Factors contributing to the poorer survival of black Americans diagnosed with oral cancer (United States)

S J Arbes Jr; A F Olshan; D J Caplan; V J Schoenbach; G D Slade; M J Symons

doi:10.1023/A:1008911300100

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Factors contributing to the poorer survival of black Americans diagnosed with oral cancer (United States)

Journal article

Peer reviewed

Factors contributing to the poorer survival of black Americans diagnosed with oral cancer (United States)

S J Arbes Jr, A F Olshan, D J Caplan, V J Schoenbach, G D Slade and M J Symons

Cancer causes & control, Vol.10(6), pp.513-523

12/1999

DOI: 10.1023/A:1008911300100

PMID: 10616821

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Abstract

The purpose of this study was to identify factors that contribute to the poorer survival of blacks in the United States diagnosed with oral cancer. Data for 6,338 whites and 1,165 blacks diagnosed from 1988 to 1993 with squamous cell carcinoma of the oral cavity and pharynx were obtained from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program 1973-1993 Public-Use Database. The covariables were sex, age, geographic area, marital status, socioeconomic status (five census-tract measures), stage, anatomic site, grade, lymph node involvement, tumor size, and treatment. Hazard ratios were estimated with Cox regression. Adjusted for age and geographic area, the hazard of death from oral cancer was 1.7 (95% confidence interval: 1.5-1.9) times greater among blacks than whites. The addition of the socioeconomic status (SES) variables to the model reduced the hazard ratio for race to 1.3 (1.0-1.7). Further adjustment by stage and treatment reduced the hazard ratio for race to 1.1 (0.9-1.4). In a model containing all covariables (except lymph node involvement and tumor size), the hazard ratio for race remained 1.1 (0.9-1.4). Analyses with the outcome death from any cause gave similar results. Lower SES, more advanced stage, and differences in treatment accounted for 86% of the excess hazard of death from oral cancer among blacks.

United States - epidemiology

Age Distribution

Humans

Middle Aged

Male

Socioeconomic Factors

Carcinoma, Squamous Cell - ethnology

Mouth Neoplasms - ethnology

Pharyngeal Neoplasms - ethnology

Carcinoma, Squamous Cell - mortality

Aged, 80 and over

Adult

Female

Child

Proportional Hazards Models

European Continental Ancestry Group - statistics & numerical data

Mouth Neoplasms - mortality

Pharyngeal Neoplasms - mortality

Regression Analysis

African Americans - statistics & numerical data

Adolescent

Survival Analysis

Sex Distribution

Aged

SEER Program - statistics & numerical data

Details

Title: Subtitle: Factors contributing to the poorer survival of black Americans diagnosed with oral cancer (United States)
Creators: S J Arbes Jr - Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA. sam_arbes@dentistry.unc.edu
A F Olshan
D J Caplan
V J Schoenbach
G D Slade
M J Symons
Resource Type: Journal article
Publication Details: Cancer causes & control, Vol.10(6), pp.513-523
Publisher: Netherlands
DOI: 10.1023/A:1008911300100
PMID: 10616821
ISSN: 0957-5243
eISSN: 1573-7225
Grant note: T32 DE07191 / NIDCR NIH HHS
Language: English
Date published: 12/1999
Academic Unit: Preventive and Community Dentistry
Record Identifier: 9983917687602771

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105 Times Cited - Web of Science