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Scientific Oral Presentations

Care Equity, Quality, and Safety

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

Hispanic Health Paradox in Head and Neck Cancer Survival Outcomes: A Systematic Review and Meta-analysis

Sunday, September 29, 2024
1:30 PM – 1:36 PM EDT
Location: MBCC, 224
Disclosure(s):
Alejandro R. Marrero-Gonzalez, BS:

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

Douglas P. Nanu, BS:

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

Alexandra E. Kejner, MD:

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

W. Greer G. Albergotti, MD:

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

Jason G. Newman, MD: No relevant relationships to disclose.
Evan Michael Graboyes, MD, MPH:

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

Introduction: Despite having a higher risk factor profile, Hispanic White (HW) people in the United States often experience better health outcomes than non-Hispanic White people (NHW), a phenomenon known as the Hispanic Health Paradox (HHP). Although profound racial disparities in survival between Black and White patients with HNC have been well documented, the HHP, and whether HW patients with HNC have improved or worse survival, has not been explored. The objective of this study is to evaluate the association of HW ethnicity with survival among patients with HNC.

Methods: COCHRANE Library, CINAHL, PubMed, and Scopus were searched for English-language articles from January 1, 2000, to December 27, 2023, that compared survival of HW patients with HNC to NHW patients with HNC of the oral cavity, pharynx, and larynx. The primary outcome was overall survival (OS); cancer-specific survival (CSS) was a secondary outcome. Meta-analysis (MA) of continuous measures (mean), proportions (%), and hazard ratios (HRs) with 95% confidence intervals (CIs) was conducted to determine OS and CSS among HW patients with HNC relative to NHW patients with HNC.

Results: Of the 3,292 unique abstracts identified, 36 studies were included in the MA, of which 29 evaluated OS, 8 evaluated CSS, and 6 evaluated both. HW patients represented 7.72% of the sample ([95%CI: 6.45%-9.09%]). HW patients with HNC had improved OS relative to NHW patients with HNC (HR = 0.93, 95% CI 0.89-0.98). However, CSS was the same among HW patients with HNC relative to NHW patients with HNC (HR = 0.91, 95% CI 0.82-1.02). Findings were consistent with improved OS of HW patients relative to NHW patients in subgroup analysis of patients with human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC) (HR = 0.82, 95% CI 0.72-0.94), but no difference was seen in HPV-positive OPSCC (HR = 1.00, 95% CI 0.88-1.14).

Conclusions: HW patients with HNC have improved OS relative to NHW patients with HNC. These findings support the HHP in the context of HNC cancer. Research is needed to understand the characteristics and mechanisms that lead to this survival advantage.

    Presenting Author(s)

  • Alejandro R. Marrero-Gonzalez, BS

    Medical Student
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Johns Island, SC, United States

    Disclosure(s):

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

    • Co-Author(s)

  • Douglas P. Nanu, BS

    Medical Student
    Washington State University Elson S. Floyd College of Medicine
    Renton, WA, United States

    Disclosure(s):

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

  • SN

    Shaun A. Nguyen, MD

    Clinical Research Director
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Charleston, South Carolina, United States

    Disclosure information not submitted.

  • Alexandra E. Kejner, MD

    Associate Professor of Head and Neck Surgical Oncology/Microvascular Reconstruction
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Charleston, SC, United States

    Disclosure(s):

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

  • WA

    W. Greer Albergotti, MD

    Associate Professor
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Charleston, South Carolina, United States

    Disclosure(s):

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

  • JN

    Jason G. Newman, MD

    Professor
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Mount Pleasant, SC, United States

    Disclosure(s): No relevant relationships to disclose.

    • Senior Author(s)

  • Evan Michael Graboyes, MD, MPH

    Associate Professor
    Medical University of South Carolina
    Charleston, South Carolina, United States

    Disclosure(s):

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