Perceived Discrimination Among Patients With Head and Neck Cancer

Head and neck cancer (HNC) accounts for 5% of U.S. cancers, causing ~14,400 deaths annually. Racial minorities and socioeconomically disadvantaged HNC patients experience worse outcomes, presenting at advanced stages and receiving less effective treatment. Even after adjusting for socioeconomic status, insurance, and disease severity, racial and ethnic disparities persist, suggesting additional contributing factors. Perceived discrimination may drive these disparities. This study examines associations between perceived discrimination and demographic, racial, and oncologic factors in HNC patients, hypothesizing associations with race and later-stage diagnoses.

Seventy two HNC patients diagnosed and treated in the past 5 years were recruited. Discrimination was measured using the Discrimination in Medical Settings Scale (DMS), scoring from 7 (no discrimination) to 35 (high discrimination). Patient characteristics and DMS scores were summarized, and associations were analyzed using general linear models. Qualitative insights were collected to guide future research.

Most participants were Non-Hispanic White (86.1%), male (68.1%), with an average DMS score of 9.1. Black patients reported lower (nonsignificant) discrimination scores than White patients. Lower-income patients reported significantly higher discrimination scores than high-income patients. No association was found between DMS scores and cancer stage. Qualitative data revealed higher discrimination perceptions among patients with stigmatized histories (e.g., substance use) and lower perceptions among those with limited healthcare exposure.

Perceived discrimination in HNC patients is most strongly associated with income, with lower-income patients reporting higher levels of discrimination. Addressing income-related barriers and health-related social needs may help to mitigate perceived discrimination in this population.

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