Related Experiment Video
Updated: Jun 22, 2025
Therapy Testing in a Spheroid-based 3D Cell Culture Model for Head and Neck Squamous Cell Carcinoma
Published on: April 20, 2018
Inequities Associated With Advanced Stage at Presentation of Head and Neck Cancer: A Systematic Review
Patrick Ioerger1, Kale Mills2, Sarah F Wagoner3
1University of Kansas School of Medicine, Kansas City.
Importance:
Social determinants of health (SDoH) are defined by a wide range of factors (eg, built environment, economic stability, education level, discrimination, racism, access to health care). Advanced stage at presentation or delayed diagnosis heavily influences health outcomes in patients with head and neck cancer (HNC). While the drivers of advanced-stage presentation come from a multitude of sources, SDoH plays an outsized role.
Objective:
To systematically review the published literature to identify which SDoH are established as risk factors for delayed diagnosis or advanced stage at presentation among patients with HNC.
Evidence Review:
In this systematic review, a literature search of PubMed, Web of Science, and Embase was conducted on February 27, 2023, using keywords related to advanced stage at presentation and delayed diagnosis of HNC between 2013 and 2023. Quality assessment was evaluated through the Newcastle-Ottawa Scale. Articles were included if they focused on US-based populations and factors associated with advanced stage at presentation or delayed diagnosis of HNC.
Findings:
Overall, 50 articles were included for full-text extraction, of which 30 (60%) were database studies. Race was the most commonly reported variable (46 studies [92%]), with Black race (43 studies [93%]) being the most studied racial group showing an increased risk of delay in diagnosis of HNC. Other commonly studied variables that were associated with advanced stage at presentation included sex and gender (41 studies [82%]), insurance status (25 studies [50%]), geographic region (5 studies [10%]), and socioeconomic status (20 studies [40%]). Male sex, lack of insurance, rurality, and low socioeconomic status were all identified as risk factors for advanced stage at presentation.
Conclusions And Relevance:
This systematic review provides a comprehensive list of factors that were associated with advanced HNC stage at presentation. Future studies should focus on evaluating interventions aimed at addressing the SDoH in communities experiencing disparities to provide a net positive effect on HNC care.
Related Concept Videos
01:21Cancer Survival Analysis
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...