Assessments of social vulnerability on laryngeal cancer treatment & prognosis in the US
Menée à partir de données 1975-2017 des registres américains des cancers portant sur 74 495 patients atteints d'un cancer du larynx, cette étude de cohorte rétrospective analyse l'association entre des déterminants sociaux de santé (statut socioéconomique, langue parlée, composition du foyer, moyens de transport, habitat, etc.) et les disparités dans les traitements reçus et dans le pronostic de la maladie
Background: Previous social determinants of health (SDoH) studies on laryngeal cancer (LC) have assessed individual factors of socioeconomic status and race/ethnicity but seldom investigate a wider breadth of SDoH-factors for their effects in the real-world. This study aims to delineate how a wider array of SDoH-vulnerabilities interactively associates with LC-disparities.
Methods: This retrospective cohort study assessed 74,495 LC-patients between 1975 and 2017 from the Surveillance-Epidemiology-End Results (SEER) database using the Social Vulnerability Index (SVI) from the CDC, total SDoH-vulnerability from 15 SDoH variables across specific vulnerabilities of socioeconomic status, minority-language status, household composition, and infrastructure/housing and transportation, which were measured across US counties. Univariate linear and logistic regressions were performed on length of care/follow-up and survival, staging, and treatment across SVI scores.
Results: Survival time dropped significantly by 34.37% (from 72.83 to 47.80 months), and surveillance time decreased by 28.09% (from 80.99 to 58.24 months) with increasing overall social vulnerability, alongside advanced staging (OR 1.15; 95%CI 1.13–1.16), increased chemotherapy (OR 1.13; 95%CI 1.11–1.14), decreased surgical resection (OR 0.91; 95%CI 0.90–0.92), and decreased radiotherapy (OR 0.97; 95%CI 0.96–0.99).
Discussion: In this SDoH-study of LCs, detrimental care and prognostic trends were observed with increasing overall SDoH-vulnerability.
British Journal of Cancer , article en libre accès, 2025