Instead, they took a more holistic approach with a very diverse patient population to better understand how a wide array of risk factors the killer aspects of the tumor and patient factors like smoking and alcohol use interact with disease stage, diagnosis and survival.
The study looked 689 Henry Ford patients from 1986 to 2005 with a primary diagnosis of HNSCC. Most notably, 42 percent of the study group was African American.
It examined 23 non-genetic patient risk factors including race, martial status and family history, and also looked at patients' tumor biology by examining tumor DNA for 113 genes from 2,166 tissue blocks.
All of these factors were placed into statistical models to determine both individual (univariate) and commingling independent variables (multivariate) that influence late-stage disease.
While previous studies have suggested African Americans are more likely to have late-stage disease with worse survival, the Henry Ford multivariate analysis found that race is not a risk factor for late-stage HNSCC.
Dr. Worsham suspects her team's study was not able to support that for two reasons: Unlike previous studies, their study included a large African American population and of those patients, 88 percent had some form of insurance.
"A large proportion of our study group, both African American and Caucasian, had insurance," notes Dr. Worsham. "This finding really shows the impact of insurance and access to care on overall patient care. Removing barriers does make a difference."
The study also found that the site of the tumor in head and neck cancer had an impact on disease stage. Patients with cancer in the oropharynx, which lies behind the oral cavity, and those with cancer in
|Contact: Krista Hopson|
Henry Ford Health System