Association of metropolitan residential status on survival from tongue cancer (2010- 2015): A SEER Study Público
Natarajan, Varsha (Spring 2021)
Published
Abstract
Abstract
Association of metropolitan residential status on survival from tongue cancer (2010- 2015): A SEER Study
By Varsha Natarajan
Background: The incidence of squamous cell carcinoma of the tongue has increased over the years in the US. Living in non-metropolitan areas has shown a better prognosis and long-term survival in patients with oral cavity squamous cell carcinoma compared to their metropolitan counterparts in some studies. To further explore this phenomenon, we sought to examine the association between survival from squamous cell cancer of the oral tongue and metropolitan residential status at the time of diagnosis in a population-based US cohort.
Methods: We identified 5,761 cases diagnosed with squamous cell carcinoma (OSCC) of the oral tongue between the years 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Cases were categorized by their age, sex, race, poverty, marital status, stage at diagnosis, grade of the carcinoma (differentiation), surgical procedure, chemotherapy, and radiation therapy. We examined the metropolitan versus non-metropolitan residential status differences in survival using Cox regression model while controlling for potential confounders.
Results: Eighty-eight percent of our final cohort were from metropolitan areas while only twelve percent were from non-metropolitan areas. The study cohort was predominantly comprised of white individuals and had more males than females. About half of the cohort was diagnosed with early-stage cancer (stage I and II), and the other half included late stage (stage III and IV) and unknown stages. Relative to non-metropolitan areas, metropolitan areas comprised a larger proportion of non-white cancer patients, had fewer patients living below the poverty line and had a slightly larger patient population that received chemotherapy. Kaplan-Meier survival curves and Cox regression modeling showed no statistically significant association between survival and metropolitan residential status (HR=0.99, 95% CI: (0.92,1.08)). Increasing stage and grade were the strongest predictors of poor outcomes along with receipt of non-surgical therapies.
Conclusions: The findings of this study, conducted in a large US population-based registry cohort, do not show evidence of an association between metropolitan residential status and survival from oral tongue cancer as observed in other studies on oral cancer. Further research should be conducted to explore the pathways more fully through which residential status can lead to differences in cancer outcomes.
Table of Contents
Table of Contents
Chapter I:
Background...........................................................................................................................1
Chapter II:
Title, Author(s), Abstract .................................................................................................... 7
Introduction ......................................................................................................................... 8
Methods ............................................................................................................................... 9
Results ................................................................................................................................ 12
Discussion .......................................................................................................................... 14
References............................................................................................................................17
Tables and Figures ..............................................................................................................23
Chapter III:
Summary, Public Health Implications, Possible Future Directions ...................................28
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