Sociodemographic correlates of head and neck cancer survival among patients with metastatic disease

Background To describe sociodemographic factors associated with head and neck cancer (HNC) survival among patients with distant metastatic disease. Methods We retrospectively analyzed national data for 2889 adult patients with metastatic HNC (2007-2015). We used Fine and Gray competing risks proportional hazard models, stratified by oropharyngeal cancer status, controlled for sociodemographic factors (age, sex, race/ethnicity, marital status, and insurance status), and accounted for multiple testing. Results Median survival time was 11 months (15 months for patients married/partnered; 13 months for patients with non-Medicaid insurance;P< .01). Among patients with oropharyngeal cancer, being married/partnered was associated with lower mortality hazard (sdHR(divorced/separated)= 1.37, 97.5% confidence interval [CI] = 1.07, 1.75; and sdHR(never married)= 1.43, 97.5% CI = 1.14, 1.80), as was having non-Medicaid insurance (sdHR(uninsured)= 1.44, 97.5% CI = 1.02, 2.04). Conclusions Health insurance and marital status are sociodemographic factors associated with survival among HNC patients with distant metastatic disease, especially in oropharyngeal cases.