Author(s)
Ravi Dhamija
Nikita Das
Affiliation(s)
Case Western Reserve University School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should understand the significant gender disparities in head and neck cancer treatment and mortality rates, as revealed by a comprehensive analysis using the TriNetX database and appreciate the implications for clinical decision making and future research in the field.
Objectives: This study explores gender disparities in treatment modalities and mortality rates among head and neck cancer patients. The primary outcome assessed was mortality rate at 90 days, 1 year, and 5 years, while secondary outcomes included a comparison of treatment modalities at 90 days post-diagnosis.
Study Design: A retrospective study on TriNetX - comprising 60 U.S. healthcare organizations - identified women (n=95,204) and men (n=190,783) diagnosed with head and neck cancer in the last 20 years. Propensity score matching, accounting for demographics and comorbidities, created final cohorts (n=86,070).
Methods: Relative risks (RR) and 95% confidence intervals (CI) were calculated to compare mortality at 90 days, 1 year, and 5 years post-diagnosis. Treatment modalities (chemotherapy, radiation therapy, targeted therapy, hormone therapy, and head and neck surgery) were assessed within 90 days post-diagnosis.
Results: At 90 days, women were significantly less likely to undergo chemotherapy (RR: 0.664, 95% CI: 0.646-0.683) and radiation therapy (RR: 0.696, 95% CI: 0.677-0.714) than men. Conversely, women were more likely to receive hormone therapy (RR: 1.2, 95% CI: 1.048-1.374) and slightly more likely to undergo head and neck surgery (RR: 1.059, 95% CI: 1.018-1.102). At 90 days, women exhibited reduced mortality rates (RR: 0.855, 95% CI: 0.811-0.901). This difference in mortality persisted at 1 year (RR: 0.855, 95% CI: 0.83-0.882) and 5 years (RR: 0.83, 95% CI: 0.814-0.847), with women consistently having a lower risk.
Conclusions: Leveraging the extensive TriNetX database with data from 100 million U.S. patients, this analysis underscores significant gender disparities in treatment modalities and mortality outcomes among head and neck cancer patients. These findings have substantial implications for clinical decision making, the development of gender specific treatment strategies, and future research addressing disparities in head and neck cancer management.