, prognosis, and treatment with increasing overall digital inequity, as measured by the DII. DII was calculated based on 17 census-tract level variables derived from the American Community Survey and Federal Communications Commission. Variables were categorized as infrastructure-access (i.e., electronic device ownership, type of broadband, internet provider availability, income-broadband subscription ratio) or sociodemographic (i.e., education, income, disability status), ranked, and then averaged into a composite score.

Results: With increasing digital inequity, decreases in the length of long-term follow-up (10.22%, 32.9 to 29.5 months; p < 0.001) and survival period (8.93%, 19 to 17.3 months; p < 0.001) were observed. Affordability of internet access was the largest contributor, followed by device access and internet service availability. Compared to OPC patients with low digital-inequity, high digital-inequity was associated with increased odds of diagnosing more than one malignant tumor (OR 1.01, 95% CI 1.01-1.03; p = 0.012) and decreased odds of receiving indicated chemotherapy (OR 0.98, 95% CI 0.97-0.99; p < 0.001) and radiation therapy (OR 0.98, 95% CI 0.97-0.99; p < 0.001).

Conclusions: Digital inequities contribute to detrimental trends in OPC patient care in the US, informing discourse for targeted means of alleviating disparities while contextualizing national sociodemographic trends of the impact of online access on informed care.

    Presenting Author(s)

  • Achilles A. Kanaris

    Medical Student
    Northwestern University - Feinberg School of Medicine
    San Jose, CA, United States

    Disclosure(s):

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

    • Co-Author(s)

  • Achilles A. Kanaris

    Medical Student
    Northwestern University - Feinberg School of Medicine
    San Jose, CA, 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.