Nasopharynx cancer in the United States: Racial and ethnic disparities in stage at presentation Journal Article
| Authors: | Dee, E. C.; Wang, S.; Ho, F. D. V.; Patel, R. R.; Lapen, K.; Wu, Y.; Yang, F.; Patel, T. A.; Feliciano, E. J. G.; McBride, S. M.; Lee, N. Y. |
| Article Title: | Nasopharynx cancer in the United States: Racial and ethnic disparities in stage at presentation |
| Abstract: | Introduction: Although nasopharynx cancer (NPC) is rare in the United States, global epidemiology varies greatly. Therefore, understanding NPC disparities in the diverse US setting is critical. Methods and Materials: Data from the National Cancer Database (NCDB, 2004-2021) identified patients with NPC; NCDB allows disaggregation by Asian American (AA) subgroups. Multivariable ordinal logistic regression adjusting for demographic and socioeconomic factors defined adjusted odds ratios (aORs). Results: Of 15,862 patients, 11,173 (70.4%) were male (median age 59). Commonest groups included 10,034 (63.3%) White, 2,272 (14.3%) Black, 1,103 (7.0%) Chinese, 442 (2.8%) Filipino, and 338 (2.1%) Vietnamese patients. Prior to disaggregation, the proportion of stage IV disease at presentation was 43.2% among White (ref), 50.0% among Black (aOR 1.12, p = 0.012), 52.0% among Native American (aOR 1.18, p > 0.05), 41.9% among AA (aOR 0.97, p > 0.05), and 55.1% among Native Hawaiian and Other Pacific Islander patients (aOR 1.47, p = 0.021). Upon disaggregation, the proportion of stage IV disease was the greatest (>50%) among Black (50.0%, aOR 1.12, p = 0.012), Laotian (61.5%, aOR 2.21, p = 0.001), Hmong (73.2%, aOR 2.92, p < 0.001), and Other Pacific Islander patients (60.9%, aOR 1.83, p = 0.004); 44.2% of Filipino patients also presented with stage IV disease (aOR 1.21, p = 0.033). Odds of presenting with advanced stage disease were lower among Chinese patients (35.7% stage IV, aOR 0.72, p < 0.001). Conclusions: Although most NPC patients were Chinese, White, or Black, stage IV disease at presentation was most common among Hmong, Laotian, non-Hawaiian Pacific Islander, and Black patients. Efforts are needed to improve awareness of NPC among less canonically affected groups. Level of Evidence: 4 Laryngoscope, 135:1113–1119, 2025. © 2024 The American Laryngological, Rhinological and Otological Society, Inc. |
| Keywords: | health services; head and neck cancer; nasopharynx cancer; racial disparities; nasopharyngeal cancer; cancer disparities |
| Journal Title: | Laryngoscope |
| Volume: | 135 |
| Issue: | 3 |
| ISSN: | 0023-852X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2025-03-01 |
| Start Page: | 1113 |
| End Page: | 1119 |
| Language: | English |
| DOI: | 10.1002/lary.31907 |
| PUBMED: | 39548864 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Nancy Y. Lee -- Source: Scopus |
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