Race Does Not Significantly Impact Quality of Life in Alabama Head, Neck Cancer Patients

Website: http://www.sic2004.org/

Newswise — Using local database information, University of Alabama at Birmingham researchers have determined that race does not affect quality of life for Alabama head and neck cancer patients. Interestingly, female head and neck cancer patients and those who are married report a lower quality of life.

Previous studies regarding socioeconomic factors and race of head and neck cancer patients have found that: the incidence of head and neck cancer correlates with socioeconomic status, lower education level correlates with poor outcomes in head and neck cancer, and death from oral cancer is 1.7 times greater among African Americans (33 percent vs 55 percent 5-year survival). However, the impact of race and social factors on quality of life in head and neck cancer patients remains poorly defined.

Researchers set out to determine if socioeconomic factors and race negatively impact Alabama head and neck cancer patients. The results of their work are detailed in "The Impact of Social Factors and Race on Quality of Life in Head and Neck Cancer" and will be presented by Eben Rosenthal, MD, Benjamin McGrew, MD, Toni Leeth, MPH, Scott Magnuson, MD, Glenn Peters, MD, William Carroll, MD, all of the University of Alabama Birmingham, at the 6th International Conference on Head and Neck Cancer (http://www.sic2004.org) being held August 7-11, 2004, at the Wardman Park Marriott in Washington, DC.

Methodology: A total of 161 patients who presented at the University of Alabama Birmingham (UAB) otolaryngology clinic with mucosal head and neck cancer were included in this study. Using the UAB QOL Database, the impact of race, employment, marital status, and insurance on QOL was assessed. The previously validated Head and Neck Cancer Inventory (HNCI), given to all patients at zero, three, six, nine, and 12 month intervals, was used in a cross-sectional analysis of patients presenting at the clinic. A multiple linear regression model was done for factors associated with individual functional and attitudinal domains using pretreatment scores. (HNCI tests seven domains: functional speech, attitudinal speech, functional eating, attitudinal eating, attitudinal aesthetics, functional social, attitudinal social.) Scores were assessed for each domain. Only patients with at least a nine month follow-up were included; 36 patients had a follow-up of greater than nine months.

Demographic information taken from the UAB database included: gender, race, age, insurance status, employment status, employment changes, marital status, tumor stage, previous treatments, and free flap reconstruction.

Results: African Americans (n=34) did not have a statistically significant difference in QOL when compared to Caucasians (n=131) in all domains measured. Attitudinal and functional speech domains were found to be lower in females and married patients. Older patients presenting with new lesions report a higher QOL in their attitude toward social disruption; age has no further correlation to QOL. Higher tumor stage was found to negatively impact the functional and attitudinal eating domain but not speech or social disruption (T1 vs T2 (HR -16, p<.05) T2 vs T4 (HR -32, p<.05)). No correlation was found with respect to reconstruction type or previous treatment (XRT/Chemotherapy).

The general trend of HNCI scores show that the worst scores are at three months and stabilize at nine to 12 months. This trend is consistent with other QOL data on head and neck cancer patients. Findings were considered statistically significant in five of the seven HNCI domains.

Alcohol and tobacco use were found to negatively correlate to QOL in all patients, while the insured had a slightly higher QOL.

Conclusions: These results suggest that gender, marital status, and tumor stage negatively affect QOL at presentation, but race does not significantly impact QOL.