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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 4 - Head and Neck Surgery

Relationship Between Socioeconomic Status and Severity of Pretreatment Swallowing Dysfunction for Oropharyngeal Cancer Patients

Sunday, September 29, 2024
1:36 PM – 1:42 PM EDT
Location: MBCC, 208
Disclosure(s):
Prerita V. Pandya:

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

Shravan Asthana, BS:

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

Hannah Soltani, BA:

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

Alex E. Clain, PhD:

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

Urjeet a. Patel, MD:

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

Introduction: Physiological swallowing dysfunction is an important symptom of head and neck cancer (HNC); patients of lower socioeconomic status (SES) may have fewer resources to cope with swallowing dysfunction. We hypothesized that SES is associated with greater pretreatment dysphagia.

Methods: Oropharyngeal cancer patients with pretreatment modified barium swallow impairment profiles (MBSImP) from 2015 to 2020 were included. MBSImP Oral Total (OT) and Pharyngeal Total (PT) were calculated with higher scores signifying greater swallowing impairment. SES was measured as Social Vulnerability Index (SVI) and applied to the patient’s residence at time of diagnosis with higher SVI representing more disadvantage. An ordinary least squares linear regression model was utilized with SVI and clinicodemographic factors as variables for a multivariate analysis.

Results: A total of 149 patients were analyzed (mean age 68.1 ± 9.5). Of them, 84% were male, 90% were White, and 92% were p16 positive. Removing patients with missing MBSImP scores, the OT model evaluated 138 patients and the PT model analyzed 145 patients. Controlling for other clinicodemographic variables such as tumor stage and p16 status, lower, as SES measured by SVI, was associated with worse swallowing function as measured by OT score (regression coefficient (β) = 2.08, standard error (SE) = 0.86, p = 0.02), as was age (β = 0.04, SE = 0.02, p = 0.02). SVI was not significantly associated with PT scores when controlling for other factors, but tumor stage (β = 2.62, SE = 0.86, p < 0.001), age (β = 0.12, SE = 0.03, p < 0.001), and male sex (β = 2.16, SE = 0.88, p = 0.02) were positively associated with PT scores.

Conclusions: The association between OT and SVI suggests that pre-treatment swallowing impairment may be sensitive to social factors, particularly in the oral domain. Patients of lower SES may have less resources to cope with swallowing dysfunction, such as decreased access to nutritional supplements and Speech-Language Pathology support. Future efforts to mitigate cancer care disparities should explore SES correlation with symptom burden.

    Presenting Author(s)

  • Prerita V. Pandya

    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)

  • SA

    Shravan Asthana, BS

    Medical Student
    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.

  • HS

    Hannah Soltani, BA

    Medical Student
    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.

  • AC

    Alex E. Clain, PhD

    Postdoctoral Scholar
    Roxelyn and Richard Pepper Department of Communications
    Riverside, CT, United States

    Disclosure(s):

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

    • Senior Author(s)

  • LG

    Laila Gharzai, MD

    Feinberg School of Medicine, United States

    Disclosure information not submitted.

  • Urjeet A. Patel, MD

    Professor
    Feinberg School of Medicine
    chicago, Illinois, United States

    Disclosure(s):

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

  • SS

    Sandeep Samant, MD

    Professor
    Northwestern University Department of Otolaryngology - Head and Neck Surgery
    Chicago, Illinois, United States

    Disclosure information not submitted.

  • Andrew P. Stein, MD

    Assistant Professor
    Feinberg School of Medicine
    Chicago, IL, United States

    Disclosure information not submitted.

  • Bonnie Martin-Harris, PhD

    Alice Gabrielle Twight Professor and Associate Dean for Faculty Affairs
    Roxelyn and Richard Pepper Department of Communications
    Evanston, IL, United States

    Disclosure information not submitted.

  • Katelyn O. Stepan, MD

    Assistant Professor
    Northwestern Memorial Hospital
    Chicago, IL, United States

    Disclosure information not submitted.