Impact of social deprivation on the outcome of major head and neck cancer surgery in England: A national analysis

• Published in: Head & neck Vol. 41; no. 3; pp. 692 - 700
• Main Authors: Mirza, Adal H., Aylin, Paul, Middleton, Steve, King, Emma V., Nouraei, Reza A. R., Repanos, Costa
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-03-2019; Wiley Subscription Services, Inc
• Subjects: Cancer; Head & neck cancer; Morbidity; Population studies; Socioeconomic factors; Surgery; United Kingdom > UK; England
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.25461

Background
Socioeconomic status plays an important role in the incidence and prognosis of many cancers. We examined the relationship between social deprivation and clinical outcomes in patients undergoing major surgery for head and neck cancer.
Methods
A retrospective population‐based observational study was performed. Patients undergoing head and neck surgical procedures in England between 2002 and 2012 were identified. This totaled 5051 patients in the less socially deprived (LSD) and 7282 in the more socially deprived (MSD) group.
Results
MSD patients were younger (61 vs 63) and were more likely to present with hypopharyngeal‐laryngeal cancers (41% vs 30%). They had higher burdens of morbidity and more frequently required emergency surgery (odds ratio [OR] 1.74 [95% CI 1.52‐1.99]). Following surgery, MSD patients had higher lengths of inpatient stay (OR 1.72 [95% CI 1.57‐1.88]) and higher proportions of both inpatient (OR 1.47 [95% CI 1.19‐1.82]) and overall mortality (OR 1.34 [95% CI 1.24‐1.45]).
Conclusion
Increasing socioeconomic deprivation is associated with poor health outcomes in patients with head and neck cancer.