Abstract A177: Racial disparity in temporal survival trends among patients with head and neck cancer

Abstract

In the United States, HNC comprises about 3.5% of new cancer cases. Overall, survival among HNC patients improved in the early 2000s, and this trend is attributed to factors such as advances in treatment modalities, earlier detection, and improved staging accuracy. Despite these gains, improvements in survival have not been equally distributed across racial groups. These disparities have prompted extensive research into factors such as stage at diagnosis and socioeconomic status. However, limited evidence exists on how these disparities have changed over time. We evaluated temporal trends in cause-specific survival among patients diagnosed between 2004 and 2021 and examined whether survival improvements differed by race. We conducted a retrospective cohort study using SEER Research data (17 registries, November 2023 sub) among 181,977 adults diagnosed with HNC between 2004 and 2021. Multivariable Cox proportional hazards models were used to estimate cause-specific hazards for HNC mortality, while Fine and Gray models evaluated subdistribution hazards (sHR) accounting for competing risks. Race-by-year interactions assessed whether temporal trends differed by race. Kaplan-Meier analysis estimated 5-year survival across the study period. Logistic regression assessed temporal trends in late-stage diagnosis. Models were adjusted for demographic, neighborhood level socioeconomic, and tumor-related factors. Overall, survival improved across the study period. However, the magnitude of improvement differed by race. Non-Hispanic Black (NHB) patients had significantly worse mortality compared to NHW patients at the start of the study period (aHR 1.47, 95% CI 1.40–1.54), and this disparity did not significantly narrow over time (Year × NHB aHR 1.00, 95% CI 1.00–1.01). Hispanic patients also experienced smaller annual reductions in HNC-specific mortality compared with non-Hispanic White (NHW) patients (Year × Hispanic aHR 1.02, 95% CI 1.01–1.02). Similar trends were observed in Fine and Gray models accounting for competing risks. Temporal trends in late-stage diagnosis also differed by race. Among NHW patients, the odds of late-stage diagnosis increased over the study period (aOR per year 1.02, 95% CI 1.02–1.03). Compared with NHW patients, annual increases were smaller among Hispanic patients (Year × Hispanic aOR 0.99, 95% CI 0.98–1.00) and NHB patients (Year × NHB aOR 0.98, 95% CI 0.97–0.99). These findings demonstrate that despite overall improvements in survival, compared to NHW, NHB patients experienced persistent disparities while Hispanics faced a widening disparity in HNC outcomes over time. The apparent narrowing of disparities in late-stage diagnosis may reflect larger increases among NHW patients rather than substantial improvements in early detection among minority racial groups. These findings highlight the need for culturally tailored, evidence-based interventions to improve early detection and ensure that advances in HNC care translate into equitable survival gains. Kwabena D. Boateng, Sena A. Gbeku, Gwendolyn deGraft-Johnson, Morgan Byrd, Kaitlyn Garcia, Eric Adjei Boakye, Nosa Peters. Racial disparity in temporal survival trends among patients with head and neck cancer [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr A177.