Abstract 1952: Persistent poverty and oral and pharynx cancer incidence and relative survival rates
Authors: Karanth Shama D. , Wheeler Meghann , Yoon Alex H. , Washington Caretia J. , Braithwaite Dejana 
Published: April 2023

Abstract
Purpose In the United States, cancers of the oral cavity and pharynx account for 3% of cancers diagnosed each year. The purpose of the study was to examine incidence and 5-years relative survival rates for persistent poverty counties versus non-persistent poverty counties by race/ethnicity and sex. Methods Data on county-level cancer incidence and 5-year relative survival came from the National Center for Health Statistics (NCHS), accessed through SEER*Stat. Analysis was based on data obtained from the SEER database linked to 2010-2018 American Community Survey (ACS) data. Persistent poverty is defined by census tracts as being persistently poor if 20% or more of the population has lived below the poverty level for a period spanning about 30 years based on ACS. Age-adjusted incidence rate ratios (IRR) were calculated by comparing living in the persistent poverty counties to living in the non-persistent poverty counties by sex, separately for each race/ethnic group (non-Hispanic (NH)-White, NH-Black, Hispanic, NH-Asian/Pacific Islander). Results We identified 105,103 patients with oral and pharynx cancer diagnosed from 2009-2018. The majority were male (70.5%), NH-White (76.1%), and diagnosed with oral cancers (64.8%). There was a significant trend of higher incidence in counties with persistent poverty for NH-Blacks (IRR persistent poverty vs. non-persistent poverty counties: 1.46, 95 % CI 1.39-1.53; p-value &lt;0.0001) and NH-Whites (IRR poverty vs. non-persistent poverty counties: 1.12, 95 % CI 1.08-1.16; p-value &lt;0.0001), while Hispanics had lower incidence (IRR persistent poverty vs. non-persistent poverty counties: 0.91, 95 % CI 0.85-0.98; p-value &lt;0.001), and there was no association among NH-Asian/PI patients. Stratifying by sex, NH-Black, NH-White, NH-Asian/PI males, and NH-Black females in persistent poverty had significantly higher IRRs; while Hispanics in persistent poverty counties had lower IRRs compared to non-persistent counties. The overall 5-year relative survival among NH-Blacks was lower in persistent poverty counties 41.0% [standard error (SE)=1.4] compared to 54.1% (SE=1.0) in non-persistent poverty counties; NH-Whites in persistent poverty counties also had lower survival rates of 55.1% (SE=1.2) compared to 69.6% (SE=0.3) in non-persistent poverty counties. Similar survival rates were seen among the NH-Asian/PI and Hispanics. Conclusion
Oral and pharynx incidence and 5-year survival rates were worse among patients living in persistent poverty counties, suggesting the necessity for multilevel research to reduce disparities.
Citation Format: Shama D. Karanth, Meghann Wheeler, Alex H. Yoon, Caretia J. Washington, Dejana Braithwaite. Persistent poverty and oral and pharynx cancer incidence and relative survival rates [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1952.