Research Grants Program Office

OBJECTIVE: To compare head and neck cancer (HNC) stage at diagnosis and survival outcomes between South Asian, Other Asian, and non-Hispanic white individuals in the United States. STUDY DESIGN: Retrospective population-based cohort study. SETTING: Data from Surveillance, Epidemiology, and End Results Research Plus 17 database. METHODS: Patients diagnosed with squamous HNC from 2006 to 2020 were categorized as South Asian, Other Asian, and non-Hispanic white. Logistic regression assessed the association between race/ethnicity and advanced-stage disease (stage III/IV vs I/II). Overall survival (OS) and disease-specific survival (DSS) outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression models, respectively. RESULTS: Among 92,664 patients (1066 South Asian, 3260 Other Asian, and 88,338 non-Hispanic white individuals), adjusted logistic regression showed South Asian individuals had a higher risk of advanced stage at diagnosis (odds ratio [OR] 1.48, 95% CI 1.29-1.70) than Other Asian (OR 1.13, 95% CI 1.05-1.22) and non-Hispanic white individuals. Adjusted Cox regression showed Other Asian (hazard ratio [HR] 0.89, 95% CI 0.84-0.94) individuals had improved OS, while South Asian individuals had similar OS (HR 1.09, 95% CI 0.99-1.21) as non-Hispanic white individuals. South Asian individuals had worse DSS (HR 1.30, 95% CI 1.16-1.46) than Other Asian (HR 1.05, 95% CI 0.98-1.12), and non-Hispanic white individuals. CONCLUSION: South Asian individuals with HNC are more likely to present with advanced disease stage and have worse survival compared with Other Asian and non-Hispanic white individuals, highlighting the importance of disaggregating Asian ethnic groups when assessing HNC outcome disparities.