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Racial and ethnic disparities in treatment refusal for head and neck cutaneous malignancies
Journal article   Peer reviewed

Racial and ethnic disparities in treatment refusal for head and neck cutaneous malignancies

Abraham Araya, Willow Pastard, Tatiana Ferraro, Abdulla K. Ahmed, Janyla Seltzer, Arjun Joshi and Leonard Knoedler
Journal of plastic, reconstructive & aesthetic surgery, v 99, pp 168-174
Dec 2024
DOI: https://doi.org/10.1016/j.bjps.2024.08.055
PMID: 39378556
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Disparities Head and neck cancer Melanoma Skin Cancer
Racial and ethnic minorities with skin cancer experience disproportionately worse prognoses and adverse outcomes compared to non-Hispanic, White patients. We analyzed patients diagnosed with any cutaneous malignancies of the head and neck between 2010 to 2021 using the data from the National Cancer Database to quantify disparities. The primary outcome variable was treatment refusal, and secondary variables included days from diagnosis to treatment, tumor depth, and mortality. Among the 151,733 patients analyzed, most were non-Hispanic White (99%) and male (71%). Black patients had the greatest odds of treatment refusal (4.166, 95% CI: 2.054–8.452, p < 0.001) across all cutaneous malignancies of the head and neck. Black and Hispanic patients also had increased times from diagnosis to treatment (p < 0.001). Black patients had higher odds of 90-day mortality compared to non-Hispanic White patients (p < 0.001). This coincided with greater tumor depth in Black and Hispanic patients compared to that of non-Hispanic White patients (p < 0.001). Black patients were more likely to refuse treatment for head and neck cutaneous malignancies. Moreover, Black and Hispanic patients experienced more treatment delays. These findings may relate to the increased 90-day mortality among Black patients and increased tumor depth in Black and Hispanic patients. Further investigation into the quality of life and functional impairment is warranted alongside interventions to reduce these disparities.

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Surgery
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