Impact of the affordable care act and early Medicaid expansion on head and neck cancer mortality in the United States.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7035-7035
Author(s):  
Nosayaba Osazuwa-Peters ◽  
Justin M Barnes ◽  
Jaibir S Pannu ◽  
Matthew C Simpson ◽  
Sai D Challapalli ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Access To Care ◽  
Head And Neck ◽  
Neck Cancer ◽  
The United States ◽  
Mortality Rates ◽  
Medicaid Expansion ◽  
Quasi Experimental

7035 Background: Medicaid expansion has been associated with increased access to care and earlier stage at diagnosis among patients with head and neck cancer (HNC). However, it is unclear whether Medicaid expansion has impacted HNC mortality rates. We examined the associations between early Medicaid expansions (2010-2011) with mortality rates for HNC in the United States. Methods: Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program. SEER*Stat was utilized to obtain mortality rates for early expansion (CA, CT, DC, MN, NJ, and WA) and non-early expansion states (all others) in the year ranges as available in SEER: 2005-2007 (pre-expansion) and 2012-2016 (post-expansion). Deaths in 2008-2011 were excluded as a phase-in/washout period. Difference-in-differences analyses were utilized to compare mortality rates pre- and post-early expansion in early expansion vs. non-early expansion states. The parallel trends assumption was tested comparing changes in HNC mortality rates between early expansion and non-early expansion states from 2002-2004 to 2005-2007 and from 2005-2007 to 2008-2011. Results: There were 6882 and 35459 deaths due to HNC in early expansion and non-early expansion states, respectively. HNC mortality rates (deaths per 100,000) decreased from 2005-2007 to 2012-2016 in both early expansion (2.17 to 1.85, difference = -0.32, 95% CI = -0.42 to -0.22) and non-expansion states (2.59 to 2.43, difference = -0.16, 95% CI = -0.22 to -0.11). Relative to non-expansion states, there was a reduction of 0.16 deaths per 100,000 (95% CI = 0.05 to 0.27, p = 0.007) after early Medicaid expansion in expansion states. However, in parallel trends testing, there was no difference in the change in mortality rates between early expansion and non-expansion states from 2002-2011 (p > 0.37). Conclusions: In this quasi-experimental analysis, there was an association between early Medicaid expansion with decreased HNC mortality. Thus, Medicaid expansion might help decrease disparities associated with access to care among HNC survivors. As longer-term data emerges, additional follow-up will be necessary to understand the mechanisms that underlie the HNC mortality benefits seen in early Medicaid expansion.

scholarly journals Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer

2021 ◽  
pp. 1-11
Author(s):  
Johannes J. Fagan ◽  
Vanita Noronha ◽  
Evan Michael Graboyes
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Access To Care ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cancer Care ◽  
Value Added ◽  
The United States ◽  
Sub Saharan Africa ◽  
Middle Income

The overwhelming majority of head and neck cancers and related deaths occur in low- and middle-income countries, which have challenges related to burden of disease versus access to care. Yet the additional health care burden of the COVID-19 pandemic has also impacted access to care for patients with head and neck cancer in the United States. This article focuses on challenges and innovation in prioritizing head and neck cancer care in Sub-Saharan Africa, the Indian experience of value-added head and neck cancer care in busy and densely populated regions, and strategies to optimize the management of head and neck cancer in the United States during the COVID-19 pandemic.

scholarly journals Epidemiological Trends of Head and Neck Cancer in the United States: A SEER Population Study

2017 ◽  
Vol 75 (12) ◽  
pp. 2562-2572 ◽  
Author(s):  
Moustafa Mourad ◽  
Thomas Jetmore ◽  
Ameya A. Jategaonkar ◽  
Sami Moubayed ◽  
Erin Moshier ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Population Study ◽  
Neck Cancer ◽  
The United States ◽  
Epidemiological Trends

scholarly journals Assessment of Imaging Utilization and Treatment Patterns for Head and Neck Cancer Patients in the United States

2014 ◽  
Vol 17 (3) ◽  
pp. A98
Author(s):  
B.W. Bresnahan ◽  
R. Alfonso-Cristancho ◽  
H. He ◽  
E. Mendez ◽  
B. Goulart ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
The United States ◽  
Treatment Patterns ◽  
Imaging Utilization

Racial disparities in outcome among head and neck cancer patients in the United States: An analysis using SEER-Medicare linked database.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6051-6051 ◽  
Author(s):  
Ikumi Suzuki ◽  
Kevin J. Cullen ◽  
Ranee Mehra ◽  
Søren Bentzen ◽  
Olga G. Goloubeva
Keyword(s):  
United States ◽  
Overall Survival ◽  
Head And Neck Cancer ◽  
African Americans ◽  
Oral Cavity ◽  
Head And Neck ◽  
Cancer Patients ◽  
Ethnic Groups ◽  
Neck Cancer ◽  
The United States

6051 Background: Despite overall decline in cancer mortality, African Americans suffer from higher mortality in most cancer types including cancers of the head and neck. These differences likely result from a complex interplay of clinical and non-clinical factors. We aim to estimate disparities in overall survival across racial groups in HNSCC in the United States. Methods: This study used SEER-Medicare linked database. We identified all patients aged 66 years or older diagnosed with HNSCC as their first cancer from 1992 to 2011. We excluded those in HMO, diagnosed by death certificate or autopsy, non-SCC, unknown race, and missing month and/or year of diagnosis. Further exclusions included metastatic disease, salivary gland cancers, receiving no treatment in the first 180 days, and unknown stage. Analytic data set included oropharynx, oral cavity, nasopharynx, hypopharynx, and larynx. Primary treatment was defined as any treatment modality received within 180 days after diagnosis. Overall survival (OS) parameters were estimated across ethnic groups by the Cox regression model stratified by site and stage of cancer at diagnosis, adjusted for clinical and demographic characteristics, and propensity score weighted. Results: Our study population included 15, 547 patients. Median OS was 3.5 years (95% CI: 3.4-3.7) across all ethnic groups. African Americans (AA) had inferior outcome with median OS of 2.0 years (95% CI: 1.9-2.3) compared to 3.7 years (95% CI: 3.6-3.8) for Caucasian Americans (CA) (p < 0.0001). This difference was seen despite AA patients receiving comparable treatments and presenting at similar stage of disease, except for cancers of the oral cavity where AA were more likely to present with advanced disease (67% versus 47%; P < 0.001). The difference was most pronounced in the oropharynx where median OS was 1.9 years (95% CI: 1.7-2.1) for AA and 3.8 years (95% CI: 3.5-4.1) in CA (P < 0.0001). AA also had consistently worse OS over time from 1992 to 2011. This study clearly demonstrated AA have inferior outcomes despite similar treatments, comorbidities, age at diagnosis, stage at presentation, tumor location, year of diagnosis and sex. Conclusions: The current study demonstrates inferior overall survival for African American head and neck cancer patients independent of primary site and treatment modalities.

Utilization of rehabilitation services in patients with head and neck cancer in the United States: A SEER‐Medicare analysis

Head & Neck ◽  
2019 ◽  
Vol 41 (9) ◽  
pp. 3299-3308
Author(s):  
Jennifer R. Wang ◽  
Zhannat Nurgalieva ◽  
Shuangshuang Fu ◽  
Samantha Tam ◽  
Hui Zhao ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
The United States ◽  
Rehabilitation Services

Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States

Oral Oncology ◽  
2019 ◽  
Vol 89 ◽  
pp. 95-101 ◽  
Author(s):  
Matthew E. Gaubatz ◽  
Aleksandr R. Bukatko ◽  
Matthew C. Simpson ◽  
Katherine M. Polednik ◽  
Eric Adjei Boakye ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
The United States ◽  
Socioeconomic Disparities

scholarly journals Temporal Changes in Head and Neck Cancer Incidence in Thailand Suggest Changing Oropharyngeal Epidemiology in the Region

2019 ◽  
pp. 1-11 ◽  
Author(s):  
Ilona Argirion ◽  
Katie R. Zarins ◽  
Kali Defever ◽  
Krittika Suwanrungruang ◽  
Joanne T. Chang ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Head And Neck ◽  
Neck Cancer ◽  
Temporal Trends ◽  
The United States ◽  
Incidence Rates ◽  
Khon Kaen ◽  
Icd10 Code

PURPOSE Head and neck cancer is the sixth most common cancer in the world, and the largest burden occurs in developing countries. Although the primary risk factors have been well characterized, little is known about temporal trends in head and neck cancer across Thailand. METHODS Head and neck squamous cell carcinoma (HNSCC) occurrences diagnosed between 1990 and 2014 were selected by International Classification of Diseases (10th revision; ICD10) code from the Songkhla, Lampang, Chiang Mai, and Khon Kaen cancer registries and the US SEER program for oral cavity (ICD10 codes 00, 03-06), tongue (ICD10 codes 01-02), pharynx (ICD10 codes 09-10, 12-14), and larynx (ICD10 code 32). The data were analyzed using R and Joinpoint regression software to determine age-standardized incidence rates and trends of annual percent change (APC). Incidence rates were standardized using the Segi (1960) population. Stratified linear regression models were conducted to assess temporal trends in early-onset HNSCC across 20-year age groups. RESULTS Although overall HNSCC rates are decreasing across all registries, subsite analyses demonstrate consistent decreases in both larynx and oral cavity cancers but suggest increases in tongue cancers among both sexes in the United States (APCmen, 2.36; APCwomen, 0.77) and in pharyngeal cancer in Khon Kaen and US men (APC, 2.1 and 2.23, respectively). Age-stratified APC analyses to assess young-onset (< 60 years old) trends demonstrated increased incidence in tongue cancer in Thailand and the United States as well as in pharyngeal cancers in Khon Kaen men age 40 to 59 years and US men age 50 to 59 years. CONCLUSION Although overall trends in HNSCC are decreasing across both Thailand and the United States, there is reason to believe that the etiologic shift to oropharyngeal cancers in the United States may be occurring in Thailand.

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