Assessing social vulnerabilities of salivary gland cancer care, prognosis, and treatment in the United States

Govind S Bindra; David J Fei-Zhang; Atharva Desai; John Maddalozzo; Stephanie S Smith; Urjeet A Patel; Daniel C Chelius; Jill N D'Souza; Jeffrey C Rastatter; M Boyd Gillespie; Anthony M Sheyn

doi:10.1002/hed.27783

Assessing social vulnerabilities of salivary gland cancer care, prognosis, and treatment in the United States

Head Neck. 2024 Apr 23. doi: 10.1002/hed.27783. Online ahead of print.

Authors

Govind S Bindra¹, David J Fei-Zhang², Atharva Desai³, John Maddalozzo⁴, Stephanie S Smith⁵, Urjeet A Patel⁵, Daniel C Chelius⁶, Jill N D'Souza⁷, Jeffrey C Rastatter^{4

5}, M Boyd Gillespie⁸, Anthony M Sheyn^{8

9

10}

Affiliations

¹ University of Tennessee Health Science Center, Memphis, Tennessee, USA.
² Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
³ University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
⁴ Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
⁵ Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
⁶ Department of Otolaryngology-Head and Neck Surgery, Pediatric Thyroid Tumor Program and Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
⁷ Division of Pediatric Otolaryngology, Children's Hospital of New Orleans and Louisiana State University, New Orleans, Louisiana, USA.
⁸ Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
⁹ Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee, USA.
¹⁰ Department of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.

PMID: 38651501
DOI: 10.1002/hed.27783

Abstract

Background: Salivary gland cancers (SGC)-social determinants of health (SDoH) investigations are limited by narrow scopes of SGC-types and SDoH. This Social Vulnerability Index (SVI)-study hypothesized that socioeconomic status (SES) most contributed to SDoH-associated SGC-disparities.

Methods: Retrospective cohort of 24 775 SGCs assessed SES, minority-language status (ML), household composition (HH), housing-transportation (HT), and composite-SDoH measured by the SVI via regressions with surveillance and survival length, late-staging presentation, and treatment (surgery, radio-, chemotherapy) receipt.

Results: Increasing social vulnerability showed decreases in surveillance/survival; increased odds of advanced-presenting-stage (OR: 1.12, 95% CI: 1.07, 1.17), chemotherapy receipt (OR: 1.13, 95% CI: 1.03, 1.23); decreased odds of primary surgery (0.89, 0.84, 0.94), radiotherapy (0.91, 0.85, 0.97, p = 0.003) for SGCs. Trends were differentially correlated with SES, ML, HH, and HT-vulnerabilities.

Conclusions: Through quantifying SDoH-derived SGC-disparities, the SVI can guide targeted initiatives against SDoH that elicit the most detrimental associations for specific sociodemographics.

Keywords: epidemiology; head and neck cancer; salivary gland cancer; social determinants of health; social vulnerability.