Place-Based Disparities in Treatment and Time-to-Initiation for Head and Neck Cancer
Description
Background: In the US, 72,000+ adults are diagnosed with Head and Neck Cancer (HNC) annually. Despite improving outcomes overall, place-based disparities persist at the extremes of the care continuum. While existing evidence emphasizes disparities at diagnosis, less is known about how care patterns differ afterward. To inform system-level strategies in low-income communities, we evaluated disparities in treatment type and time-to-treatment initiation for HNC patients.
Methods: We analyzed Surveillance, Epidemiological, and End Results (SEER) data (2018–2022). Outcomes included treatment type (surgery only, surgery with adjuvant radiotherapy, definitive chemoradiation, radiation/chemotherapy alone, or no treatment) and time from diagnosis to treatment initiation (0–29, 30–59, 60–89, 90+ days). Linear probability and multinomial regression models adjusted for tumor site, stage, demographics, and geography estimated associations between low-income county residence (< $80k median household income) and differences in the probability of each outcome.
Results: Our sample included 70,468 HNC cases. We found no differences in adjuvant or definitive treatment. Compared to high-income counties, low-income patients were 1.1%-points less likely to receive surgery only (−2.2 to −0.1) and 1.0%-points more likely to receive radiation/chemotherapy alone (0.1 to 1.8); and 2.1%-points less likely to begin treatment within 0–29 days (−3.7 to −0.4) and 1.4%-points more likely to delay until 60–89 days (0.5 to 2.3). Differences remained consistent across most subgroups.
Conclusion: Our findings warrant system-level interventions to promote access to high-quality, timely HNC treatment in low-income communities. The extent to which treatment disparities influence survival remains unknown.
Citation Information
Erickson, Anders and Semprini, Jason, "Place-Based Disparities in Treatment and Time-to-Initiation for Head and Neck Cancer" (2026). Office of Research DMU Research Symposium. 14.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/14
Place-Based Disparities in Treatment and Time-to-Initiation for Head and Neck Cancer
Background: In the US, 72,000+ adults are diagnosed with Head and Neck Cancer (HNC) annually. Despite improving outcomes overall, place-based disparities persist at the extremes of the care continuum. While existing evidence emphasizes disparities at diagnosis, less is known about how care patterns differ afterward. To inform system-level strategies in low-income communities, we evaluated disparities in treatment type and time-to-treatment initiation for HNC patients.
Methods: We analyzed Surveillance, Epidemiological, and End Results (SEER) data (2018–2022). Outcomes included treatment type (surgery only, surgery with adjuvant radiotherapy, definitive chemoradiation, radiation/chemotherapy alone, or no treatment) and time from diagnosis to treatment initiation (0–29, 30–59, 60–89, 90+ days). Linear probability and multinomial regression models adjusted for tumor site, stage, demographics, and geography estimated associations between low-income county residence (< $80k median household income) and differences in the probability of each outcome.
Results: Our sample included 70,468 HNC cases. We found no differences in adjuvant or definitive treatment. Compared to high-income counties, low-income patients were 1.1%-points less likely to receive surgery only (−2.2 to −0.1) and 1.0%-points more likely to receive radiation/chemotherapy alone (0.1 to 1.8); and 2.1%-points less likely to begin treatment within 0–29 days (−3.7 to −0.4) and 1.4%-points more likely to delay until 60–89 days (0.5 to 2.3). Differences remained consistent across most subgroups.
Conclusion: Our findings warrant system-level interventions to promote access to high-quality, timely HNC treatment in low-income communities. The extent to which treatment disparities influence survival remains unknown.
