Higher mortality, less improvement seen for rural residents with head, neck cancer

Compared with their urban counterparts, rural residents with head and neck cancer (HNC) have higher mortality rates and less annual improvement, according to a research letter published online June 27 in JAMA Otolaryngology-Head & Neck Surgery.

Nino Balanchivadze, M.D., from the Virginia Oncology Associates in Norfolk, and colleagues examined disparities in age-adjusted mortality rates (AAMRs) and place of death for individuals with HNC in rural and metropolitan (metro) areas by analyzing the U.S. Centers for Disease Control and Prevention WONDER database from 2003 to 2019.

The researchers found that 221,861 patients with HNC died from 2003 to 2019 (48.5, 31.9, and 19.7 percent for large metro, small/medium metro, and rural, respectively). From 2003 to 2019, AAMRs declined from 6.7 to 5.8 per 100,000. Higher AAMRs and slower annual improvement were seen in rural areas (annual percentage change [APC], −0.11) compared with small/medium and large metro areas (APCs, −0.51 and −1.19, respectively).

The largest proportion of deaths and least improvements overall were seen for White individuals (62, 67, and 76 percent for large metro, small/medium metro, and rural). The highest AAMR and quickest annual improvement was seen for Black patients compared with Hispanic and White patients (APC, −2.91 versus −1.42 and −0.26, respectively).

“Policy interventions and infrastructural investments supporting disadvantaged populations are imperative,” the authors write.

One author disclosed ties to Gilead Advisory.

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