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Updated: May 17, 2025

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
A geographical comparison between head & neck cancer incidence and distribution of otolaryngologists
Henry C Ideker1, Ahmad Odeh1, Angela Mazul2
1Saint Louis University School of Medicine, Department of Otolaryngology, St Louis, MO, United States of America.
Objective:
The incidence of head and neck cancer (HNC) is increasing, and research is needed to identify and treat populations at higher risk.
Methods:
The Surveillance, Epidemiology, and End Result (SEER), Area Health Resource File (AHRF), and American Community Survey (ACS) databases were queried for incidence of HNC, provider demographics, and county demographics, respectively. The primary outcome was county-level incidence rate. Multivariate analysis of county variables identified risk factors associated with higher incidence.
Results:
The geographic incidence of HNC is unequally distributed with higher incidence in counties with older age (3.68 % increase, CI: 3.46-3.89 %), white (1.71 %, CI: 1.08-2.35 %) and black (1.20 %, CI: 0.40-2.00 %) race, and higher percentage of smokers (1.36 %, CI: 1.17-1.55 %). The otolaryngology workforce was inversely related to the county-level incidence. Compared to counties with no Otolaryngologist, those with 11+ had 41.5 % (39.7-43.4 %) lower incidence.
Conclusion:
The otolaryngology workforce is not optimally distributed to address geospatial variation in HNC incidence.
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