Study: Race could be a factor in HNC survival rates

Survival rates for African-Americans diagnosed with head and neck cancer (HNC) have not improved in the last 40 years, despite advances in disease treatment and management. That is one of the findings from a study presented at the recent American Society of Clinical Oncology annual meeting in Chicago.

Researchers from the University of Missouri (MU) School of Medicine found that despite advances in treatment options, the prognosis for African-Americans with head and neck cancer has not improved.

Shahzad Raza, MD, postdoctoral fellow in the University of Missouri School of Medicine Division of Hematology and Oncology. Image courtesy of University of Missouri School of Medicine.

"This study shows that we've made good progress in treating head and neck cancer over the last 37 years, and survival has dramatically improved," said lead study investigator Shahzad Raza, MD, a postdoctoral fellow in the division of hematology and oncology at the MU School of Medicine, in a press release. "However, we found no change in the survival or prognosis for African-Americans in the last four decades."

The researchers analyzed data from 1973 to 2010 on 247,310 HNC patients nationwide. They found that the incidence of HNC was higher in African-Americans than in Caucasians, Hispanics, Asians and Pacific Islanders, or Asian-Indian and Alaskan natives. Currently, there are more than 52,000 men and women in the U.S. with HNC.

Except for the African-American group, all other groups showed improved five-year survival rates over a 40-year period. African-Americans had a significantly decreased five-year overall survival rate of 41.8%, compared with 60.8% survival for Caucasians, 59.3% survival for Hispanics, 62% survival for Asians and Pacific Islanders, and 50.2% survival for Asian-Indian and Alaskan natives.

In the 40-year figures, the primary sites where the cancer was found were the lip (11%), tongue (27%), floor of mouth (8%), gum and other parts of mouth (16%), tonsils (15%), oropharynx (4%), nasopharynx (7%), hypopharynx (9%), and others (3%). Overall, 71% patients were male.

"One commonly held theory is that socioeconomic status, access to healthcare, and the stage in which the cancer is diagnosed all play a major role in the survival rates of African-Americans with head and neck cancer," Dr. Raza said. "However, these factors are not completely accurate predictors of a patient's prognosis."

The treatment for HNC depends on the location of the tumor, the stage of the cancer, and the patient's age and overall health, he said. Treatments can include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of treatment options.

Inherent genetic factors in African-Americans may make some tumors resistant to treatments, the researchers suggested. However, more research needs to be done on the subject of survival disparity in patients with HNC, they noted.

"This research shows there is an urgent need for a national trial on head and neck cancer within the African-American community to evaluate new forms of treatment and biogenetic markers to learn why this ethnic group has decreased survival rates," Dr. Raza said.

The researchers were guided by Mosharraf Hossain, MD, an assistant professor in the MU School of Medicine's Division of Hematology and Oncology and a physician with the Ellis Fischel Cancer Center in Columbia, MO.