(612) Demographic Determinants of Treatment Likelihood in Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study

Introduction: This study investigates the impact of demographic, socioeconomic, and geographic factors on mortality and treatment likelihood among Oropharyngeal Squamous Cell Carcinoma (OPSCC) patients to further elucidate the mechanisms behind persistent survival disparities.

Methods: In this retrospective cohort analysis, the National Cancer Database (NCDB) was used to identify patients (n=53,137) diagnosed with OPSCC between 2004-2021. Patients with missing demographic, treatment, or HPV status data were excluded. Cox hazards regression analyzed mortality. Multivariable logistic regression calculated odds ratios for receipt of surgery, chemotherapy, and radiation, adjusted for stage and HPV status.

Results: Female sex had higher odds of surgery (aOR 1.192) and radiation (aOR 1.1) but lower odds of chemotherapy (aOR 0.761). Treatment use declined with age. Black patients had higher mortality (HR 1.461) and were less likely to receive surgery (aOR 0.666) or radiation (aOR 0.646) treatments. Hispanic patients had a lower mortality risk (HR 0.763) and lower surgical or radiation odds (aOR 0.871; OR 0.848).

Private and Medicare insurance status predicted lower mortality (HR 0.387; HR 0.742). Higher income was associated with lower mortality (≥$63,000: HR 0.688). Surgery (aOR 1.334) and radiation (aOR 1.33) odds increased with higher educational attainment. Chemotherapy use was higher in urban and rural patients (aOR 1.245; aOR 1.495). Traveling > 50 miles increased surgery (aOR 1.835) and radiation (aOR 1.179) odds but decreased the odds of chemotherapy (aOR 0.526).

Conclusions: Among OPSCC patients, treatment odds and mortality outcomes were influenced by sex, ethnicity, age, geography, race, insurance type, and socioeconomic status.