Your ethnicity and geographic location can increase your risk of head and neck cancers

Your ethnicity and geographic location can increase your risk of head and neck cancers

Black Americans are 50 percent more likely to die of head and neck cancer — cancers of the lips, mouth, larynx, throat and salivary glands — than their white counterparts. Of all patients, survival rates are lower for people living in rural areas, but rural black patients are more likely to die within five years of diagnosis than rural white patients.

For this reason, researchers are working to determine why black people living in rural areas are at a higher risk of developing and dying from head and neck cancers and what they and their health care providers can do to help.

In a study of patients from the National Cancer Database from 2004 to 2015, researchers suggested that lack of access to treatment centres, medical specialists and public transport in rural areas caused delays in the diagnosis and treatment of cancer patients. head and neck. Early diagnosis and treatment improve the chances of long-term survival for most cancers.

Another study found that mental health and quality of life were worse for head and neck cancer survivors in rural areas than their urban counterparts, and that head and neck cancer patients in rural areas had five times more likely to commit suicide than patients in the general population.

Compounding these problems for survivors in rural areas, black patients in general tend to report greater distrust of the health care system and health care professionals, due to a history of discrimination and current examples of mistreatment. This can make some black patients unmotivated to get tested regularly, and inequalities in income and health insurance coverage can also limit access to health care for black patients in lower socioeconomic groups.

Genetics, social behavior, or both?

A team of researchers suggests that people’s racial background isn’t the contributing factor to a higher or lower risk of developing head and neck cancer, it could be cultural, environmental, and socioeconomic factors in communities that play a role. important. .

Aviane Auguste, MD, the lead author of a study that looked at diagnoses of head and neck cancer in black patients from Africa, the Caribbean and the United States, said her team’s main research finding was that the environment people lived in had a greater influence on their risk of developing head and neck cancer than genetic factors. They evaluated data from black women in the United States, the Caribbean and Africa and found that head and neck cancer rates varied regionally, even in racially similar populations.

Kenyan women had some of the highest rates of head and neck cancers in the study, and the researchers noted a cultural factor that may have contributed to this difference.

“Kenyan men and women developed head and neck cancers at nearly the same rate, which is not common for these cancers, so we tried to determine why,” said Dr. Auguste. “We found that both men and women traditionally chewed a leaf called catha edulis, which may be related to increased risk in that population.”

Doctors at the Medical University of South Carolina’s Hollings Cancer Center suggest that racial differences in head and neck cancer survival rates have biological and social components.

For example, cases of cancers of the throat or oropharynx and in particular cases associated with human papillomavirus (HPV) have increased in the last 20 years. Dr. Marvella Ford, SmartState Professor of Prostate Cancer Inequalities at South Carolina State University and associate director of Population Sciences and Cancer Inequalities at the Hollings Center, said in an article that whites were more likely to have a human papillomavirus (HPV)-related head and neck cancer diagnoses, whereas black head and neck cancer diagnoses were more likely to be HPV-related.

“Unfortunately, the prognosis is worse for blacks,” she said in the article.

Another study evaluated only head and neck cancer patients with a non-HPV diagnosis. In this study, black patients had lower survival rates, and the authors suggested that the patients’ lower socioeconomic status contributed to these disparities, not just their racial background.

Reduce the risk of head and neck cancer

Health care advocates say improving access to testing and treatment can improve head and neck cancer survival rates for black patients in rural areas. Providing clinics in rural areas or having more specialists visit them to provide medical advice can be helpful, as can improving insurance coverage to make health care more financially accessible.

Regardless of race, on an individual level, women can best reduce their risk of developing head and neck cancer through behavioral modifications, said Dr. Auguste.

“When it comes to prevention, based on well-known scientific evidence, I would say the best measures to take are behavioral, such as quitting smoking and reducing alcohol consumption as much as possible,” she said. “We have the HPV vaccine, and depending on the age range recommendations, I would consider testing it, because HPV is still a major risk factor, especially in the US and the Caribbean. These are the three most important things women can do to reduce their risk because most cases of head and neck cancer can be attributed to one of these three factors.”

This resource has been prepared with support from Merck.