Demographics and Trends in Outpatient Surgery for Laryngeal Cancer: 2016-2021

To analyze the utilization patterns of outpatient laryngoscopic excision procedures for laryngeal cancer in the United States, examining procedural costs and patient demographics to identify disparities in healthcare access.

Retrospective cohort study.

National Ambulatory Surgery Sample database of major ambulatory surgeries in the United States, 2016-2021.

Encounters for endoscopic resection of laryngeal cancers were identified focusing on patient demographics and procedural costs. Analysis was performed regarding trends over time.

Of 11,371 encounters in 2016-2021, patients were mostly male (82.6%), White (75.3%), and living in metropolitan areas with greater than 1 million residents (54.1%), with an even distribution between income quartiles. Predictors of utilization at urban teaching hospitals progressively decreased in patients residing in smaller metropolitan areas (250-999,000 residents (odds ratio [OR] = 0.451, P ≤ .0001) and 50-249,000 residents (OR = 0.193, P ≤ .0001). Higher utilization was found in non-White patients (Black [OR = 1.673, P = .0075], Hispanic [OR = 1.752, P = .0118]), and those with patients with higher income (2nd quartile [OR = 1.411, P = .0058], 3rd quartile [OR = 2.017, P ≤ .0001], and 4th quartile [OR = 4.422, P < .0001]). These findings were consistent on multivariate analysis, however belonging to a racial minority lost significance (Black patients [P = .0508], Hispanic [P = .3008]).

There are existing disparities in endoscopic resection of laryngeal cancers. Our findings add to the literature underscoring the importance of expanding access to minimally invasive laryngeal preserving surgical treatment.