Inequality in survival of people with head and neck cancer: Head and Neck 5000 cohort study

Kate Ingarfield, Alex D McMahon, Katrina Hurley, Stu Toms, Miranda Pring, Steve J Thomas, Andrea Waylen, Michael Pawlita, Tim Waterboer, Andy R Ness, David I Conway

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

BACKGROUND: Explanations for socioeconomic inequalities in survival of head and neck cancer (HNC) patients have had limited attention and are not well understood.

METHODS: The UK Head and Neck 5000 prospective clinical cohort study was analyzed. Survival relating to measures of socioeconomic status was explored including area-based and individual factors. Three-year overall survival was determined using the Kaplan-Meier method. All-cause mortality was investigated via adjusted Cox Proportional Hazard models.

RESULTS: A total of 3440 people were included. Three-year overall survival was 76.3% (95% CI 74.9, 77.7). Inequality in survival by deprivation category, highest education level, and financial concerns was explained by age, sex, health, and behavioral factors. None of the potential explanatory factors fully explained the inequality associated with annual household income or the proportion of income of benefits.

CONCLUSION: These results support the interventions to address the financial issues within the wider care and support provided to HNC patients.

Original languageEnglish
Pages (from-to)1252-1270
Number of pages19
JournalHead and Neck
Volume43
Issue number4
Early online date8 Jan 2021
DOIs
Publication statusPublished - Apr 2021

Bibliographical note

Funding Information:
Above and Beyond, University Hospitals Bristol Research Capability Funding; Cancer Research UK Programme Grant, the Integrative Cancer Epidemiology Programme, Grant/Award Number: C18281/A19169; National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Scheme, Grant/Award Number: RP‐PG‐0707‐10034; NHS National Services Scotland (NSS) PhD Studentship Funding information

Funding Information:
The authors would like to thank the participants in the HN5000 study and the co‐ordination team. This publication presents data from the HN5000 study. The study was a component of independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Scheme (RP‐PG‐0707‐10 034). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Core funding was also provided through awards from Above and Beyond, University Hospitals Bristol Research Capability Funding and the NIHR Senior Investigator award to Professor Andy Ness. HPV serology was supported by a Cancer Research UK Programme Grant, the Integrative Cancer Epidemiology Programme (grant number: C18281/A19169). K. I. is funded by the NHS National Services Scotland (NSS) PhD Studentship. Data available on request due to privacy/ethical restrictions: http://www.headandneck5000.org.uk/ .

Publisher Copyright:
© 2021 Wiley Periodicals LLC

Keywords

  • cancer epidemiology
  • cohort study
  • head and neck cancer
  • inequality
  • Kaplan-Meier
  • survival

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