Social Determinants of Health and Oral Cavity Cancer Treatment and Survival: A Competing Risk Analysis.

摘要: OBJECTIVE Competing risk analysis is a powerful assessment for cancer factors and covariates. This method can better elucidate insurance status other social determinants of health covariates in oral cavity treatment, survival, disparities. STUDY DESIGN Retrospective cohort study using the Surveillance, Epidemiology, End Results (SEER) database. METHODS Data regarding patient characteristics, clinical stage at diagnosis, survival data 20,271 patients diagnosed with was extracted from SEER 18 Regs Research including Hurricane Katrina Impacted Louisiana Cases 1973 to 2014. All statistical analyses were performed SAS 9.5 (SAS Institute Inc., Cary, NC). The Fine-Gray assessing impact, risk, employed. RESULTS Medicaid presented later disease, larger tumor size, more distant metastases, lymph node involvement diagnosis compared insured patients. less likely receive cancer-directed surgery. also associated worse cancer-specific (subhazard ratios 1.87, 95% confidence interval 1.72-2.04, P < .0001) after adjustment all CONCLUSION first examining specifically how impact treatment outcomes methods validated complex Patients present extensive disease burden are definitive therapy have significantly overall than those forms insurance. identifies disparities need improving literacy, at-risk population, guide clinicians. LEVEL OF EVIDENCE NA Laryngoscope, 130:2160-2165, 2020.