Black Americans and Head and Neck Cancer

Head and Neck Cancer and the Black Community

The American Cancer Society reports that the lifetime risk of developing oral or oropharyngeal cancer is about 1 in 60 for men and 1 in 141 for women. Despite oral and oropharyngeal cancer being slightly more common in white Americans than in Black Americans, the mortality rate for Black patients diagnosed with oral or oropharyngeal cancer is higher.

According to the American Society of Clinical Oncology, the five-year survival rate for white patients with the disease is 69 percent compared to 51 percent for Black patients with the same diagnosis. A study published in April 2021 in the American Cancer Society Journals reported that in the year 2000, mortality rates for oral cancer were 85 percent higher for Black men than white men. Additionally, although the incidence rates of oral and pharynx cancers from 2011 to 2015 were higher for white Americans than Black Americans, Black patients still had a death rate of 20 percent higher than that of white patients.

Researchers continue to examine why Black people experience higher mortality rates and are at more advanced stages of the disease at the time of diagnosis than white people. According to Burtness, one of the more frequently researched causes has been related to access to healthcare and socioeconomic factors.

A study published in the American Journal of Public Health, which examined access to quality healthcare, investigated the outcomes of cancer of the larynx in Black and white patients in two different healthcare systems: the Veterans Health Administration system and the U.S. hybrid-payer system. The study found that financial and insurance issues within the hybrid-payer system adversely affected the delivery of quality care for cancer patients. Furthermore, the participants with the worse outcomes were Black patients with limited access to healthcare, which caused delays in their diagnosis.

Burtness says that there are several other reasons for some members of the Black community having limited access to healthcare, such as:

  • Higher unemployment rates
  • Racism experienced within the healthcare system
  • Time delays in referral by the primary care provider
  • Long-distance travel to seek medical assistance

Research suggests that if either oral or oropharyngeal cancer is diagnosed early, the overall five-year survival rate for all people is 85 percent. However, if the cancer has spread to surrounding tissues, organs, or regional lymph nodes, the five-year survival rate drops to 68 percent. If the cancer has spread to a distant part of the body, the overall five-year survival rate drops even further to 40 percent.

These statistics illustrate the importance of early diagnosis to expedite treatment, intervention, and mortality. Furthermore, it helps us better understand why having limited access to health care — which impacts receiving a timely diagnosis and treatment — can increase mortality rates within these populations. Research has also found that increased time to start treatment for Black patients may also help to explain increased mortality among this population.

Genetic Differences in Head and Neck Cancer in Black and White Populations

More recent research has found that a difference in genetic mutations between white and Black patients may also cause increased mortality rates in Black patients. A May 2021 study published in the JCO Oncology Practice examined patients diagnosed with oral cancer treated at UH Seidman Cancer Center in Cleveland between 2010 and 2017. The study revealed that Black patients had significantly higher mutational loads in their tumors when compared with white patients. Tumors from Black patients also tended to have a lower density of immune cells compared to white patients.

Another study published in December 2022 in the Journal of the National Cancer Institute found that Black patients seemed to respond differently to treatment than white patients. Researchers are working to better understand if these genetic differences impact the rate at which the disease progresses and the effectiveness of currently established treatments among Black patients.

How to Improve Outcomes of a Head and Neck Cancer Diagnosis

While oncologists and researchers continue to examine disparities among Black patients diagnosed with head and neck cancer, Burtness says that there are steps you can take to improve your treatment outcomes.

Seek out early diagnosis and treatment. Prompt diagnosis is crucial for improving head and neck cancer outcomes. “The earlier a patient is diagnosed, the sooner they can begin treatment, which can immensely improve their outcomes and treatment effectiveness,” says Burtness.

Stop using tobacco and limit alcohol consumption. Because tobacco usage and heavy alcohol consumption can make a person more at risk for developing the disease, Burtness recommends limiting or eliminating the use of tobacco products and alcohol to improve outcomes.

Educate yourself. It is crucial to learn all you can about your diagnosis and to work with your oncology team to make sure your team of specialists are a good fit for your specific circumstance.

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