Influence of Social Vulnerabilities in Tongue Carcinoma Prognosis and Treatment

Sunday, October 1, 2023

1:48 PM - 1:54 PM East Coast USA Time

Location: 201AB

Presenting Author(s)

Asher C. Park, BS

Medican Student
Northwestern University - Feinberg School of Medicine
Chicago, IL, United States

Co-Author(s)

Asher C. Park, BS

Medican Student
Northwestern University - Feinberg School of Medicine
Chicago, IL, United States
David J. Fei-Zhang, BA

MD-MBA Student
Northwestern University - Feinberg School of Medicine
Chicago, IL, United States

Co-Author(s)

Daniel C. Chelius, MD

Associate Professor
Baylor College of Medicine / Texas Children's Hospital
Houston, TX, United States

Co-Author(s)

Urjeet A. Patel, MD

Associate Professor
Department of Otolaryngology-- Head and Neck Surgery, Northwestern university School of Medicine
Chicago, Illinois, United States
Anthony M. Sheyn, MD, FACS

Division Chief, Pediatric Otolaryngology
LeBonheur Children's Hospital
Memphis, Tennessee, United States
JR

Jeffrey C. Rastatter, MD, MPH

Associate Professor
Lurie Children's Hospital / Northwestern University
Chicago, IL, United States

Senior Author(s)

JR

Jeffrey C. Rastatter, MD, MPH

Associate Professor
Lurie Children's Hospital / Northwestern University
Chicago, IL, United States

Disclosure(s):

Asher C. Park, BS: No relevant relationships to disclose.

David J. Fei-Zhang, BA: No relevant relationships to disclose.

Daniel C. Chelius, MD: No relevant relationships to disclose.

Anthony M. Sheyn, MD, FACS: No relevant relationships to disclose.

Introduction: Social determinants of health in patients with squamous cell carcinoma of the tongue have not been extensively studied. This study addresses the lack of research in this area and aims to investigate the real-world contribution of specific disparities in the United States.

Methods: The CDC-Social Vulnerability Index (SVI) and National Cancer Institute-Surveillance, Epidemiology, and End Results Program (NCI-SEER) database were used to conduct a retrospective cohort study of 62,103 adult tongue squamous cell carcinoma patients from 1975-2017. Multivariate regressions were performed for assessing trends in months of follow-up and survival across overall social vulnerability as well as across four different subcategories of social vulnerability.

Results: As overall SVI score increases (increased social vulnerability), there is a significant decrease in the average length of follow-up (22.95% decrease from 63.99 to 49.31 months; p< 0.001) across patients from the lowest and highest social vulnerability groups. Socioeconomic status is the greatest contributor to decreased average length of follow-up, followed by household composition, and then housing-transportation, which are also significant contributors. Additionally, as the overall SVI score increases, there is a significant decrease in the average months of survival from the lowest to highest social vulnerability groups (28.00% decrease from 49.20 to 35.43 months; p< 0.001). Socioeconomic status is again the greatest contributor to this decrease in average survival time, followed by other significant contributors such as household composition, housing-transportation status, and then minority-language status.

Conclusions: Increased social vulnerability is shown to have a detrimental impact on the treatment and prognosis of patients with squamous cell carcinoma of the tongue with low socioeconomic status being the strongest influencer of increased overall social vulnerability. This provides a framework for future investigation of disparities across patients with squamous cell carcinoma of the tongue.